Prevalence of fear of falling, in a sample of elderly adults in the community / Prevalência do medo de cair em uma população de idosos da comunidade

Abstract Objectives: To investigate the prevalence of fear of falling among a sample of elderly persons in the community, and to analyze its correlation with age, self-perceived health, difficulty walking, use of an assistive device for walking, history of falls, and functional capacity. Method: A cross-sectional study of 314 non-institutionalized elderly individuals, living in the city of Juiz de Fora in the state of Minas Gerais) in 2015, was carried out. A household survey was conducted and fear of falling was assessed using the Falls Efficacy Scale - International - Brazil (FES-I-BRASIL). The Spearman correlation was used to verify the correlation of the independent variables with the fear of falling. The significance level for the study was 5%. Results: The prevalence of fear of falling among the elderly was 95.2% (95% CI= 92.3; 97.3). Fear of falling was significantly correlated with all the variables analyzed: age (r= 0.199), self-perceived health (r=0.299), difficulty walking (r= -0.480), use of an assistive device for walking (r=0.337), history of falls (r= -0.177), and functional capacity (r = -0.476) . Conclusions: A high prevalence of fear of falling was observed, with a significant correlation between the outcome and the variables studied. These findings point to the need for rehabilitation, prevention, and health promotion strategies that enable healthy aging. AU

Resumo Objetivos: Verificar a prevalência do medo de cair em uma população de idosos da comunidade e analisar a sua correlação com idade, autopercepção de saúde, dificuldade para andar, uso de dispositivo auxiliar, histórico de quedas e capacidade funcional. Método: Estudo transversal com 314 idosos, não institucionalizados, residentes na cidade de Juiz de Fora, MG, em 2015. Foi realizado inquérito domiciliar e o medo de cair foi avaliado usando Falls Efficacy Scale Internacional - Brasil (FES-I-BRASIL). Para verificar a correlação das variáveis independentes com o medo de cair, foi utilizada correlação de Spearman. Nível de significância do estudo foi de 5%. Resultados: A prevalência do medo de cair entre os idosos foi de 95,2% (IC95%=92,3; 97,3). O medo de cair correlacionou-se significativamente com todas as variáveis analisadas: idade (r=0,199), autopercepção de saúde (r=0,299), dificuldade para andar (r=-0,480), uso de dispositivo auxiliar da marcha (r=0,337), histórico de quedas (r=-0,177) e capacidade funcional (r=-0,476). Conclusões: Foi verificada alta prevalência do medo de cair e correlação significativa entre o desfecho e as variáveis estudadas. Esses achados apontam para a necessidade de estratégias de reabilitação, prevenção e promoção à saúde que possibilitem o envelhecimento saudável. AU

Parasacral transcutaneous electrical neural stimulation (PTENS) once a week for the treatment of overactive bladder in children: A randomized controlled trial.

INTRODUCTION: Overactive bladder (OAB) is the most prevalent voiding disorder in childhood, and its main manifestation is urinary urgency. In general, urotherapy and anticholinergics are the first choices of treatment. Parasacral Transcutaneous Electrical Neural Stimulation (PTENS) was introduced as an alternative for the treatment of detrusor overactivity in children, but treatment protocols described to date require several sessions per week or long-lasting sessions, making it difficult for the child to adhere to the treatment. Thus, this study aims to evaluate the effectiveness of PTENS in single weekly sessions in the treatment of OAB in children. STUDY DESIGN: This prospective, randomized controlled trial included 16 children with OAB. Children were divided into two groups: CG (urotherapy and electrical stimulation placebo) and EG (urotherapy and PTENS). For both groups, therapy was delivered in 20 weekly sessions, of duration 20 min each. Placebo electrical stimulation was done in the scapular area. The children were evaluated prior to treatment (T1), at the end of the 20 sessions (T2), and 60 days after the completion of treatment (T3), with a 3-day voiding diary, visual analogue scale (VAS), Rome III diagnostic criteria, and the Bristol Scale. RESULTS: The groups were similar in age, gender, and ethnicity. In the initial assessment, all children, in both groups, had urgency and incontinence, 50% in each group had constipation, and enuresis was present in seven children (87.5%) in the EG and six (75%) in the CG. No differences were found between the groups regarding the volumetric measurements made in the voiding diary, urinary frequency and constipation evaluated by the Rome III criteria and the Bristol Scale. Sixty days after treatment, a significant improvement was found in the EG group (p = 0.03) regarding urgency (Table), as well as an increase in dry nights in those presenting with enuresis (p = 0.03). No difference was noted regarding urinary incontinence (Table). At the end of 20 sessions and after 60 days of treatment, those responsible for the children in the EG perceived greater improvement in symptoms measured by the VAS (p = 0.05 and 0.04, respectively). CONCLUSIONS: Our preliminary results demonstrate that PTENS performed in single weekly sessions is effective in treating the bladder for symptoms of urinary urgency and enuresis, and in the perception of those responsible for the children. Further studies with larger populations are needed to corroborate these results.

Atribuições do PET-Saúde na atenção primária: um relato de experiência / Attribution of the health care work education program in primary care: an experience report

O Sistema Único de Saúde, instituído pela Constituição de 1988, propiciou um grande avanço nas políticas de saúde pública no Brasil, principalmente acerca da qualidade dos serviços oferecidos à população. Dessa forma, tornou-se necessária a revisão da formação dos profissionais da saú- de atuantes nessa esfera desde sua formação acadêmica, por meio de parcerias entre universidades, gestores e a comunidade. Nesse contexto, a Universidade Federal de Juiz de Fora (UFJF) aderiu ao Programa de Educação pelo Trabalho para Saúde (PET?Saúde), visando à formação de grupos multidisciplinares de aprendizagem tutorial em áreas estratégicas para o SUS, como forma de qualificação em serviço dos futuros profissionais da saúde. O presente artigo consiste em um relato de um grupo multidisciplinar de acadêmicos, monitores do PET?Saúde, acerca de sua experiência na atenção básica à saúde, descrevendo sua participação em diferentes esferas desse nível, na unidade Santos Dumont, no município de Juiz de Fora (MG). Essas ações proporcionaram um meio de aprendizagem teórico-prática dos preceitos adotados pelo SUS, a fim de ampliar o leque de soluções, valorizar o trabalho em equipe e aumentar a resolutividade da Atenção Primária.

The Unified Health System, instituted by the 1988 constitution, brought a major advance in Brazilian public health care policies, mainly involving the quality of services offered to the population. Thus it became necessary to revise the training of health professionals, beginning with their academic training, through partnerships between universities, health management, and the community. In this context, the Federal University of Juiz de Fora (UFJF) joined the Education Program for Work in Health Care (EPW - Health Care), aimed at forming multidisciplinary learning groups in Unified Health System strategic areas, to qualify future health care professionals. This article consists of a report from a multidisciplinary group of college students, EPW - Health Care monitors, about their experience in a basic health care unit, in Santos Dumont, a district of Juiz de Fora - Minas Gerais. Describing their participation in different areas at this level, such experience gave them a means to theory-practice learning of the precepts adopted by the Unified Health System in order to broaden the range of solutions, get the most value from team work, and increase the resolution rate of Primary Care.