Identifying Frailty Levels and Associated Factors in a Population Living in the Context of Poverty and Social Vulnerability.

This study aimed to investigate a vulnerable population living in the context of poverty in a Brazilian municipality, in order to identify the factors that are associated with frailty syndrome in elderly people. From the total population living in the area, a random sample of 363 community-dwelling people, 60 years and older, age and gender-stratified, was selected to participate in the research. After losses, a sample of 304 older adults was classified as non-frail, pre-frail and frail. According to the Fried frailty criteria, the prevalence was 12.2% for non-frail individuals, 60.5% pre-frail and 27.3% frail. The main factors associated with frailty in the studied sample were low level of physical activity (OR: 5.2, 95%CI: 2.5-11.0), the occurrence of two or more falls within 12 months (OR: 3.1, 95%CI: 1.4-7.1), mobility deficits (OR: 3.0, 95%CI: 1.5-5.8), and depressive symptoms (OR: 1.9, 95%CI: 1.1-3.7). This study identified the most important factors that must be evaluated to identify frailty syndrome in a socially vulnerable population in the context of poverty. The data should help to encourage effective strategies concerning public health policies for this population.

Influência da universidade aberta da terceira idade (UATI) e do programa de revitalização (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos / Influence of the Open University for the Third Age (UATI) and the revitalization program (REVT) on quality of life in middle-aged and elderly adults

OBJETIVO: Foi avaliada a influência da Universidade Aberta da Terceira Idade - Fundação Educacional de São Carlos (UATI-FESC) e do Programa de Revitalização Geriátrica (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos. MÉTODO: Participaram deste estudo 70 indivíduos do primeiro ano da UATI e do REVT. Os critérios de inclusão foram ter 50 anos ou mais e ser capaz de preencher os questionários. A UATI é um programa interdisciplinar com seis disciplinas (uma vez por semana cada), três de atividades físicas: Tai Chi Chi Kung, Expressão Corporal, Fisioterapia e Promoção da Saúde; e três de promoção social e cultural: Educação Musical, Arte, Cidadania e Terceira Idade, além de atividades comemorativas e turismo cultural. O REVT teve 48 sessões de atividade física, três vezes por semana, com duração de 50-55 minutos cada. Todos os participantes foram avaliados por meio dos instrumentos de qualidade de vida World Health Organization Quality of Life (WHOQOL-bref) e Short-Form 36 - Medical Outcomes Study (SF36) no início e ao término da intervenção de 16 semanas. Para análise dos dados, foi utilizada ANOVA com medida repetida. RESULTADOS: Não houve diferença entre os grupos. Ambos os grupos apresentaram melhora significativa do nível de qualidade de vida de acordo com o resultado geral do WHOQOL-bref e também nos domínios psicológico, meio ambiente e questões iniciais: "Como você avaliaria sua qualidade de vida?" e "Quão satisfeito(a) você está com a sua saúde?" do WHOQOL-bref. Também houve melhora significativa do domínio Estado Geral de Saúde do SF36. Para os domínios Físico e Relações Sociais do WHOQOL-bref e outros domínios do SF36 não houve melhora significativa. CONCLUSÃO: Esses programas melhoraram a qualidade de vida segundo o WHOQOL-bref e EGS-SF36.

OBJECTIVE: The influence of the Open University of the Third Age (São Carlos Educational Foundation) (UATI-FESC) and the Geriatric Revitalization Program (REVT) on the quality of life of middle-aged and elderly adults was evaluated. METHOD: Seventy individuals in their first year at UATI and REVT participated in this study. The inclusion criteria were that the subjects had to be at least 50 years old and be capable of filling out questionnaires. UATI had an interdisciplinary program comprising six lectures (once a week each). Three were on physical activities: Tai Chi Chi Kung, Body Expression and Physical Therapy and Health Promotion; three on social and cultural promotion: Musical Education, Art and Citizenship in the Third Age; and there were also commemorative activities and cultural tourism. REVT had 48 physical activity sessions, three times a week, lasting 50-55 minutes each. All the participants were evaluated using the World Health Organization Quality-of-Life (WHOQOL-bref) and Short-Form 36 Medical Outcomes Study (SF36) questionnaires at baseline and at the end of the 16-week intervention. The data were analyzed using ANOVA with repeated measurements. RESULTS: There were no differences between the groups. Both groups showed significant improvement in quality of life according to the overall result from WHOQOL-bref and also in the Psychological and Environmental domains and the initial questions: "How would you rate your quality of life?" and "How satisfied are you with your health?", in WHOQOL-bref. There was also a significant improvement in the General Health domain of SF36. For the Physical and Social Relations domains of WHOQOL-bref and other domains of SF36, there was no significant improvement. CONCLUSIONS: These programs improved quality of life according to WHOQOL-bref and the General Health domain of SF36.

Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting: results of a meta-analysis of randomized controlled trials.

BACKGROUND: The introduction of serotonin antagonists as antiemetics for prophylaxis of chemotherapy-induced nausea and vomiting represented a major step toward better patient tolerance and adherence to this type of treatment. Several published trials compared different serotonin antagonists without demonstrating clear superiority of any one of them. Because most of these trials compared ondansetron with granisetron, the authors conducted a meta-analysis to determine if the current data available show any therapeutic difference between them. METHODS: MEDLINE and CANCERLIT databases were searched from 1990 to May 1999, and pertinent article references also were surveyed, without restriction to English language. The authors included all randomized controlled trials (RCTs) that had more than 25 patients per arm and compared ondansetron to granisetron for prophylaxis of acute (A) (< 24 hours) and delayed (D) (> 24 hours) nausea (N) and vomiting (V) induced by highly (H) or moderately (M) emetogenic chemotherapy. Only the first chemotherapy cycle was considered for studies that involved a crossover design. RESULTS: Fourteen studies with 6467 evaluable patients among the 21 studies retrieved were selected for this meta-analysis. In none of the eight scenarios studied (AHV, AHN, AMV, AMN, DHV, DHN, DMV, and DMN) could the authors detect any significant differences in the antiemetic efficacy of any of these medications. CONCLUSIONS: The authors conclude that both granisetron and ondansetron have similar antiemetic efficacy for prophylaxis of chemotherapy-induced nausea and vomiting. Because the number of comparative studies that addressed the delayed nausea and vomiting scenarios is low, further RCTs are still needed to confirm these results.

[Vaccination coverage in the first year of life in 4 cities of the state of São Paulo, Brazil]. / Cobertura vacinal no primeiro ano de vida em quatro cidades do Estado de São Paulo, Brasil.

Immunization is an important disease prevention measure, and evaluating the effectiveness of immunization programs is crucial to ensuring their success. This study describes the results of a household survey in four cities in the state of São Paulo, Brazil: Francisco Morato, Guarulhos, Osasco, and São Paulo. The survey was done in order to estimate immunization coverage for the cohort of children born in 1996. The city of São Paulo was divided into five strata, according to socioeconomic and living conditions. The survey followed the methodology that the Pan American Health Organization recommends for immunization coverage surveys. The proportion of children who had received a complete set of the recommended vaccinations at the time of the interview, taking into account both oral reports and information recorded on the children's immunization cards, was above 90% for all the cities except Francisco Morato, which had the worst living conditions. In the city of São Paulo, the worst coverage was found in the lowest and highest strata. When only the doses received during the first year of life were considered, the coverage was not adequate to produce herd immunity. The use of private vaccination services was higher in the areas with better living conditions. The difference between the coverage calculated based on data from health services and the coverage calculated based on the survey was inversely proportional to living conditions. Our results suggest that surveys similar to the one described here should be carried out in other cities. Employees who provide vaccination services should be trained to correctly record vaccination data. In addition, it is important to make health professionals aware of the official immunization calendar, and to facilitate the public's access to health services.