914 resultados para the elderly service development


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Includes bibliography

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Includes bibliography

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Presenta algunos antecedentes de la creacion del BID, asi como su tarea y sus proyecciones innovadoras en su papel de financiar importantes proyectos multinacionales.

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Analiza los factores que permiten comprender por qué la solución a la crisis no ha sido fácil: la mayor integración en una economía internacional inestable; la crisis de los paradigmas económicos; y los problemas técnicos, políticos e ideológicos que enfrenta el actual esquema de planificación de la región. Esboza algunas ideas acerca de como afrontar estos factores.

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Revisa los objetivos y metas propuestos para las estrategias anteriores y la medida en que estos se cumplieron. Analiza los temas que deberia atender el debate sobre la conveniencia de definir una estrategia para el Cuarto Decenio de las Naciones Unidas para el desarrollo, y se mencionan elementos que favorecen la iniciativa.

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Abstract. Background: The use of potentially inappropriate medications (PIM) among the elderly is a serious public health problem because it is intrinsically linked to increased morbidity and mortality, causing high costs to public health systems. This study's objective was to verify the prevalence of and the factors associated with the use of PIMs by elderly Brazilians in institutional settings. Methods. We performed a transversal study, by consulting the case files of elderly people living in Long Term Care for the Elderly (LTC) in towns in the State of São Paulo, Brazil, as well as structured interviews with the nurses responsible for them.We identified PIMs using the list of recently updated Beers criteria developed by a group of specialists from the American Geriatrics Society (AGS), who reviewed the criteria based on studies with high scientific evidence levels. We defined the factors studied to evaluate the association with PIM use prior to the statistical analyses, which were the chi-square test and multiple logistic regression. Results: Among the elderly who used drugs daily, 82.6% were taking at least one PIM, with antipsychotics (26.5%) and analgesics (15.1%) being the most commonly used. Out of all the medications used, 32.4% were PIMs, with 29.7% of these being PIMs that the elderly should avoid independent of their condition, 1.1% being inappropriate medication for older adults with certain illnesses or syndromes, and 1.6% being medications that older adults should use with caution. In the multivariate analysis, the factors associated with PIM use were: polypharmacy (p = 0.0187), cerebrovascular disease (p = 0.0036), psychiatric disorders (p < 0.0001) and dependency (p = 0.0404). Conclusions: The results of this study showed a high prevalence of PIM use in institutionalized elderly Brazilian patients. and the associated factors were polypharmacy, psychiatric disorders, cerebrovascular diseases and dependency. © 2013 Lima et al.; licensee BioMed Central Ltd.