Velocidade da marcha como preditor de fragilidade em uma amostra populacional de idosos brasileiros

Gait speed has been described as a predictive indicator of important adverse outcomes in older populations. Among the criteria to evaluate frailty, gait speed has been identified as the most reliable predictor of fragility, practical and low cost. Objective: This study assesses the discriminating capability of gait speed in determining the presence of fragility in the elderly community in northeast of Brazil. Method: We performed an observational analytic study with a transversal character with a sample of 391 community-living elders, aged 65 years or older, of both sexes, in the city of Santa Cruz-RN. Participants were interviewed using a multidimensional questionnaire to obtain sociodemographic information, physical-related and mental health-related information. The unintentional weight loss, muscle weakness, self-reported exhaustion, slow gait and low-physical activity were considered to evaluate the frailty syndrome. Gait velocity was measured as the time taken to walk the middle 4,6 meters of 8,6 meters (excluding 2 meters to warm-up phase and 2 meters to deceleration phase).We calculate the sensitivity and specificity of gait speed test in different cutoff points for the test run time, from which ROC curve was constructed as a measure of test predictive value to identify frail elders. The prevalence of frailty in Santa Cruz-RN was 17.1%. The gait speed test accuracy was 71%when speed is below 0,91m/s. Among women, the gait speed test accuracy was 80%(gait speed below 0.77m/s) and among men, the test accuracy was 86% (gait spend below 0,82%) (p<0,0001).Conclusion: our findings have clinical relevance when we consider that the detection of frailty presence by the gait speed test can be observed in elderly men and women by a simple, cheap and efficient exam

Equacões preditivas para as pressões respiratórias estáticas máximas de adolescentes brasileiros

Introduction: The reference values and prediction equations for maximal respiratory pressures (MRP) differ significantly between the available studies. This large discrepancy can be attributed to the different methodologies proposed. Although the importance of MRP is widely recognized, there are no Brazilian studies that provide predictive equations and reference values for PRM adolescents. Objectives: The purpose of this study was to provide normal values and propose predictive equations for maximal static respiratory pressures of Brazilian adolescents. Methods: An observational cross-sectional study, which evaluated 182 adolescents of both sexes aged between 12 and 18 years, enrolled in schools of the state and private in the city of Natal / RN. The selection of schools and participants of the study was randomly through a lottery system. The spirometric evaluation was performed through the digital spirometer One Flow FVC prior to the assessment of respiratory muscle strength. The MICs were measured with MVD digital manometer 300. Statistical analysis was performed using the SPSS 17.0 software STATISTICS, assigning the significance level of 5%. The normality of data distribution was verified using the Kolmogorov-Smirnov (KS). The descriptive analysis was expressed as mean and standard deviation. We used one-way ANOVA test to verify the difference of the averages of MRPs between age and gender and comparing the averages of MRPs between levels of physical activity. The test t'Student unpaired compared the averages of MRPs being ages and sexes. The comparison of mean values obtained in this study PRM with the values predicted using the equations mentioned above was relizada by testing paired t'Student. To verify the correlation between the PRM and the independent variables (age, weight, height) was used Pearson correlation test. Levene's test evaluated the homogeneity of variance. To obtain predictive equations analysis was used stepwise multiple linear regression. Results: There was no significant difference in mean age between the PRM. The male adolescents, regardless of age, showed superiority in MRP values when compared to the opposite sex. Weight, height and sex correlated with the PRM. Regression analysis suggested in this study, pointed out that the weight and sex had an influence in MIP and MEP only in relation to sex influenced. The mean for each PRM adolescents classified as very active were superior to those observed in adolescents classified as irregularly active. Conclusion: This study provides reference values and two models of predictive equations for maximal inspiratory and expiratory pressures, and to establish the lower limits of normality that will serve as an indispensable condition for careful evaluation of respiratory muscle strength in Brazilian adolescents

Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

A eletricidade chega à cidade: inovação técnica e a vida urbana em Natal (1911-1940)

Dans les premières décennies du XXème siècle, un groupe d intellectuels brésiliens a pris pour soi la mission de conduire la nation aux chemins du progrès, en réfléchissant sur les transformations des villes et, souvent, en proposant et en mettant en avant des actions et mesures qui dirigeraient la modernisation du pays. Dans ce contexte, la ville apparaissait comme un synonyme de progrès en opposition à la campagne, en donnant emphase à la construction du Brésil urbain. À Natal, celui-ci a été une période de sensible modification dans l espace urbain, en suivant les préceptes de l hygiénisme et de l esthétique racionaliste, qui ont orienté les réformes entreprises dans beaucoup de villes brésiliennes. Les élites politiques et socioéconomiques de la capitale du Rio Grande do Norte ont developpé le discours en faveur de la modernisation qui avait pour objectif de justifier les interventions dans la ville et l introduction de l infra-structure de services urbains, par exemple, les services d illumination et de transport, qui à partir de 1911, ont commencé à être stimulés par l électricité. Cette modernisation est matérialisée par de nouveaux équipements et services, par des espaces remodelés en accord avec la rationalité technique de l urbaniste, pour l utilisation de nouvelles sources d énergie (gaz, électricité), en plus de la croissance de la population résidente en ville. Cependant, nous ne pouvons pas oublier que la construction de la ville moderne est passée tant par des transformations physiques, matérielles, comme par l absorption de valeurs, symboles, gestes, vocabulaires, objets, adoptions de nouvelles normes de comportement et par la formation de nouvelles sensibilités sur l espace urbain et la vie en ville. De cette manière, les nouvelles normes technologiques, comme l électricité, ont rendu possible des transformations dans la structure matérielle de la ville et en vie urbaine dans ses plus divers aspects. Ce travail propose d analyser la relation entre énergie électrique et la vie urbaine à Natal entre 1911 et 1940, en prenant en compte, pour cela, les actions d intervention de l État sur l espace urbain et les perceptions d intellectuels face aux transformations urbaines dont ils étaient les témoins. À partir de cette analyse, nous cherchons à préciser les efforts gouvernementaux pour la manutention des services d électricité et conservation des équipements urbains; comprendre comment l utilisation d énergie électrique a aidé à produire de nouvelles situations quotidiennes et comment elle a été perçue, traduite en sentiments et perceptions fondées dans la cohabitation avec cette innovation technique. Les élites locales désiraient diffuser des habitudes considerées modernes, en construisant une identification avec la manière de vie urbaine, fortement inspirée dans la vie dans les villes Européennes et Américaines. L électricité a rendu possible des expériences et sensations qui allaient caractériser l habitant de la ville

Mundo de medo: inquisição e cristãos-novos nos espaços coloniais capitanias de Pernambuco, Itamaracá e Paraíba (1593-1595)

Founded in 1536, the Court of the Holy Office of the Portuguese Inquisition was established as an ecclesiastical institution, but at the same time subordinate to the real powers. Among the main victims of persecution effected by the Holy Office, were the New Christians - Jews forcibly converted in 1497 or their descendants - that due to their socio-religious were repeatedly accused of heresy. This paper conducted a survey that sought to understand the historical performance of the Inquisition in Brazil in the sixteenth century on the New Christians, especially those accused of secretly retaining the religious customs of the Mosaic law, given the investigative and punitive procedures employed by the Inquisition as part of a set of actions that produce social insecurities and producers / broadcasters of fear in the populations under scrutiny. In this sense, the approach was based on the analysis of documents produced on the first visit of inspection performed in Brazil inquisitorial sixteenth century, concerning the captaincy of Pernambuco and Paraiba Itamaracá (1593-1595), not excluding, however, the sources of the first stage of visitation that occurred between 1591-1593 in the province of Bahia de Todos os Santos, even though its use is ancillary and punctual. The objective of this research was to understand the consequences of inquisitorial procedures generated on the imaginary, and the Inquisition, using the expressions and signs of fears relating to individuals contained in the New Christian complaints to the Holy Office as documentary evidence of the fear caused by the Holy Tribunal. The adoption of specific behaviors by the New Christians in the home - these spaces are appropriate and adapted to the detriment of the religious practices of Judaism features - characterizes the spatial perspective of the study, thus indicating a further objective of the study: to understand how the New Christians experienced domestic spaces in a historical context marked by behavioral surveillance generally considered morally condemned and suspected of heresy. The research was conducted to analyze the complaints and quantitative survey of some indices of documentation for the understanding of overall charges and how individuals New Christians were concerned with the domestic space, using them to maintain criptojudaica religiosity, transformed places housing often esnogas, makeshift synagogue for meetings and celebrations of Judaizing New Christians. The formulations of Michel de Certeau on appropriations and meanings of space - presented by the author in the metaphor of "practice areas" - were integrated into the workforce in order to understand the ways in which the New Christians appropriated the colonial houses, designed these spaces a very specific language in the Crypto, in which women are prominent figures. The works of Jean Delumeau and Bartholomé Benassar integrate the discussion of the Inquisition and the sensibilities of fear in the work performed. The analysis allowed the documentation to understand the meaning and the extent related to the general fear that the Inquisition represented. Some complaints are indicative of fears that can be perceived implicitly based on behaviors and attitudes adopted by the New Christians, others, however, are direct expressions of fear caused by allusion or initiative of the actions of the Inquisition in colonial Brazil in the sixteenth century