Análise do Índice de Vulnerabilidade Clínico-Funcional-20 dos idosos usuários do sistema único de saúde / Clinical-Functional Vulnerability Index-20 analysis of older people using the Brazilian Public Health System

Objetivo: Aplicar a versão do profissional de saúde do Índice de Vulnerabilidade Clínico-Funcional-20 em uma população-alvo idosa. Métodos: Foi conduzido um estudo de caráter transversal, observacional e individuado, em idosos cadastrados no Ambulatório Cruz Preta, em Alfenas (MG), sendo aplicado o Índice de Vulnerabilidade Clínico-Funcional-20 na amostra selecionada. Para tanto, foram selecionados 66 idosos, e os dados obtidos foram submetidos à análise multivariada. Resultados: Dentre os participantes, 29% apresentaram alto risco de vulnerabilidade, seguidos de 41% com risco moderado e 30% com baixo risco. Ao se considerar o ponto de corte para fragilidade, 70% da população de idosos classificou-se como frágil ou sob risco de fragilização. Houve correlação entre as características dos idosos com as variáveis do Índice de Vulnerabilidade Clínico-Funcional-20, que foram: redução da capacidade de exercer atividades de vida diária, declínio cognitivo, alteração de humor, dificuldade para caminhar e quedas. Conclusão: A população-alvo de idosos pode ser considerada frágil ou sob risco de fragilização, o que indica a necessidade de ampliação do atendimento geriátrico especializado estudado. Além disso, foi possível identificar os principais fatores que levam à fragilização da população idosa, o que permite delinear estratégias com o objetivo de prevenção da fragilidade e melhorar o atendimento da população fragilizada.

Objective: To apply the Medical Professional version of the Clinical-Functional Vulnerability Index-20 in the target population of older people. Methods: A cross-sectional, observational, and individual study was conducted with older patients enrolled in Ambulatório Cruz Preta, in the city of Alfenas (MG), and the Clinical-Functional Vulnerability Index-20 was applied to the selected sample. For this, 66 older people were selected and data were subjected to multivariate analysis. Results: Of the participants, 29% presented high risk of vulnerability, followed by 41% with moderate risk, and 30% with low risk. When considering the cut-off point for fragility, 70% of the elderly population were classified as frail or under risk of becoming frail. There was a correlation between the characteristics of the older people with Clinical-Functional Vulnerability Index-20 variables, which were: reduced ability to perform activities of daily life, cognitive decline, mood alteration, difficulty walking, and falls. Conclusion: the target population of older individuals may be considered frail or under risk of becoming frail, which indicates the need for expanded specialized geriatric care studied. In addition, it was possible to identify the main factors leading to older population frailty, which allows the development of strategies aimed at preventing frailty and improving care for the frail population.

Determination of the spatial susceptibility to Yellow Fever using a multicriteria analysis

BACKGROUND The outbreak of sylvatic Yellow Fever (SYF) in humans during 2016-2017 in Brazil is one of the greatest in the history of the disease. The occurrence of the disease in areas with low vaccination coverage favoured the dissemination of the disease; therefore, it is necessary to identify the areas vulnerability to the YF virus (YFV) to assist in the adoption of preventive measures. OBJECTIVE To correlate the physical-environmental elements associated with the occurrence of SYF in humans via a multicriteria analysis. METHODS For the multicriteria analysis, preponderant elements related to SYF occurrences, including soil usage and coverage, temperature, precipitation, altitude, mosquito transmitters, and non-human primate occurrence areas, were considered. The results were validated by assessing the correlation between the incidence of SYF and the vulnerable areas identified in the multicriteria analysis. RESULTS Two regions with different vulnerability to the occurrence of the disease were identified in the multicriteria analysis, with emphasis on the southern areas of the state of São Paulo northeast areas of Minas Gerais, and the entire states of Rio de Janeiro and Espírito Santo. The map of SYF vulnerability obtained in the multicriteria analysis coincides with the areas in which cases of the disease have been recorded. The regions that presented the greatest suitability were in fact the municipalities with the highest incidence. MAIN CONCLUSIONS The multicriteria analysis revealed that the elements that were used are suited for and consistent in the prediction of the areas that are vulnerable to SYF. The results obtained indicate the proximity of the areas that are most vulnerable to the disease to densely populated areas where an Aedes aegypti infestation was observed, which confers a high risk of re-urbanisation of YF.

Análisis y distribución espacial de la vulnerabilidad social en la prov. de Salta, Argentina / Analysis and spatial distribution of social vulnerability in the province of Salta, Argentina

A lo largo de su historia, la provincia de Salta ha sido afectada por distintos tipos de desastres, siendo aquellos de origen hidrometeorológico los más predominantes. Se acepta que para que se produzca una situación de desastre, una amenaza debe operar sobre una comunidad en situación de vulnerabilidad, esto es el grado de exposición de una familia o una comunidad, dada la probabilidad de ocurrencia de un peligro potencialmente dañino, y la insuficiencia o incapacidad de protegerse.Se realizó un análisis descriptivo de la base de datos correspondiente a los datos de la provincia de Salta del Censo Nacional de Población y Vivienda del año 2001, procesados a través de Redatam + SP Process. Se construyeron índices de acuerdo a la metodología empleada por Melina Con, a partir de las dimensiones: hacinamiento del hogar, calidad de los materiales de la vivienda, carga de dependencia sobre los perceptores de ingresos, las posibilidades de acceso al sistema de salud, y aspectos educativos del hogar. Los resultados obtenidos dan cuenta de que las zonas más alejadas a la región centro son las más postergadas y fundamentalmente los departamentos de la región este de la provincia de Salta. Se destaca la cantidad de hogares que acumulan 2 o más dimensiones de vulnerabilidad.

Throughout its history, Salta has been affected by several disasters, hydrometeorological ones have been the most prevalent. It is accepted that for a disaster situation to happen, a threat must operate on a vulnerable community; i.e., the degree of exposure of a family or a community in case of harmful hazards, and their failure or inability to protect themselves.We performed a descriptive analysis of the database corresponding to the information about the province of Salta gathered through the National Census of Population and Housing 2001, processed with Redatam + SP Process. Indexes were made according to the methodology employed by Melina Con, based on sizes: overcrowding, quality of building materials, dependency burden on income earners, access to health care, and learning aspects of the home. Results show that the furthest areas from the central region are the most neglected ones, mainly those in the eastern area of the province of Salta. An important number of households accumulate 2 or more dimensions of vulnerabilit.