Vulnerabilidade clínico funcional e condições de saúde de idosos com doença de Parkinson / Clinical functional vulnerability and health conditions of elderly people with Parkinson's disease / Vulnerabilidad clínica funcional y condiciones de salud de personas mayores con enfermedad de Parkinson

Objetivo: caracterizar a vulnerabilidade clinico funcional e as condições de saúde de idosos com Parkinson de um serviço de atenção especializada de um município de grande porte brasileiro. Método: trata-se de um estudo documental, transversal, realizado com 230 idosos com diagnóstico de Doença de Parkinson. Foram avaliados os prontuários dos pacientes com enfoque nos instrumentos.: Índice de Vulnerabilidade Clínico Funcional-20 e o Plano de Cuidados da avaliação multidimensional. As análises estatísticas foram realizadas utilizando o software R. Resultados: predomínio de idosos entre 80 e 89 anos, sexo feminino e baixa escolaridade. Apresentaram como principais marcadores de vulnerabilidade clinico funcional o comprometimento da mobilidade, incontinência urinária, sarcopenia, marcha/quedas, distúrbio de humor, comorbidade múltipla e polifarmácia. Conclusão: os achados mostraram alta prevalência de comprometimento funcional na doença de Parkinson. Acredita-se que os resultados possam contribuir na melhoria do cuidado a essa população, possibilitando aos profissionais da enfermagem atuarem na promoção do autocuidado

Objective: to characterize the clinical-functional vulnerability and health conditions of elderly people with Parkinson's in a specialized care service in a large Brazilian city. Method: this is a documentary, cross-sectional study, carried out with 230 elderly people diagnosed with Parkinson's disease. Patient records were evaluated focusing on the instruments: Functional Clinical Vulnerability Index-20 and the multidimensional assessment Care Plan. Statistical analyzes were carried out using the R software. Results: predominance of elderly people between 80 and 89 years old, female and with low education. The main markers of clinical-functional vulnerability were mobility impairment, urinary incontinence, sarcopenia, gait/falls, mood disorder, multiple comorbidities and polypharmacy. Conclusion: the findings showed a high prevalence of functional impairment in Parkinson's disease. It is believed that the results can contribute to improving care for this population, enabling nursing professionals to work to promote self-care

Objetivos:caracterizar la vulnerabilidad clínico-funcional y las condiciones de salud de personas mayores con Parkinson en un servicio de atención especializada de una gran ciudad brasileña. Método: se trata de un estudio documental, transversal, realizado con 230 personas mayores diagnosticadas con Enfermedad de Parkinson. Se evaluaron los expedientes de los pacientes centrándose en los instrumentos: Índice de Vulnerabilidad Clínica Funcional-20 y Plan de Cuidados de la evaluación multidimensional. Los análisis estadísticos se realizaron mediante el software R. Resultados: predominio de personas mayores entre 80 y 89 años, del sexo femenino y con baja escolaridad. Los principales marcadores de vulnerabilidad clínico-funcional fueron la alteración de la movilidad, la incontinencia urinaria, la sarcopenia, la marcha/caídas, los trastornos del estado de ánimo, las comorbilidades múltiples y la polifarmacia. Conclusión: los hallazgos mostraron una alta prevalencia de deterioro funcional en la enfermedad de Parkinson. Se cree que los resultados pueden contribuir para mejorar la atención a esta población, permitiendo a los profesionales de enfermería trabajar para promover el autocuidado

Towards DNA-Based Methods Analysis for Honey: An Update.

Honey is a natural product widely consumed all over the world due to its relationship with healthy benefits. Additionally, environmental and ethical issues have a higher weight in the consumer's choice to buy honey as a natural product. Following the high demand of this product, several approaches have been suggested and developed aiming at the assessment of honey's quality and authenticity. Target approaches, such as pollen analysis, phenolic compounds, sugars, volatile compounds, organic acids, proteins, amino acids, minerals, and trace elements, showed an efficacy, particularly concerning the honey origin. However, a special highlight is given to DNA markers, due to their useful applicability in environmental and biodiversity studies, besides the geographical, botanical, and entomological origins. Different DNA target genes were already explored for addressing diverse sources of honey DNA, with DNA metabarcoding attaining a relevant importance. This review aims to describe the latest advances on DNA-based methods applied in honey related studies, identifying the research needs for the development of new and additional required methodologies, and to select the most adequate tools for future research projects.

Factors associated with frailty syndrome in elderly people with Parkinson's disease.

OBJECTIVES: to analyze the sociodemographic and clinical factors associated with frailty in the elderly with Parkinson's disease in the context of a Specialized Health Care Service for the Elderly. METHODS: documentary, analytical, correlational, cross-sectional study carried out with 230 elderly people with Parkinson's. The medical records of the patients were evaluated with a focus on two instruments: Clinical-Functional Vulnerability Index - 20; and the Multidimensional Assessment Care Plan. RESULTS: predominance of elderly people between 80 and 89 years old; women; with low education; classified as fragile. There was a correlation between frailty and the variables: sex; age; age group; schooling; motor manifestations; non-motor manifestations; Hoehn and Yahr staging and time to diagnosis. CONCLUSIONS: high simultaneity of frailty conditions and Parkinson's disease was observed. It is believed that the results will be able to help the structuring of protocols for nursing performance in a systematic way in the promotion of self-care of these individuals.

As relações da enfermagem no cuidado ao idoso na atenção primária / Nursing relations in the care of the elderly in primary care primaria / Relaciones de enfermería para el cuidado de ancianos en atención primaria

Objetivo: Compreender as relações da enfermagem no cuidado ao idoso na Atenção Primária na perspectiva do referencial teórico-filosófico de Foucault. Método: Estudo qualitativo de análise de conteúdo. Os sujeitos foram os enfermeiros da Atenção Primária de Belo Horizonte, Minas Gerais, Brasil. Para coleta de dados realizou-se cinco grupos focais com 8 participantes. Resultados: Emergiram as categorias: o suporte adequado para o cuidado ao idoso, o enfermeiro define a trajetória de cuidados ao idoso, as relações de poder-saber no atendimento ao idoso. Conclusão: O cuidado ao idoso a partir da Atenção Primária implica na compreensão das relações da enfermagem permeadas por poderes e saberes. Esta compreensão é importante para o desenvolvimento de interações qualificadas que potencializem as práticas de enfermagem como ações sociais consolidadas na rede de atenção para a saúde da pessoa idosa.

Objective: To understand the nursing relationships in the care of the elderly in Primary Care from the perspective of Foucault's theoretical-philosophical framework. Method: Qualitative study of content analysis. The subjects were Primary Care nurses from Belo Horizonte, Minas Gerais, Brazil. For data collection, five focus groups were held with 8 participants. Results: The following categories emerged: adequate support for the care of the elderly, the nurse defines the trajectory of care for the elderly, the power-knowledge relationships in the care of the elderly. Conclusion: Elderly care based on Primary Care implies the understanding of nursing relationships permeated by powers and knowledge. This understanding is important for the development of qualified interactions that enhance nursing practices as social actions consolidated in the health care network for the elderly.

Objetivo: Comprender las relaciones de enfermería en el cuidado del anciano en la Atención Primaria desde la perspectiva del marco teórico-filosófico de Foucault. Método: Estudio cualitativo de análisis de contenido. Los sujetos fueron enfermeros de Atención Primaria de Belo Horizonte, Minas Gerais, Brasil. Se realizaron cinco grupos focales con 8 participantes. Resultados: Surgieron las siguientes categorías: apoyo adecuado para el cuidado del anciano, la enfermera define la trayectoria del cuidado de los ancianos, las relaciones de poder-saber en el cuidado del anciano. Conclusión: El cuidado del anciano a partir de la Atención Primaria implica la comprensión de las relaciones de enfermería permeadas por competencias y saberes. Esta comprensión es importante para el desarrollo de interacciones cualificadas que potencien las prácticas de enfermería como acciones sociales consolidadas en la red de atención a la salud del anciano.

Factors associated with frailty syndrome in elderly people with Parkinson's disease / Factores relacionados a la síndrome de fragilidad en ancianos con enfermedad de Parkinson / Fatores associados à síndrome de fragilidade em idosos com doença de Parkinson

ABSTRACT Objectives: to analyze the sociodemographic and clinical factors associated with frailty in the elderly with Parkinson's disease in the context of a Specialized Health Care Service for the Elderly. Methods: documentary, analytical, correlational, cross-sectional study carried out with 230 elderly people with Parkinson's. The medical records of the patients were evaluated with a focus on two instruments: Clinical-Functional Vulnerability Index - 20; and the Multidimensional Assessment Care Plan. Results: predominance of elderly people between 80 and 89 years old; women; with low education; classified as fragile. There was a correlation between frailty and the variables: sex; age; age group; schooling; motor manifestations; non-motor manifestations; Hoehn and Yahr staging and time to diagnosis. Conclusions: high simultaneity of frailty conditions and Parkinson's disease was observed. It is believed that the results will be able to help the structuring of protocols for nursing performance in a systematic way in the promotion of self-care of these individuals.

RESUMEN Objetivos: analizar factores sociodemográficos y clínicos relacionados a la fragilidad en ancianos con enfermedad de Parkinson en el contexto de un Servicio de Atención Especializada en Salud del Anciano. Métodos: estudio documental, analítico, correlacional, de cohorte transversal, realizado con 230 ancianos con Parkinson. Fueron evaluados prontuarios de los pacientes basados en dos instrumentos: Índice de Vulnerabilidad Clínico-Funcional - 20; y el Plan de Cuidados de la evaluación multidimensional. Resultados: predominio de ancianos entre 80 y 89 años; sexo femenino; con baja escolaridad; clasificados como frágiles. Hubo correlación entre la fragilidad y las variables: sexo; edad; franja etaria; escolaridad; manifestaciones motoras; manifestaciones no motoras; estadios de Hoehn y Yahr y tiempo de diagnóstico. Conclusiones: constatado alta simultaneidad de las condiciones de fragilidad y enfermedad de Parkinson. Considerado que los resultados podrán auxiliar la estructuración de protocolos para actuación de la enfermería de manera sistematizada en la promoción del autocuidado de eses indivíduos.

RESUMO Objetivos: analisar os fatores sociodemográficos e clínicos associados à fragilidade em idosos com doença de Parkinson no contexto de um Serviço de Atenção Especializada em Saúde do Idoso. Métodos: estudo documental, analítico, correlacional, de corte transversal, realizado com 230 idosos com Parkinson. Foram avaliados os prontuários dos pacientes com enfoque em dois instrumentos: Índice de Vulnerabilidade Clínico-Funcional - 20; e o Plano de Cuidados da avaliação multidimensional. Resultados: predomínio de idosos entre 80 e 89 anos; sexo feminino; com baixa escolaridade; classificados como frágeis. Houve correlação entre a fragilidade e as variáveis: sexo; idade; faixa etária; escolaridade; manifestações motoras; manifestações não motoras; estadiamento de Hoehn e Yahr e tempo de diagnóstico. Conclusões: constatou-se alta simultaneidade das condições de fragilidade e doença de Parkinson. Acredita-se que os resultados poderão auxiliar a estruturação de protocolos para atuação da enfermagem de forma sistematizada na promoção do autocuidado desses indivíduos.

Autorrelato da saúde de pacientes com tuberculose e diabetes: contribuição ao manejo integrado das comorbidades / Autoinforme de la salud de pacientes con tuberculosis y diabetes: contribución al manejo integrado de las comorbilidades / Self-report on the health of patients with tuberculosis and diabetes: contribution to the integrated management of comorbidities

RESUMO Objetivo: analisar o autorrelato da saúde de pacientes com tuberculose e com diabetes mellitus, por meio da procura por atendimento, identificação de sintomas e realização de exames diagnósticos pelos mesmos, visando contribuir com o manejo integrado das comorbidades. Métodos: estudo quantitativo, analítico, ocorrido em município de Minas Gerais, Brasil. Os dados foram coletados por meio de contato telefônico a pessoas com diabetes, já diagnosticadas, por meio de 10 equipes de saúde da família do município; e a pessoas com tuberculose, em tratamento, identificadas no Sistema de Informação de Agravos de Notificação. Resultados: Foram contactados 411 pacientes com diabetes, com 159 respondentes, e entre os 72 pacientes com tuberculose, 16 atenderam às ligações telefônicas. Por meio do autorrelato foram identificados 34% de pacientes com diabetes e tosse concomitantes, maioria mulheres, 72%; Entre os pacientes com tuberculose, 37% realizaram glicemia de jejum nos três últimos meses, 12% possuíam diabetes autodeclarada. Considerações finais: os resultados mostraram fragilidades no atendimento prestado nos serviços de saúde relacionadas com o manejo integrado tuberculose-diabetes. Conhecer a relação entre essas doenças faz-se necessário a fim de contribuir para o enfrentamento das mesmas como problema de saúde pública. A enfermagem tem função importante na propagação do conhecimento e de ações que vislumbrem o manejo integrado da tuberculose e diabetes na busca da especificidade do cuidado.

RESUMEN Objetivo: analizar el autoinforme de la salud de pacientes con tuberculosis y diabetes mellitus, con base en la demanda por atención, identificación de síntomas y realización de exámenes diagnósticos, con finalidad de contribuir para el manejo integrado de las comorbilidades. Métodos: estudio cuantitativo y analítico ocurrido en municipio de Minas Gerais, Brasil. Los datos fueron recolectados de personas con diabetes ya diagnosticadas, vía contacto telefónico por diez equipos del programa Salud de la Familia del municipio, y de pacientes con tuberculosis en tratamiento, identificados en el Sistema de Información de Agravios de Notificación. Resultados: fueron contactados 411 pacientes con diabetes, con devolución de 159 encuestados, y 72 pacientes con tuberculosis, con devolución de 16. El autoinforme permitió identificar que 34% de pacientes presentaban diabetes y tos concomitantes y que 72% eran mujeres, mientras que de los pacientes con tuberculosis 37% realizaron glucemia de ayuno en los tres últimos meses y 12% poseían diabetes autodeclarada. Consideraciones finales: los resultados mostraron fragilidades en la atención prestada en los servicios de salud relacionados con el manejo integrado tuberculosis-diabetes. Es necesario conocer la relación entre esas enfermedades si se pretende contribuir al enfrentamiento de esas enfermedades como problema de salud pública. La enfermería tiene la importante función de propagar el conocimiento y las acciones que tienen por objetivo el manejo integrado de la tuberculosis y diabetes en la búsqueda de la especificidad del cuidado.

ABSTRACT Objective: to analyze the self-report of the health of patients with tuberculosis and diabetes mellitus, through the search for care, identification of symptoms and diagnostic tests performed by them, in order to contribute to the integrated management of comorbidities. Methods: quantitative, analytical study, carried out in a municipality of Minas Gerais, Brazil. Data were collected through telephone contact with people with diabetes, already diagnosed, through 10 family health teams in the municipality; and people with tuberculosis, under treatment, identified in the Notifiable Diseases Information System. Results: 411 patients with diabetes were contacted, with 159 respondents, and among the 72 patients with tuberculosis, 16 answered the phone calls. Through self-report, 34% of patients with concomitant diabetes and cough were identified, most of them women, 72%; Among patients with tuberculosis, 37% had fasting blood glucose in the last three months, 12% had self-reported diabetes. Final considerations: the results showed weaknesses in the care provided in health services related to the integrated management of tuberculosis-and diabetes. Knowing the relationship between these diseases is necessary in order to contribute to facing them as a public health problem. Nursing plays an important role in the propagation of knowledge and actions that envision the integrated management of tuberculosis and diabetes in the search for the specificity of care.

Validação psicométrica da versão brasileira do Geriatric Institutional Assessment Profile / Validación psicométrica de la versión brasileña del Geriatric Institutional Assessment Profile / Psychometric validation of the Brazilian version of the Geriatric Institutional Assessment Profile

Resumo Objetivo Avaliar as propriedades psicométricas do instrumento Geriatric Institutional Assessment Profile em uma amostra de enfermeiros brasileiros que atuam em instituições hospitalares. Métodos Estudo metodológico e transversal, realizado em uma amostra de 301 enfermeiros que atuavam na assistência a pacientes de cinco hospitais, localizados nos estados do Piauí e Minas Gerais. Foi utilizada a análise fatorial exploratória com a extração dos fatores pelo método dos componentes principais. Em seguida, aplicou-se a rotação Varimax. Foram avaliados os seguintes constructos correlatos: conhecimento geriátrico (escala Geriatric Nursing Knowledge/Attitudes); um que envolve barreiras institucionais e facilitadores de melhores práticas (escala Geriatric Care Environment) e outro que enfatiza a relação interpessoal e aspectos coordenativos da prática profissional (subescalas Professional Issues). Resultados A análise fatorial exploratória indicou que na versão brasileira da escala Geriatric Nursing Knowledge/Attitudes, 30 itens apresentaram cargas fatoriais adequadas (>=0,40) e definiram seis fatores. O total de variância explicada foi de 40,5%. Na escala Geriatric Care Environment, 28 itens foram adequados e definiram cinco fatores. O total de variância explicada foi de 59,27%. Nas subescalas Professional Issues, 45 itens foram adequados e definiram seis fatores. O total de variância explicada foi de 57,78%. Conclusão A versão brasileira do Geriatric Institucional Assessment Profile é válido e confiável e pode ser aplicada para avaliar as percepções, atitudes e conhecimentos acerca de distúrbios geriátricos mais comuns e identificar as barreiras enfrentadas por enfermeiros no desenvolvimento de uma assistência com qualidade.

Resumen Objetivo Evaluar las propiedades psicométricas del instrumento Geriatric Institutional Assessment Profile en una muestra de enfermeros brasileños que trabajan en instituciones hospitalarias. Métodos Estudio metodológico y transversal, realizado en una muestra de 301 enfermeros que trabajaban en la atención a pacientes de cinco hospitales ubicados en los estados de Piauí y Minas Gerais. Se utilizó el análisis factorial exploratorio con la extracción de los factores por el método de los componentes principales. A continuación, se aplicó la rotación Varimax. Se evaluaron los siguientes constructos correlacionados: conocimiento geriátrico (escala Geriatric Nursing Knowledge/Attitudes); uno que incluye barreras institucionales y facilitadores de mejores prácticas (escala Geriatric Care Environment) y otro que enfatiza la relación interpersonal y los aspectos de coordinación de la práctica profesional (subescalas Professional Issues). Resultados El análisis factorial exploratorio indicó que, en la versión brasileña de la escala Geriatric Nursing Knowledge/Attitudes, 30 ítems presentaron cargas factoriales adecuadas (>=0,40) y definieron a seis factores. El total de varianza explicada fue del 40,5 %. En la escala Geriatric Care Environment, 28 ítems fueron adecuados y definieron cinco factores. El total de varianza explicada fue del 59,27 %. En las subescalas Professional Issues, 45 ítems fueron adecuados y definieron a seis factores. El total de varianza explicada fue del 57,78 %. Conclusión La versión brasileña del Geriatric Institucional Assessment Profile es válida y confiable y se puede aplicar para evaluar las percepciones, actitudes y conocimientos sobre los disturbios geriátricos más comunes e identificar las barreras enfrentadas por enfermeros en el desarrollo de una atención de calidad.

Abstract Objective To evaluate the psychometric properties of the Geriatric Institutional Assessment Profile instrument in a sample of Brazilian nurses working in hospitals. Methods Methodological and cross-sectional study, carried out with a sample of 301 nurses who worked in the care of patients in five hospitals, located in the states of Piaui and Minas Gerais. Exploratory factor analysis was used with the extraction of factors by the mean components' method. Then, the Varimax rotation was applied. The following correlated constructs were evaluated: geriatric knowledge (Geriatric Nursing Knowledge/Attitudes scale); one that involves institutional barriers and facilitators of best practices (Geriatric Care Environment scale) and another one that emphasizes the interpersonal relationship and coordinating aspects of professional practice (Professional Issues subscales). Results Exploratory factor analysis indicated that in the Brazilian version of the Geriatric Nursing Knowledge/Attitudes scale, a total of 30 items had adequate factor loadings (>=0.40) and defined six factors. The total explained variance was 40.5%. In the Geriatric Care Environment scale, 28 items were adequate and defined five factors. The total explained variance was 59.27%. In the Professional Issues subscales, 45 items were adequate and defined six factors. The total explained variance was 57.78%. Conclusion The Brazilian version of the Geriatric Institutional Assessment Profile is valid and reliable and can be applied to assess perceptions, attitudes and knowledge about the most common geriatric disorders and identify barriers faced by nurses in the development of quality care.

"We are humans after all": Family caregivers' experience of caring for dependent older adults in Brazil. / "A gente não é de ferro": Vivências de cuidadores familiares sobre o cuidado com idosos dependentes no Brasil.

This paper aims to understand the experiences of family caregivers with dependent older adults in Brazil and the consequences of caring for dependent older adults in the family caregiver's life. This is a qualitative multicenter study employing dialectical hermeneutics as a theoretical framework. In-depth interviews were conducted with 84 family caregivers in Brasília, Rio de Janeiro, Belo Horizonte, Fortaleza, Teresina, Porto Alegre, and Araranguá, and Manaus. The thematic analysis yielded three categories: motivations for taking on the caregiving role, influences on the family caregiver's life, coping, and self-care modalities. The care assumed is influenced by affective relationships with older adults and ethical and moral responsibilities. The influences are related to the lack of preparation for caregiving, financial hardship, restricted freedom, and physical and mental health problems. Coping strategies were religion, spirituality, turn-taking between family caregivers, and learning about the tasks. Women predominate in caregiving due to cultural, ethical, and moral reasons. However, family caregivers often lack guidance and require protection and a support network.

O artigo visa compreender a vivência dos(as) cuidadores(as) familiares com a pessoa idosa dependente no Brasil, bem como entender as consequências dos cuidados de idosos dependentes na vida do cuidador familiar. Estudo multicêntrico, de caráter qualitativo, com referencial teórico hermenêutico-dialético. Foram realizadas entrevistas em profundidade com 84 cuidadores familiares nas cidades de Brasília, Rio de Janeiro, Belo Horizonte, Fortaleza, Teresina, Porto Alegre, Araranguá e Manaus. Da análise temática, emergiram três categorias: motivações para assumir o papel de cuidador; influências na vida do cuidador familiar; e modalidades de enfrentamento e de cuidado de si. O cuidado assumido é influenciado pelas relações afetivas com o idoso e pela responsabilidade ética e, também, moral. As influências dizem respeito a despreparo para o cuidado, dificuldades financeiras, cerceamento da liberdade e problemas de saúde física e mental. A religião, a espiritualidade, a alternância entre os cuidadores familiares no cuidado e o aprendizado sobre essas tarefas foram estratégias de enfrentamento. A mulher predomina no ato de cuidar por motivações culturais, éticas e morais. Mas frequentemente falta orientação aos cuidadores familiares, que precisam de uma rede de apoio e proteção.

"A gente não é de ferro": Vivências de cuidadores familiares sobre o cuidado com idosos dependentes no Brasil / "We are humans after all": Family caregivers' experience of caring for dependent older adults in Brazil

Resumo O artigo visa compreender a vivência dos(as) cuidadores(as) familiares com a pessoa idosa dependente no Brasil, bem como entender as consequências dos cuidados de idosos dependentes na vida do cuidador familiar. Estudo multicêntrico, de caráter qualitativo, com referencial teórico hermenêutico-dialético. Foram realizadas entrevistas em profundidade com 84 cuidadores familiares nas cidades de Brasília, Rio de Janeiro, Belo Horizonte, Fortaleza, Teresina, Porto Alegre, Araranguá e Manaus. Da análise temática, emergiram três categorias: motivações para assumir o papel de cuidador; influências na vida do cuidador familiar; e modalidades de enfrentamento e de cuidado de si. O cuidado assumido é influenciado pelas relações afetivas com o idoso e pela responsabilidade ética e, também, moral. As influências dizem respeito a despreparo para o cuidado, dificuldades financeiras, cerceamento da liberdade e problemas de saúde física e mental. A religião, a espiritualidade, a alternância entre os cuidadores familiares no cuidado e o aprendizado sobre essas tarefas foram estratégias de enfrentamento. A mulher predomina no ato de cuidar por motivações culturais, éticas e morais. Mas frequentemente falta orientação aos cuidadores familiares, que precisam de uma rede de apoio e proteção.

Abstract This paper aims to understand the experiences of family caregivers with dependent older adults in Brazil and the consequences of caring for dependent older adults in the family caregiver's life. This is a qualitative multicenter study employing dialectical hermeneutics as a theoretical framework. In-depth interviews were conducted with 84 family caregivers in Brasília, Rio de Janeiro, Belo Horizonte, Fortaleza, Teresina, Porto Alegre, and Araranguá, and Manaus. The thematic analysis yielded three categories: motivations for taking on the caregiving role, influences on the family caregiver's life, coping, and self-care modalities. The care assumed is influenced by affective relationships with older adults and ethical and moral responsibilities. The influences are related to the lack of preparation for caregiving, financial hardship, restricted freedom, and physical and mental health problems. Coping strategies were religion, spirituality, turn-taking between family caregivers, and learning about the tasks. Women predominate in caregiving due to cultural, ethical, and moral reasons. However, family caregivers often lack guidance and require protection and a support network.

Caracterização do perfil epidemiológico de idosos cadastrados na atenção primária à saúde / Characterization of the health profile of elderly registered persons in primary health care / Caracterización del perfil epidemiológico de ancianos registrados en la atención primaria a la salud

Objetivo: Caracterizar o perfil epidemiológico de idosos cadastrados na Atenção Primária à Saúde do município de Pombal, Paraíba. Método: Estudo transversal, com 307 idosos cadastrados na Atenção Primaria à Saúde, utilizou-sedo instrumento de coleta elaborado pelo Grupo de Pesquisa do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano, da Universidade Federal de Minas Gerais. Resultados: Prevaleceu idosos do sexo feminino (28,3%), casado/união estável (47,9%), católicos (85,3%), que não trabalham (90,6%), aposentados (91,2%), alfabetizados (57,0%), sem consumir bebida alcoólica (90,2%), sem fumar (87,6%) e com problemas de saúde (90,9%). Conclusão: Notoriamente, torna-se imprescindível a realização de medidas voltadas a promoção da saúde e prevenção de danos e agravos, bem como manutenção e reabilitação da saúde, de acordo com os princípios da equidade e integralidade do cuidado, principalmente no tocante a Atenção Primária à Saúde

Objective: To characterize the epidemiological profile of elderly registered in Primary Health Care in the city of Pombal, Paraíba. Method: Cross-sectional study with 307 elderly registered in Primary Health Care, used the collection instrument prepared by the Research Group of the Center for Studies and Research on Care and Human Development, Federal University of Minas Gerais. Results: Female elderly (28,3%), married / stable union (47,9%), Catholics (85,3%), non-working (90,6%), retired (91,2%) prevailed, literate (57,0%), without consuming alcohol (90,2%), without smoking (87,6%) and with health problems (90,9%). Conclusion: Notoriously, it is essential to carry out measures aimed at health promotion and prevention of damage and injuries, as well as maintenance and rehabilitation of health, according to the principles of equity and comprehensive care, especially with regard to Primary Care the health

Objetivo: Caracterizar el perfil epidemiológico de adultos mayores registrados en Atención Primaria de Salud en la ciudad de Pombal, Paraíba. Método: Estudio transversal con 307 adultos mayores registrados en Atención Primaria de Salud, se utilizó el instrumento de recolección preparado por el Grupo de Investigación del Centro de Estudios e Investigación en Atención y Desarrollo Humano, Universidade Federal de Minas Gerais. Resultados: Prevalecieron mujeres de edad avanzada (28,3%), casadas / unión estable (47,9%), católicas (85,3%), no trabajadoras (90,6%), jubiladas (91,2%), alfabetizados (57,0%), sin consumir alcohol (90,2%), sin fumar (87,6%) y con problemas de salud (90,9%). Conclusión: Notoriamente, es esencial llevar a cabo medidas dirigidas a la promoción de la salud y la prevención de daños y lesiones, así como al mantenimiento y rehabilitación de la salud, de acuerdo con los principios de equidad y atención integral, especialmente con respecto a la Atención Primaria la salud

Older adults frailty in Primary Health Care: a geoprocessing-based approach. / Fragilidade em idosos na Atenção Primária à Saúde: uma abordagem a partir do geoprocessamento.

This paper aimed to analyze the spatial distribution of older adults' frailty in primary health care, spatially identifying areas with a concentration of seniors, comparing the demand for care. This is an analytical study that employed spatial analysis with older adults who are frail or at risk of frailty enrolled in Primary Health Care, distributed in 32 census tracts. Concerning geolocation, we used Google Earth Pro software and "C7 GPS Data app", to elaborate the thematic and cadastral maps Qgis 2.16. In total, 43% of seniors were classified as at risk of frailty, of which 79.5% were female, with a mean age of 75 years. The organization of the services showed an unequal distribution of the facilities in the territory, and the three health care settings present or not in some tracts and the concentration of older adults where services were difficult to access. The spatial analysis pointed out the distribution and concentration areas of frailty, favoring the comparison of social vulnerability with the possible care of health services, supporting planning actions and management of the distribution of establishments or projects to visit those in need. Thus, geoinformation tools can strengthen access to health services and provide better living conditions for seniors.

O objetivo foi analisar a distribuição espacial da fragilidade em idosos na atenção primária à saúde identificando espacialmente áreas com concentração de idosos comparando a demanda por atendimento. Estudo analítico que utilizou análise espacial com idosos frágeis ou em risco de fragilização cadastrados na Atenção Primária à Saúde, distribuídos em 32 setores censitários. Para geolocalização utilizou-se software Google Earth Pro e "app C7 GPS Dados", para elaboração dos mapas temático e cadastral o Qgis 2.16. Classificou-se em risco de fragilização 43% dos idosos, sendo 79,5% do sexo feminino, com média de idade 75 anos. A organização dos serviços apresentou distribuição desigual das unidades no território, com os três cenários de atenção à saúde presentes ou não em alguns setores, e concentração de idosos onde os serviços tinham difícil acesso. A análise espacial apontou a distribuição e áreas de concentração da fragilidade, favorecendo a comparação da vulnerabilidade social com a potencialidade de atendimento por parte dos serviços de saúde, dando suporte a ações de planejamento e gestão de distribuição de unidades ou projetos de visita aos necessitados. Assim, as ferramentas de geoinformação são potenciais ao fortalecimento do acesso a serviços de saúde e melhores condições de vida do idoso.

Fragilidade em idosos na Atenção Primária à Saúde: uma abordagem a partir do geoprocessamento / Older adults frailty in Primary Health Care: a geoprocessing-based approach

Resumo O objetivo foi analisar a distribuição espacial da fragilidade em idosos na atenção primária à saúde identificando espacialmente áreas com concentração de idosos comparando a demanda por atendimento. Estudo analítico que utilizou análise espacial com idosos frágeis ou em risco de fragilização cadastrados na Atenção Primária à Saúde, distribuídos em 32 setores censitários. Para geolocalização utilizou-se software Google Earth Pro e "app C7 GPS Dados", para elaboração dos mapas temático e cadastral o Qgis 2.16. Classificou-se em risco de fragilização 43% dos idosos, sendo 79,5% do sexo feminino, com média de idade 75 anos. A organização dos serviços apresentou distribuição desigual das unidades no território, com os três cenários de atenção à saúde presentes ou não em alguns setores, e concentração de idosos onde os serviços tinham difícil acesso. A análise espacial apontou a distribuição e áreas de concentração da fragilidade, favorecendo a comparação da vulnerabilidade social com a potencialidade de atendimento por parte dos serviços de saúde, dando suporte a ações de planejamento e gestão de distribuição de unidades ou projetos de visita aos necessitados. Assim, as ferramentas de geoinformação são potenciais ao fortalecimento do acesso a serviços de saúde e melhores condições de vida do idoso.

Abstract This paper aimed to analyze the spatial distribution of older adults' frailty in primary health care, spatially identifying areas with a concentration of seniors, comparing the demand for care. This is an analytical study that employed spatial analysis with older adults who are frail or at risk of frailty enrolled in Primary Health Care, distributed in 32 census tracts. Concerning geolocation, we used Google Earth Pro software and "C7 GPS Data app", to elaborate the thematic and cadastral maps Qgis 2.16. In total, 43% of seniors were classified as at risk of frailty, of which 79.5% were female, with a mean age of 75 years. The organization of the services showed an unequal distribution of the facilities in the territory, and the three health care settings present or not in some tracts and the concentration of older adults where services were difficult to access. The spatial analysis pointed out the distribution and concentration areas of frailty, favoring the comparison of social vulnerability with the possible care of health services, supporting planning actions and management of the distribution of establishments or projects to visit those in need. Thus, geoinformation tools can strengthen access to health services and provide better living conditions for seniors.

Brazilian public policy for chronic kidney disease prevention: challenges and perspectives.

Chronic kidney disease is a pathology with exponential increasing prevalence worldwide. This trend derives mainly from population aging and the growth of chronic conditions, making prevention a priority in public health. Thus, this observation instigates debates on the advances and challenges in public policies aimed at facing the progression of this disease and its risk factors in a contemporary reality that requires changes in the management models of chronic conditions. Brazilian and international experiences show that actions to prevent chronic kidney disease in risk groups remain incipient, especially in low-income countries. This area requires investment, supporting planning individualized, interdisciplinary and shared care with primary health care, as well as the user's responsibility for their care, with proactivity and establishment and monitoring of goals to achieve satisfactory results.

Quality of life of older adults admitted to a Medical Clinic Unit of a Public Hospital in Brazil.

OBJECTIVE: To evaluate the quality of life of older adults admitted to the Medical Clinic Unit of a public hospital in Belo Horizonte, Brazil, to correlate the quality of life with the functionality proposed by the Katz index, and to characterize the clinical and epidemiological profile of the studied population. METHOD: This is a descriptive cross-sectional study with a quantitative approach. Data collection was performed through applying the Nottingham Health Profile instrument and the Katz Index instrument. RESULTS: 116 older adults participated. The quality of life found in the study was considered good. It correlated with the Katz index (the more dependent, the worse the quality of life), the number of comorbidities (the higher the number of comorbidities, the worse the quality of life) and the family structure who lived with the older adults (there was worse quality of life for older adults who lived with their children). CONCLUSION: In this study it was found that the quality of life in the evaluated sample was good and that it is related to functionality, the number of comorbidities and with whom the older adult lives. Thus, poor quality of life cannot be associated with hospitalization in this sample.

Oral interactions between a green tea flavanol extract and red wine anthocyanin extract using a new cell-based model: insights on the effect of different oral epithelia.

Phenolic compounds (PC) are linked to astringency sensation. Astringency studies typically use simple models, with pure PC and/or proteins, far from what is likely to occur in the oral cavity. Different oral models have been developed here, comprising different oral epithelia (buccal mucosa (TR146) and tongue (HSC-3)) and other main oral constituents (human saliva and mucosal pellicle). These models, were used to study the interaction with two PC extracts, one rich in flavanols (a green tea extract) and one rich in anthocyanins (a red wine extract). It was observed that within a family of PC, the PC seem to have a similar binding to both TR146 and HSC-3 cell lines. When the oral constituents occur altogether, flavanols showed a higher interaction, driven by the salivary proteins. Conversely, anthocyanins showed a lower interaction when the oral constituents occur altogether, having a higher interaction only with oral cells. Epigallocatechin gallate, epicatechin gallate, epigallocatechin-3-O(3-O-methyl) gallate were the flavanols with the highest interaction. For the studied anthocyanins (delphinidin-3-glucoside, peonidin-3-glucoside, petunidin-3-glucoside and malvidin-3-glucoside), there was not a marked difference on their interaction ability. Overall, the results support that the different oral constituents can have a different function at different phases of food (PC) intake. These differences can be related to the perception of different astringency sub-qualities.

Tannins in Food: Insights into the Molecular Perception of Astringency and Bitter Taste.

Astringency and bitterness are organoleptic properties widely linked to tannin compounds. Due to their significance to food chemistry, the food industry, and to human nutrition and health, these tannins' taste properties have been a line of worldwide research. In recent years, significant advances have been made in understanding the molecular perception of astringency pointing to the contribution of different oral key players. Regarding bitterness, several polyphenols have been identified has new agonists of these receptors. This review summarizes the last data about the knowledge of these taste properties perceived by tannins. Ultimately, tannins' astringency and bitterness are hand-in-hand taste properties, and future studies should be adapted to understand how the proper perception of one taste could affect the perception of the other one.

Drowsiness and distraction while driving: A study based on smartphone app data.

INTRODUCTION: Due to the negative impact on road safety from driver drowsiness and distraction, several studies have been conducted, usually under driving simulator and naturalistic conditions. Nevertheless, emerging technologies offer the opportunity to explore novel data. The present study explores retrospective data, which was gathered by an app designed to monitor the driver, which is available to any driver owning a smartphone. METHOD: Drowsiness and distraction alerts emitted during the journey were aggregated by continuous driving (called sub-journey). The data include 273 drivers who made 634 sub-journeys. Two binary logit models were used separately to analyze the probability of a drowsiness and distraction event occurring. Variables describing the continuous driving time (sub-journey time), the journey time (a set of sub-journeys), the number of breaks, the breaking duration time and the first sub-journey (categorical variable) were included. Additionally, categorical variables representing the gender and age of the drivers were also incorporated. RESULTS: Despite the limitations of the retrospective data, interesting findings were obtained. The results indicate that the main risk factor of inattention is driving continuously (i.e., without stopping), but it is irrelevant whether the stop is long or short as well as the total time spent on the journey. The probability of distraction events occurring during the journey is higher than drowsiness events. Yet, the impact of increasing the driving time of the journey and stopping during the journey on the probability of drowsiness is higher than the probability of distraction. Additionally, this study reveals that the elderly are more prone to drowsiness. The data also include a group of drivers, who did not provide information on gender and age, who were found to be associated to drowsiness and distraction risk. CONCLUSIONS: The study shows that data gathered by an app have the potential to contribute to investigating drowsiness and distraction. Practical applications: Drivers are highly recommended to frequently stop during the journey, even for a short period of time to prevent drowsiness and distraction.

Driving simulator experiments to study drowsiness: A systematic review.

Objective: The National Highway Traffic Safety Administration in the USA estimated that the effects of drowsiness while driving led to approximately 72,000 crashes, 44,000 injuries, and 800 deaths in 2013. Keeping this in mind, the risk and injuries of drowsy driving remain a major safety issue that clearly needs to be studied. Our purpose was to conduct a systematic review of international literature including studies on driving behavior associated to drowsy and fatigued drivers. The research focused on the prediction and effects of drowsiness, and particularly on studies based on driving in simulated environments. Additionally, we searched for studies related to driving simulators, in general, to better understand the tool's efficacy and its advantages and disadvantages.Methods: This review was made in accordance with PRISMA statement guidelines. After conducting in-depth research in targeted databases, 23 studies met the inclusion criteria; the papers were analyzed regarding the type of experiment and procedures and driving performance of 690 participants was studied.Results: Studies revealed that drowsiness have effects on driving performance and these effects become more relevant with time-on-task and in monotonous scenarios and landscapes. In addition, some documents include validations of several technologies to detect and predict sleepiness.Conclusions: Overall, we can conclude that drowsiness and fatigue impair driving performance, resulting in drivers who are more exposed to risky situations.

Interaction of polyphenols with model membranes: Putative implications to mouthfeel perception.

Food polyphenols in fruits juices, tea, coffee, wine and beer confer sensory properties such as colour, astringency and bitterness. The development of functional healthy drinks without the unpleasant sensory feeling is boosting research for a clearer understanding on the interactions of polyphenols within the oral mucosa. In this study we investigated the interaction of astringent polyphenols, namely ECG, EGCG, procyanidin B4 and PGG, with lipids in model membranes by spectroscopic techniques. The membrane model was built varying the cholesterol content to mimic mouth regions and experiments were conducted at pH 5 to mimic the pH drop at the moment of beverage (e.g. green tea, red wine) intake. Fluorescence quenching results conducted on LUVs with cholesterol molar fractions ranging between 0.34 < χchol < 0.74 and similar size distributions (122.9 ± 3.7 nm) showed that interaction of polyphenols is structure- and concentration-dependent. Also, the decrease of partition constants (Kp) with increasing cholesterol content (χchol) suggest that the affinity of polyphenols is weaker in cholesterol-rich liposomes. STD results revealed that the interaction of EGCG and PGG with membrane lipids involved mainly galloyl residues. Overall, spectroscopic data show that polyphenols interact to higher extent with more polar regions found in buccal, flour of the mouth and gingiva regions than with more hydrophobic regions located in the palate and tongue supporting that lipid microenvironments play a role in oral sensory perception.

Fragilidade em pessoas idosas atendidas na atenção secundária: fatores associados / Frailty of old people treated in secondary health care: associated factors

Resumo Objetivo Avaliar a associação entre características sociodemográficas, econômicas, clínicas e comportamentais e o grau de fragilidade de pessoas idosas atendidas na atenção secundária à saúde. Método Estudo transversal, analítico, realizado entre maio e setembro de 2018, com 376 pessoas idosas atendidas em um Centro de Especialidades Médicas de Belo Horizonte (MG, Brasil), selecionadas pelo método de amostragem aleatória sistemática. Os dados foram coletados por meio de entrevistas e testes da avaliação do fenótipo de fragilidade, sendo analisados por meio de estatística descritiva, análise bivariada e multivariada, com o Modelo de Chances Proporcionais. Resultados A prevalência de fragilidade foi de 25,3%. As variáveis significativamente relacionadas com a maior chance da presença de fragilidade na pessoa idosa foram: sexo feminino, baixa escolaridade, internação e quedas nos últimos 12 meses, uso de dispositivo de auxílio à marcha e ausência de prática de atividade física. Conclusão O conhecimento dos fatores associados à fragilidade permite melhorar o planejamento das ações de saúde, intervir nos fatores modificáveis que estão relacionados com a fragilidade, prevenindo sua instalação, a ocorrência de eventos negativos decorrentes dessa síndrome ou mesmo reverter seu estágio. Os resultados demonstram a importância dos gestores dos serviços de atenção secundária, implantarem uma metodologia de identificação da fragilidade em pessoas idosas, bem como, um modelo de cuidado ao idoso frágil para acompanhamento e monitoramento das condições clínicas.

Abstract Objective To evaluate the association between sociodemographic, economic, clinical, and behavioral characteristics and the degree of frailty of old people treated in secondary health care. Method Cross-sectional, analytical study carried out between May and September, 2018 with 376 old people treated at a Center of Medical Specialties of Belo Horizonte (MG, Brazil) selected by the random systematic sampling method. Data was collected by interviews and tests to assess the frailty phenotype, being analyzed using descriptive statistics, bivariate, and multivariate analysis using the Proportional Odds Model. Results The prevalence of frailty was 25.3%. The variables significantly related to the greater chance of presence of frailty in the old people were female gender, low education, hospitalization and falls in the last 12 months, use of walking aid and absence of physical activity. Conclusion The knowledge on the factors associated with frailty allows to improve the planning of health actions and to intervene in the modifiable factors related to frailty, thus preventing its onset, the occurrence of negative events resulting from this syndrome, or even reversing its stage. The results demonstrate the importance of managers of the secondary health care services implementing a methodology to identify frailties in old people, as well as a health care model for the fragile old person to follow and monitor their clinical conditions.