COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study.

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

Modelagem de sistema especialista para avaliação multidimensional de pessoas idosas / Expert system modeling for the multidimensional evaluation of aged people / Diseño de un sistema experto para la evaluación multidimensional del adulto mayor

RESUMO Objetivo: descrever a modelagem de um Sistema Especialista para Avaliação Multidimensional de pessoas idosas. Método: realizado no período de abril de 2021 a setembro de 2022, sendo conduzido por pesquisadores de universidades do interior de Minas Gerais - Brasil. Percorreu-se pelas etapas: revisão de literatura, levantamento dos requisitos para o Sistema, modelagem e implementação. Resultados: o Sistema possibilita avaliação dos aspectos físico, psicossocial e funcional, identifica as necessidades geriátrico-gerontológicas e as classifica de acordo com níveis de gravidade, além de oferecer sugestões de intervenções terapêuticas. As informações geradas podem ser compartilhadas por meio de mensageiros instantâneos através de aplicativos, dando base para o desenvolvimento de um painel de monitoramento das pessoas idosas assistidas no município. Conclusão: o Sistema se apresenta como uma solução tecnológica dada a importância da avaliação multidimensional da pessoa idosa no âmbito do cuidado a essa população e a carência de soluções tecnológicas para realizar a avaliação.

ABSTRACT Objective: to describe the modeling of an Expert System for the Multidimensional Evaluation of aged people. Method: the study was carried out from April 2021 to September 2022 by researchers from universities in the inland of Minas Gerais - Brazil. The following stages were conducted: literature review; survey of the System requirements; modeling; and implementation. Results: the System makes it possible to assess the physical, psychosocial and functional aspects; it identifies the geriatric-gerontological needs and classifies them according to severity levels, in addition to offering suggestions for therapeutic interventions. The diverse information generated can be shared through instant messengers via apps, providing the basis for the development of a monitoring panel for aged people assisted in the municipality. Conclusion: the System presents itself as a technological solution given the importance of the multidimensional evaluation of aged people within the scope of care for this population segment and the lack of technological solutions to carry out the assessment.

RESUMEN Objetivo: describir el diseño de un Sistema Experto para la Evaluación Multidimensional del adulto mayor. Método: estudio realizado, de abril de 2021 a septiembre de 2022, por investigadores de universidades del interior de Minas Gerais, Brasil. Pasó por los pasos: revisión de la literatura, relevamiento de los requisitos del Sistema, diseño e implementación. Resultados: el Sistema permite evaluar aspectos físicos, psicosociales y funcionales, identifica necesidades geriátrico-gerontológicas y las clasifica según el nivel de gravedad, además ofrece sugerencias de intervenciones terapéuticas. La información generada podrá ser compartida a través de mensajería instantánea mediante aplicaciones, y sentará las bases para el desarrollo de un panel de seguimiento de los adultos mayores atendidos en el municipio. Conclusión: el Sistema es una solución tecnológica dada la importancia que tiene la evaluación multidimensional del adulto mayor en el ámbito de la atención de esta población y la falta de soluciones tecnológicas para realizar la evaluación.

Diagnóstico tardio do Vírus da Imunodeficiência Humana e da Síndrome da Imunodeficiência Adquirida em Idosos: protocolo scoping review / Late diagnosis of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in the Elderly: scoping review protocol

As pessoas idosas, diagnosticadas tardiamente, tem maior risco de desenvolver AIDS. Com a contagem de CD4 inferior a 200 células/ml3, elas apresentam em média mais chances de morrer no primeiro ano após o diagnóstico. O objetivo desta revisão de escopo é mapear evidências relativas aos fatores associados e de risco do diagnóstico tardio de HIV/AIDS em pessoas idosas, mas especificamente, esta revisão quer dar resposta às seguintes questões: Quais são os fatores associados do diagnóstico tardio de HIV/AIDS em pessoas idosas? Quais são os fatores de riscos do diagnóstico tardio de HIV/AIDS em pessoas idosas? Que contexto o diagnóstico tardio de HIV/AIDS em pessoas idosas foi realizado? Esta revisão será orientada pela metodologia do Joanna Briggs Institute, que assentará na estratégia de definição dos participantes, conceito e contexto. Os resultados serão apresentados pelo resumo lógico e descritivo, apresentados, como um mapa de dados extraídos dos artigos e alinhado com o objetivo e as perguntas da revisão de escopo. Espera-se que esta revisão de escopo contribua para a análise compreensiva das práticas de cuidados à saúde das pessoas idosas.

Elderly people, diagnosed late, have a higher risk of developing AIDS. With a CD4 count of less than 200 cells / ml3, they are on average more likely to die in the first year after diagnosis. The purpose of this scope review is to map evidence regarding the associated risk factors of late diagnosis of HIV / AIDS in older people, but specifically, this review aims to address the following questions: What are the associated factors of late diagnosis of HIV / AIDS in elderly people? What are the risk factors for late diagnosis of HIV / AIDS in elderly people? In what context was the late diagnosis of HIV / AIDS in elderly people given? This review will be guided by the methodology of the Joanna Briggs Institute, which will be based on participant definition strategy, concept and context. Results will be presented by the logical and descriptive summary, presented as a map of data extracted from the articles and aligned with the objective and scope review questions. This scope review is expected to contribute to a comprehensive analysis of the health care practices of elderly people.

Las personas mayores, diagnosticadas tardíamente, tienen un mayor riesgo de desarrollar SIDA. Con un recuento de CD4 de menos de 200 células/ml3, tienen en promedio más probabilidades de morir en el primer año después del diagnóstico. El objetivo de esta revisión de alcance es mapear las evidencias relacionadas con los factores asociados y de riesgo del diagnóstico tardío del VIH/SIDA en personas mayores, pero específicamente esta revisión tiene como objetivo responder a las siguientes preguntas: ¿Cuáles son los factores asociados con el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuáles son los factores de riesgo para el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuál es el contexto del diagnóstico tardío del VIH/SIDA en las personas mayores? Esta revisión se guiará por la metodología del Joanna Briggs Institute, que se basará en la estrategia de definición, concepto y contexto de los participantes. Los resultados se presentarán mediante un resumen lógico y descriptivo, presentado como un mapa de los datos extraídos de los artículos y alineados con el objetivo y las preguntas de la revisión del alcance. Se espera que esta revisión del alcance contribuya al análisis exhaustivo de las prácticas de atención de la salud de los ancianos.

Factors associated with the occurrence of adverse events to antiretroviral therapy in adults and elderly living with HIV

Objectives: This study identifies the factors associated with the occurrence of adverse events in adults and elderly on antiretroviral therapy. Methods: This is a cross-sectional study carried out with adults and elderly patients, attended by the Specialized Assistance Service between September 2016 and August 2017. Adverse events were measured through self-reports collected in interviews, information collected in medical records, and changes identified in laboratory tests, with the degree of causality being assessed using the Naranjo Algorithm. Univariate analysis, with results expressed as odds ratio (OR) and their respective confidence intervals (CI 95%), was performed to estimate the association between sociodemographic, pharmacotherapeutic, and clinical characteristics (explanatory variables) with the occurrence of four or more adverse events to antiretroviral therapy (response variable). For multivariate analysis, multiple logistic regression was considered in order to verify the permanence or absence of associations previously found in the univariate analysis. Results: Prevalence of adverse events to antiretroviral therapy was 92.6%, with the median of adverse events being four (IQR 25%: 2 ; IQR 75%: 5) and two (IQR 25%: 2 ; IQR 75%: 4), respectively, among adults and elderly (p <0.05). Additionally, 340 adverse events were identified, among which nightmares (15.0%) and vertigo (13.5%) were the most frequent. Most of the adverse events identified were classified as possible (96.2% / n = 327). In the initial univariate analysis, factors such receipt of guidance on adverse events and age were associated with a higher occurrence of adverse events to antiretroviral therapy. Contrary to expectations, the elderly were considered less susceptible to have adverse events when compared to adults (OR = 0.363; CI 95% = 0.164-0.801). However, the final multivariate analysis model revealed "receipt of guidance on adverse events" as the only variable significantly associated with the presence of four or more adverse events to antiretroviral therapy (OR = 4.183 ; CI 95% = 1.775-9.855). Conclusions: Results suggest difference in perception of adverse events between patients who received and those who did not receive guidance in this regard, which indicates the importance of health professionals to provide specific information to their patients regarding adverse events to antiretroviral therapy. Thus the patient can understand the effects generated by the treatment and inform these professionals for the notification of adverse events, in order to improve pharmacovigilance actions and promote patient safety.

Ensino clínico de fundamentos de enfermagem na comunidade / Clinical teaching of nursing fundamentals in the community

Objetivo: descrever a metodologia e as estratégias do plano educacional do ensino clínico de Fundamentos de Enfermagem na comunidade que, por meio do estudo de determinantes de saúde com pessoas idosas, tem como meta a formação de competências e capacidades dos estudantes do curso de Licenciatura em Enfermagem. Método: trata-se de um estudo qualitativo, descritivo, do tipo relato de experiência, desenvolvido com estudantes de Enfermagem. Apresentam-se os resultados em forma de figuras. Resultados: conduziu-se os estudantes a desenvolver as competências definidas pelas diferentes capacidades e critérios vivenciados pelos estudantes, neste ensino clínico, durante as experiências de aprendizagem sugeridas, assim como outras que foram implementadas. Conclusão: permitiu-se, ao estudante de Enfermagem, pela integração de atividades de Enfermagem compartilhadas entre equipes e subequipes, construir seu próprio conhecimento e acrescentar qualidade técnica e científica à sua formação. Tornou-se o estudo de determinantes de saúde com pessoas idosas fundamental para a formação de competências dos estudantes do curso de Licenciatura em Enfermagem. Pode-se disponibilizar, por esta experiência, com propostas baseadas no olhar do continente europeu, uma nova dimensão de aprendizagem no ensino clínico da Licenciatura de Enfermagem para outros continentes.(AU)

Objective: to describe the methodology and strategies of the educational plan of the clinical teaching of Nursing Fundamentals in the community that, through the study of health determinants with elderly people, has the goal of training the skills and abilities of undergraduate students in Nursing. Method: this is a qualitative, descriptive, experience-type study developed with Nursing students. The results are presented in figures. Results: the students were led to develop the competencies defined by the different capacities and criteria experienced by the students, in this clinical teaching, during the suggested learning experiences, as well as others that were implemented. Conclusion: the Nursing student was allowed to integrate nursing activities shared between teams and subteams, to build their own knowledge and to add technical and scientific quality to their training. It has become the study of health determinants with older people key to the training of students' undergraduate nursing course. Through this experience, it is possible to offer, based on the perspective of the European continent, a new dimension of learning in the clinical teaching of the Nursing Degree to other continents.(AU)

Objetivo: describir la metodología y las estrategias del plan educativo de la enseñanza clínica de Fundamentos de Enfermería en la comunidad que, a través del estudio de determinantes de salud con personas mayores, tiene como meta la formación de competencias y capacidades de los estudiantes del curso de Licenciatura en Enfermería. Método: se trata de un estudio cualitativo, descriptivo, del tipo relato de experiencia, desarrollado con estudiantes de Enfermería. Se presentan los resultados en forma de figuras. Resultados: se llevó a los estudiantes a desarrollar las competencias definidas por las diferentes capacidades y criterios vivenciados por los estudiantes, en esta enseñanza clínica, durante las experiencias de aprendizaje sugeridas, así como otras que se implementaron. Conclusión: se permitió al estudiante de Enfermería, por la integración de actividades de Enfermería compartidas entre equipos y subequipos, construir su propio conocimiento y añadir calidad técnica y científica a su formación. Se ha convertido el estudio de determinantes de salud con personas de edad avanzada para la formación de competencias de los estudiantes del curso de Licenciatura en Enfermería. Se puede disponer, por esta experiencia, con propuestas basadas en la mirada del continente europeo, una nueva dimensión de aprendizaje en la enseñanza clínica de la Licenciatura de Enfermería para otros continentes.

Limitações funcionais e incapacidades de idosos com síndrome de imunodeficiência adquirida / Functional limitation and disabilities of older people with acquired immunodeficiency syndrome

Objetivo: Avaliar a capacidade funcional de idosos com síndrome de imunodeficiência adquirida (HIV/AIDS). Métodos Estudo transversal com inquérito epidemiológico observacional com a coleta de dados realizada através de entrevistas e fonte documental de 142 idosos portadores do vírus da imunodeficiência humana, entre 60 e 81 anos de idade, avaliados pelos domínios de funcionalidade cognitiva, saúde mental e Atividades da Vida Diária. Foram realizadas análise absoluta e relativa das variáveis contínuas, além da associação das variáveis independentes. Resultados Viviam com AIDS 82,39% dos idosos da amostra; 35,2% deles tinham mais de 9 anos de estudo e 35% usavam maconha. Dentre eles, 71,7% se contaminaram em relações heterossexuais e 70,3% em relações com múltiplos parceiros. Constatou-se satisfatória a adesão à terapia antirretroviral. Foi significativa a perda funcional naqueles com 70 anos ou mais de idade de ambos os sexos. Conclusão As perdas funcionais dos idosos portadores não foram diferentes das verificadas em outros estudos com população idosa não portadora.

Objective: To evaluate functional ability of older people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Methods This cross-sectional study using observational epidemiological inquiry collected data through interviews and from medical record of 142 older people with HIV/AIDS age 60 to 81 years. Participants were evaluated for cognitive functionality, mental health and activities of daily living domains. We conducted absolute and relative analyses of continuous variables and associations of independent variables. Results Among the study participants, 82.39% had AIDS, 35.2% had more than 9 years of formal education, and 35% were still using cannabis. HIV was transmitted during heterosexual intercourse in 71.7% of participants and through sex with multiple partners in 70.3%. Adherence to antiretroviral therapy was satisfactory. Functional loss was significant among those age 70 years or older from both sexes. Conclusion Functional loss of older people with HIV/AIDS did not differ from results found in the literature among the HIV-negative aging population.

Fatores de risco para doença arterial coronariana em jovens: revisão integrativa da literatura brasileira / Factores de riesgo de enfermedad coronaria en los jóvenes: revisión inegral de la literatura brasileña / Risk factors for coronary artery disease in young people: integrative review of brazilian literature

A doença arterial coronariana se caracteriza pelo estreitamento das artérias coronárias em decorrênciada formação eacúmulo de placas de ateroma; embora as manifestações clínicas venham a ser mais prevalentes entre a populaçãoadulta, o processo aterosclerótico começa a se desenvolver na infância. O objetivo deste trabalho foiidentificar osfatores de risco para doença arterial coronariana em jovens. Trata-se de uma metodologia descritiva eexploratória decaráter quantitativo baseada na revisão integrativada literatura brasileira. O levantamento bibliográfico foi realizadoem todas as bases de dados indexadas na BibliotecaVirtual em Saúde e foi utilizada a combinação das palavras-chave“fatores de risco”, “doença coronariana” e “jovem”.Os resultados mostraram 15 trabalhos que atendiamaos critériosde inclusão. Foram determinadas duas categorias para os fatores de risco; na categoria fator de risconão modificável,foi identificado apenas história familiar e, na categoria fator de risco modificável, foram identificados a dislipidemia,obesidade, hipertensão arterial, sedentarismo, tabagismo, padrão alimentar, diabetes mellitus, contraceptivo oral,estresse e valores elevados de proteína C reativa.Consideramos que políticas públicas de saúde precisam serimplementadas voltadas diretamente para jovens comintuito de reduzir os riscos de complicações cardiovascularesem adultos.

Coronary artery disease is characterized by the narrowing of the coronary arteries due to the formation andaccumulation of atheromatous plaques; although theclinical manifestations may be more prevalent amongthe adultpopulation, the atherosclerotic process begins to develop in childhood. The objective of this study was to identifyrisck factors for coronary artery disease in youngpeople. This is an exploratory and descriptive analysis ofquantitative character based on an integrative review of Brazilian literature. The bibliographic research wasconducted in all databases indexed in Virtual Health Library and used a combination of the keywords “risk factors”,“coronary disease” and “young”. The results showedthat 15 studies met the inclusion criteria. Two categories of riskfactors were determined; in the category unmodifiable risk factor, only family history was identifiedand, in thecategory modifiable risk factor, dyslipidemia, obesity, hypertension, sedentary lifestyle, smoking, dietary patterns,diabetes mellitus, oral contraceptives, stress andelevated C-reative protein were identified. We alsobelieve thatpublic health policies need to be implemented aimeddirectly at young people in order to reduce the risk ofcardiovascular complications in adults.

La enfermedad coronaria es caracterizada por estrechamiento de arterias coronarias debido a la formación yacumulación de placas de ateroma; a pesar de que las manifestaciones clínicas sean más frecuentes entre la poblaciónadulta, el proceso aterosclerótico comienza a desarrollarse en la infancia. El objetivo de este estudio fue identificarlos factores de riesgo de enfermedad coronaria en personas jóvenes. Este es un método exploratorio y descriptivo decarácter cuantitativo basado en la revisión integradora de la literatura brasileña. La bibliografía sellevó a cabo entodas las bases de datos indexadas en la BibliotecaVirtual en Salud y se utilizó la combinación de palabras clave“factores de riesgo”, “enfermedad coronaria” y “jóvenes”. Los resultados mostraron que 15 estudios cumplieron loscriterios de inclusión. Se determinaron dos categorías de factor de riesgo; en la categoría factores de riesgo nomodificable, se identificó antecedentes familiaresy, en la categoría factor de riesgo modificable...