Demographic and Epidemiological Profile of Aging and Elderly Patients Receiving Heart Transplant During the Period from 2009 to 2018

Abstract Background: The aging process may be associated with the accumulation of a wide variety of health damages, such as cardiovascular diseases. HF is the final common path of the majority of these diseases, and, in its refractory form, heart transplantation continues to be the best treatment choice. Objective: To describe the demographic and epidemiological profile of aging and elderly patients receiving heart transplant from 2009 to 2018. Methods: Retrospective, descriptive longitudinal study on heart transplantation in aging and elderly patients using data from medical records and institutional documents. Results: From a total of 234 transplant recipients, 127 were 45 years or older. For the demographic profile, the variables used were sex, age, marital status, home state, and profession. For the epidemiological profile, the variables used were previous diagnosis, comorbidities before and after transplantation, and survival. Age varied from 45 to 74 years, with a mean of 57 years. The male sex accounted for 58.27% of recipients, and 59.84% were from the Federal District. Chagas, dilated, and ischemic cardiomyopathy accounted for 66.14%, 18.9%, and 14.17% of transplants, respectively. The main comorbidities were Chagas disease (66.14%), malignant arrhythmia requiring cardioverter-defibrillator implantation (28.35%), arterial hypertension (27.56%), and dyslipidemia (15.75%). Mean survival was 3 years and 4 months. Conclusion: The demographic profile showed that the majority of patients were aging, male, married, and from the Federal District. The epidemiological profile showed that Chagas cardiomyopathy was the main cause of HF, followed by dilated cardiomyopathy.

[Human papillomavirus vaccine receptivity: a systematic reviewReceptividad con respecto a la vacuna contra el virus del papiloma humano: revisión sistemática]. / Receptividade à vacina contra o papilomavírus humano: uma revisão sistemática.

OBJECTIVE: To characterize the receptivity to human papillomavirus (HPV) vaccine and to describe factors that hinder or facilitate receptivity. METHOD: A systematic review was performed based on the 2015 PRISMA protocol. MEDLINE and Web of Science were searched using combinations of the terms papillomavirus, vaccine, adherence, and acceptance to identify articles published from 2006 to 2017. Original articles published in any language were included, and duplicate articles were excluded. Information was collected regarding article identification, methodological design, sample characteristics, and description of contents. Receptivity was characterized in terms of acceptance and adherence. RESULTS: Of 212 articles identified, 10 were selected for analysis. Most showed favorable, but heterogeneous, receptivity, with more acceptance than adherence, especially on the part of female adolescents. The analysis identified 11 facilitators and nine barriers to receptivity, especially knowledge of the theme and individual pattern of behavior regarding the problem. The analysis also detected the absence of a standardized method to evaluate receptivity and the imprecision of the concepts associated with acceptance and adherence. Therefore, a definition was proposed for acceptance (voluntary intention of receiving the vaccine or agreement that the vaccine is a good prevention strategy) and adherence (initiation and completion of the vaccination scheme). CONCLUSIONS: Additional studies are required to further investigate predictors of receptivity. For that, the development of an instrument based on the perceptions of target publics and employing precise concepts of acceptance and adherence is recommended, so as to allow a better understanding of the phenomenon and stimulate adherence and the achievement of adequate vaccine coverage.

OBJETIVO: Caracterizar la receptividad con respecto a la vacuna contra el virus del papiloma humano (VPH) y describir los factores inhibidores o facilitadores correspondientes. MÉTODOS: Se trata de una revisión sistemática según el protocolo PRISMA 2015. Se consultaron las bases de datos MEDLINE y Web of Science, utilizando combinaciones de los términos "papilomavirus", "vaccine" [vacuna], "adherence" [adhesión] y "acceptance" [aceptación] para encontrar artículos publicados desde el 2006 hasta el 2017. Se incluyeron artículos originales en cualquier idioma y se excluyeron los artículos duplicados. Se analizaron la identificación del artículo, la tipificación metodológica y las características de la muestra. La receptividad se caracterizó en términos de aceptación y adhesión. RESULTADOS: Se encontraron 212 artículos de los cuales se seleccionaron 10 para el análisis. En la mayoría de los estudios se demostró una receptividad favorable, pero heterogénea, con mayor aceptación que adhesión, principalmente por parte de adolescentes del sexo femenino. Se identificaron once factores facilitadores y nueve inhibidores de la receptividad, entre los cuales se destacan el conocimiento del tema y el patrón de comportamiento individual frente al problema. Se observó que faltaba un método normalizado que permitiera evaluar la receptividad y la imprecisión de los conceptos relacionados con la aceptación y la adhesión. Por lo tanto, se propuso una definición de aceptación (intención voluntaria de recibir una vacuna o expresión de acuerdo de que la vacuna representa una buena estrategia preventiva) y adhesión (acto de iniciar y finalizar el esquema de vacunación). CONCLUSIONES: Se necesitan nuevos estudios para profundizar el análisis de los factores de predicción de la receptividad. Para ello, se sugiere la creación de un instrumento basado en la percepción del público destinatario y el empleo de conceptos precisos de aceptación y adhesión, con el fin poder comprender mejor el fenómeno y fomentar la adhesión y el logro de tasas adecuadas de cobertura con la vacuna.

Safety culture in the operating room of a public hospital in the perception of healthcare professionals.

OBJECTIVE: To evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). METHOD: Descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. RESULTS: Participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD ± 9.2) years. And Cronbach's α of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. CONCLUSIONS: The results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.