Made available in DSpace on 2016-06-02T19:48:19Z (GMT). No. of bitstreams: 1 4120.pdf: 2761694 bytes, checksum: 77e96b493fdc70a42e1b17d0da1db90a (MD5) Previous issue date: 2012-01-26 / Financiadora de Estudos e Projetos / Culturally, care delivered to elderly individuals in Brazil is usually provided by families. Even though only 1% of the Brazilian population older than 60 years of age is cared for in long stay institutions, the search for this type of facility has increased, mainly due to population aging and new family arrangements. This study analyzes the relation between family functionality and the variables of age, gender, duration of institutionalization, family composition, depressive symptoms and cognitive changes in elderly individuals residing in long stay facilities in a city in the interior of São Paulo, SP, Brazil. This is a quantitative cross- sectional study with a descriptive correlational design. A total of 107 elderly individuals were individually interviewed using the following: Family APGAR, Mini State Mental Exam, Katz Index, Pfeffer Functional Activities Questionnaire and Geriatric Depression Scale. Outcomes were analyzed by logistic regression analysis using the hierarchical analysis using the Stepwise technique. This study complied with all ethical aspects. In relation to socio-demographic characteristics, the institutionalized elderly individuals were mostly older elderly women (61%), (45%)with a low education level, (87%) Catholic and (45%) widowed. Most independently performed basic daily living activities (46%), but were dependent for instrumental activities of daily living, had depressive symptoms (67%) and cognitive impairment (53%). The results show that 57% of the elderly individuals had a high level of family dysfunction, 22% had good family functionality and 21% moderate family dysfunction. No statistically significant association was found between the family APGAR and the variables gender and age. Elderly individuals with families composed of more distant relatives such as siblings, nephews and nieces, with greater time of institutionalization, depressive symptoms and cognitive impairment were also more dysfunctional. The institutionalization of elderly with time over 3 years (OR = 3.861, p = 0.0285), presence of depressive symptoms (OR = 5.378, p = 0.0044) and family composition formed by brothers / Nephews / Other (OR = 6.812, p = 0.0155) are more likely to experience family dysfunction. These findings can contribute to planning for care delivered to the family of institutionalized families. / No Brasil, o cuidado com os idosos é culturalmente realizado pelas famílias. Embora apenas 1% da população brasileira com mais de 60 anos seja cuidada em Instituições de Longa Permanência para Idosos - ILPI, a procura por esse tipo de instituição tem sido cada vez maior em função, principalmente, do envelhecimento populacional e dos novos arranjos familiares. O objetivo deste estudo foi analisar a relação entre funcionalidade familiar e as variáveis idade, gênero, tempo de institucionalização, composição familiar, sintomas depressivos e alterações cognitivas de idosos que residem em instituições de longa permanência em uma cidade do interior de São Paulo. Trata-se de um estudo quantitativo, transversal com desenho descritivo-correlacional. Para a coleta de dados, foram realizadas entrevistas individuais com 107 idosos institucionalizados, em São Carlos SP. Foram aplicados os seguintes instrumentos: APGAR de Família, Mini Exame do Estado Mental, Índice Katz, Questionário de Atividades Funcionais e Pfeffer e Escala de Depressão Geriátrica. Os desfechos foram analisados por meio da análise de Regressão Logística, utilizando a análise hierarquizada, utilizando a técnica Stepwise. Todos os cuidados éticos foram observados. Com relação às características sóciodemográficas, os idosos institucionalizados são em sua maioria mulheres (61%), mais longevas (45%), com baixa escolaridade (46%), católicas (87%) e viúvas (45%). A maioria é independente para as atividades básicas da vida diária (46%), dependente para as atividades instrumentais de vida diária (69%), apresentam sintomas depressivos (67%) e alterações cognitivas (53%). Os resultados mostram que 57% dos idosos apresentam elevada disfunção familiar, 22% apresentam boa funcionalidade familiar e 21% moderada disfunção familiar. Não houve associação estatisticamente significante entre o APGAR de Família e as variáveis sexo e idade. Idosos com composição familiar formada por pessoas mais distantes como irmãos/sobrinhos e outros, com maior tempo de institucionalização, com presença de sintomas depressivos e com alterações cognitivas apresentaram-se mais disfuncionais. O idoso com tempo de institucionalização acima de 3 anos (OR = 3,861; p= 0,0285 ), com presença de sintomas depressivos (OR = 5,378; p = 0,0044 ) e com composição familiar formada por Irmãos/Sobrinhos/Outros (OR = 6,812; p = 0,0155 ) tem maior chance de apresentarem disfunção familiar. Esses resultados poderão contribuir para um planejamento do cuidado da família dos idosos institucionalizados.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-12-12T12:41:39Z No. of bitstreams: 1 arquivototal.pdf: 1213951 bytes, checksum: c7704bea9766d8565d69b430bd11c064 (MD5) / Made available in DSpace on 2016-12-12T12:41:39Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1213951 bytes, checksum: c7704bea9766d8565d69b430bd11c064 (MD5) Previous issue date: 2016-05-30 / The pressure ulcers (PU) is a skin complication due to the pressure exerted on the region of bony prominence combined with friction. Objective: To analyze the risk and the prevalence of pressure ulcers in the elderly of Institutions of long permanence for the elderly in the city of Joao Pessoa. Methodology: This is a cross-sectional study, population-based and of quantitative approach, performed from the analysis of part of the database coming from the research entitled "Prevalence and Incidence of Pressure Ulcer in Institutions of Long Permanence for the Elderly in Joao Pessoa”. For the analysis of the database, the SPSS version 20.0 was used. Results: The sociodemographic data revealed that 128 (39.5%) elderly individuals were between 80- 90 years old, 244 (75.3%) were females, 289 (89.2%) single and 192 (59.3%) were institutionalized for less than five years. The prevalence of pressure ulcers corresponded to 26 cases (8%), of which 20 (77%) had only one injury, 16 (61.5%) in Stage I and 8 (30.8%) developed the lesion in the sacral region. The clinical conditions of statistically significant associations with the occurrence of PU were the variables neurological diseases (p = 0.011) and changes in vision (p = 0.005). Regarding the risk factors, fecal incontinence (p <0.001), urinary incontinence (p <0.001), cognitive deficit (p <0.007) and physical limitation (p <0.001) stood out. The strength of association evidenced by the contingency coefficient was moderate for cognitive deficit (0.375) and fecal incontinence (0.365). The results of the logistic regression model revealed that urinary incontinence increases eight times the chance of occurrence of pressure ulcers (OR = 8.805) and five times osteoarticular disorders (OR = 5,899). Conclusion: The study allowed the expansion of the knowledge about the clinical conditions, risk factors and pressure ulcers in institutionalized elderly in the capital of Paraiba, giving contributions to researches addressing the theme and to the professionals who work in these institutions, considering there is still scarcity of studies in these scenarios. / A úlcera por pressão (UPP) é uma complicação de pele decorrente da pressão exercida na região de proeminência óssea combinada ao atrito. Objetivo: Analisar o risco e a prevalência de úlcera por pressão em idosos de instituições de longa permanência para idosos no município de João Pessoa. Metodologia: Trata-se de estudo transversal, de base populacional e abordagem quantitativa, realizado a partir da análise de parte do banco de dados proveniente da pesquisa intitulada “Prevalência e Incidência de úlcera por pressão em Instituições de Longa Permanência para Idosos em João Pessoa”. Para análise do banco de foi utilizado o SPSS, versão 20.0. Resultados: Os dados sociodemográficos revelaram que 128 (39,5%) idosos tinham entre 80-90 anos, 244 (75,3%) eram do sexo feminino, 289 (89,2%) solteiros e 192 (59,3%) estavam institucionalizados há menos de cinco anos. A prevalência de úlcera por pressão correspondeu a 26 casos (8%), dos quais 20 (77%) tiveram apenas uma lesão, 16 (61,5%) em Estágio I e 8 (30,8%) desenvolveram a lesão na região sacral. As condições clínicas de associações estatisticamente significativas com a ocorrência de UPP foram as variáveis doenças neurológicas (p=0,011) e alteração da visão (p=0,005). Quanto aos fatores de risco destacaram-se incontinência fecal (p<0,001), incontinência urinária (p<0,001), déficit cognitivo (p<0,007) e limitação física (p<0,001). A força de associação evidenciada pelo coeficiente de contingência foi moderada para déficit cognitivo (0,375) e incontinência fecal (0,365). Os resultados do modelo de regressão logística revelaram que incontinência urinária aumenta oito vezes a chance de ocorrência da úlcera por pressão (OR=8,805) e doenças ostearticulares cinco vezes (OR=5,899). Conclusão: O estudo permitiu ampliar o conhecimento acerca das condições clínicas, fatores de risco e úlcera por pressão em idosos institucionalizados da capital paraibana, conferindo contribuições às pesquisas que abordam a temática e aos profissionais que atuam nessas instituições, uma vez que ainda são escassos os estudos nesses cenários.

Made available in DSpace on 2016-12-06T17:07:16Z (GMT). No. of bitstreams: 1 CRISTINA BRUST.pdf: 1148189 bytes, checksum: 4c679b5c7a4fd2aa51d98dbc0f7178ff (MD5) Previous issue date: 2008-03-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The objective of this research is to present the implementation of the Active Aging exercise program in Health Centers (HC) and its influence in the functional aptitudes of the paticipant aged women. The research was carried through in four HC of Florianópolis (Córrego Grande, Rio Tavares, Saco Grande and Estreito Polyclinic), participants of the Aged Health program, which develops the Active Aging exercise program. This study is characterized as the descriptive type and was divided in two stages. In the first one the implementation of the program was investigated. The collection of this stage was carried ugh by means of interviews and questionnaires where took part in the sample the HC doctor, nurse and some other employee (receptionist, administrative assistant,...) of each participant HC, the teachers/trainees and the aged women who participate in the exercise program since its beginning, in July of 2006. The qualitative method for content analysis was used for the data analysis. In a second stage the functional aptitude of the aged women was evaluated through the Battery of Tests of the American Alliance of Health, Physical Education, Recreation and Dance AAHPERD, which is composed of five motor tests that evaluate components of the functional aptitude. The sample was composed of aged women who participate in the exercise program since its beginning, in July of 2006, and who took part in the collections of July/2006, December/2006, March/2007 and July/2007. The data was organized in the Microsoft Excel program and analyzed in the statistical program SPSS 13.0 for Windows. For the results analysis a MANOVA with a reliable interval of 95% was used. It was evidenced that the program had an influence on the physical aptitudes (F(15)= 9,311; p<0,001), acting with a general effect of 49% (&#951;²=0,49). Through comparison analyses of the main effects, it was evidenced that the variables that contributed the most for such were coordination, aerobic resistance and upper body strength. However, for the aptitudes flexibility and agility, no significant difference was observed. For the city in study, to evaluate the implementation of an exercise program for aged, in a model of attention to the promotion of the population life quality is necessary, because to subsidize researches with data based on significant experiences that can favor the improvement of this strategy also contributes for the rising of new intervention proposals, aiming to integrate them to the community demands. / O objetivo desta pesquisa é descrever a implementação do programa de ginástica Idoso Ativo nos Centros de Saúde (CS) e sua influência nas aptidões funcionais das idosas participantes. A pesquisa foi realizada em quatro CS de Florianópolis (Córrego Grande, Rio Tavares, Saco Grande e Policlínica do Estreito), participantes do programa Saúde do Idoso, o qual desenvolve o programa de ginástica Idoso Ativo. Este estudo é caracterizado do tipo descritivo e foi dividido em duas etapas. Na primeira foi investigada a implementação do programa. A coleta desta etapa foi realizada por meio de entrevistas e questionários onde fizeram parte da amostra o médico responsável pelo CS, enfermeiro e algum outro funcionário (recepcionista, auxiliar administrativo,...) de cada CS participante, as professoras/estagiárias e as idosas que participam do programa de ginástica desde o seu início, no mês de julho de 2006. Utilizou-se o método qualitativo de análise de conteúdo para a análise dos dados. Na segunda etapa foi avaliada a aptidão funcional das idosas através da Bateria de Testes da American Alliance for Health, Physical Education, Recreation and Dance AAHPERD, a qual é composta por cinco testes motores que avaliam componentes da aptidão funcional. A amostra foi composta pelas idosas que participam do programa de ginástica desde o seu início, no mês de julho de 2006, e que realizaram as coletas em julho/2006, dezembro/2006, março/2007 e julho/2007. Os dados foram organizados no programa Microsoft Excel e analisados no programa estatístico SPSS 13.0 for Windows. Para a análise dos resultados encontrados foi utilizada uma MANOVA com intervalo de confiança de 95%. Constatou-se que o programa influenciou nas aptidões físicas (F(15)= 9,311; p<0,001), agindo com um efeito geral de 49% (&#951;²0,49). Através de análises de comparação dos efeitos principais, constatou-se que as variáveis que mais contribuíram para tal foram a coordenação, resistência aeróbica e a força dos membros superiores. Contudo, para as aptidões flexibilidade e agilidade, não se observou diferença significativa. Para o município em estudo, avaliar a implementação de um programa de ginástica para idosos, num modelo de atenção na promoção da qualidade de vida da população se faz necessário, pois subsidiar pesquisas com dados baseados em experiências significativas que possam favorecer o aperfeiçoamento desta estratégia contribui também para a iniciativa de novas propostas de intervenção, visando integrá-las às demandas da comunidade.

No description available.

This research investigated the influence of the normal aging process on truly photopic achromatic and chromatic retinal increment threshold over an extensive range of colored targets. It was found that for both achromatic and chromatic retinal thresholds there is a significant correlation between advancing age and the stimulus luminance intensity at threshold across the visible spectrum. This correlation is greater for the short wavelength range than for both the middle and the long wavelength ranges (r² (achromatic)= 0.43; r²(chromatic) = 0.49. In addition, a small exploratory study was completed which examined the role of prereceptoral changes in these age-related differences in color vision function. Results from this preliminary study (Experiment II) support the supposition that prereceptoral factors cannot account for all of the age-related losses that are seen in visual function, particularly in the middle and long wavelength ranges of the visible spectrum. / Arts, Faculty of / Psychology, Department of / Graduate

Many mid-life daughters are primary caregivers to their elderly mothers. However, in most research studies daughters have been grouped with other caregivers; thus, the daughters' experiences have not been specifically identified. Without this information nurses will be unable to adequately assist mid-life caregiving daughters to attain their optimal levels of health. The phenomenological research method was the methodology used to elicit the experiences of the mid-life daughters. The phenomenological method was congruent with the feminist perspective -- the conceptual framework -- which guided the study. The feminist perspective elucidated the importance of eliciting not only the visible caregiving experiences of the mid-life daughters, but also their internal experiences -- their feelings -- and the meanings they gave to their experiences. The researcher recruited subjects for the study through a daughters-of-aging-parents program which was held at the Women's Resource Centre in Vancouver, British Columbia. In order to collect the data, the researcher interviewed the subjects. Congruent with the phenomenological method, data collection and data analysis ran concurrently throughout the study. The conclusions that the researcher drew from the findings of this study include the following: at the start of a caregiving daughter-mother relationship, a daughter is very responsive to the needs of her mother; when a daughter realizes that she is self-sacrificing herself in order to care for her mother, she becomes less responsive to her mother's needs and focuses, instead, on caring for herself; a daughter who is able to identify her own needs and then act on them Is able to care for her mother and herself in a manner that meets both their needs; a daughter experiences a number of emotions while providing care for her mother; a daughter uses the logical process of working towards healthy differentiation in order to counterbalance her emotional reactivity, and a daughter who successfully counterbalances her emotions with logic discovers her basic self and becomes an entity distinct from, yet interdependent with, her mother. / Applied Science, Faculty of / Nursing, School of / Graduate

The purpose of this research was to model the growth and yield of bottomland hardwood forests of the Lower Mississippi Alluvial Valley and to explain the economic tradeoffs of even- and uneven-aged management. The US Forest Service (USFS) Forest Vegetation Simulator was used to model growth and yield for four different bottomland hardwood forest types using USFS inventory data. Even- and uneven-aged management scenarios were optimized for timber revenue maximization using the Land Expectation Value formula. Analyses suggested that growth and yield of even-aged and uneven-aged management approaches differ in terms of end products and harvesting time. The even-aged management scenarios performed better over the uneven-aged management scenarios with few exceptions; however, the magnitude of the economic tradeoff depended upon initial stand conditions and required rates of return. These analyses will allow landowners to understand how much economic gain or loss they may realize by adopting an alternative management.

This article explores homeless individuals' experiences of satisfaction with health care, and explores the interrelationship among experiences of being homeless, health perceptions of participants, and experiences of satisfaction with health care. It presents the findings of a phenomenological study that was conducted using participants selected from five sites in one southeastern state. Participant interviews were conducted at a nurse-managed primary health care clinic for homeless, at a night time soup-kitchen, and at three private, not-for-profit, homeless shelters in two different towns. The study was part of a larger study designed to develop and validate a reliable measure of client satisfaction with primary health care among homeless individuals. Face-to-face in-depth interviews with 17 homeless individuals were conducted, with the semistructured interview constituting the primary data source. Common themes were identified and the interrelationship of theme clusters was explored. Analysis of the data yielded five distinct themes that represent the lived experiences of satisfaction with health care. These themes were mediated and directly informed by five themes of homelessness and three themes of health identified in the shared experiences of the participants. The themes identified suggest that satisfaction with health care for homeless persons differs from currently identified dimensions of satisfaction with care, and that some aspects of homelessness are seen by participants as positive and health promoting.

Yes / To determine whether or not jugular venous reflux (JVR) is associated with structural brain parenchyma changes in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD). 16 AD patients (mean (SD): 81.9 (5.8) years), 33 MCI patients (mean (SD): 81.4 (6.1) years) and 18 healthy elderly controls (mean (SD): 81.5 (3.4) years) underwent duplex ultrasonography and magnetic resonance imaging scans to quantify structural brain parenchyma changes. Normalized whole brain (WB), gray matter (GM) and white matter (WM) volumes were collected, together with CSF volume. JVR was strongly associated with increased normalized WB (p = 0.014) and GM (p = 0.002) volumes across all three subject groups. There was a trend towards increased WB and GM volumes, which was accompanied by decreased CSF volume, in the JVR-positive subjects in both the MCI and AD groups. When the MCI and AD subjects were aggregated together significant increases were observed in both normalized WB (p = 0.009) and GM (p = 0.003) volumes for the JVR-positive group. No corresponding increases were observed for the JVR-positive subjects in the control group. Through receiver operating characteristic analysis of the brain volumetric data it was possible to discriminate between the JVR-positive and negative AD subjects with reasonable accuracy (sensitivity = 71.4%; specificity = 88.9%; p = 0.007). JVR is associated with intracranial structural changes in MCI and AD patients, which result in increased WB and GM volumes. The neuropathology of this unexpected and counterintuitive finding requires further investigation, but may suggest that JVR retrogradely transmits venous hypertension into the brain and leads to brain tissues swelling due to vasogenic edema.

No / There is a substantial body of evidence that prescribing for care home residents is suboptimal and requires improvement. Consequently, there is a need to identify effective interventions to optimise prescribing and resident outcomes in this context. OBJECTIVES: The objective of the review was to determine the effect of interventions to optimise prescribing for older people living in care homes. SEARCH METHODS: We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library (Issue 11, 2012); Cochrane Database of Systematic Reviews, The Cochrane Library (Issue 11, 2012); MEDLINE OvidSP (1980 on); EMBASE, OvidSP (1980 on); Ageline, EBSCO (1966 on); CINAHL, EBSCO (1980 on); International Pharmaceutical Abstracts, OvidSP (1980 on); PsycINFO, OvidSP (1980 on); conference proceedings in Web of Science, Conference Proceedings Citation Index - SSH & Science, ISI Web of Knowledge (1990 on); grey literature sources and trial registries; and contacted authors of relevant studies. We also reviewed the references lists of included studies and related reviews (search period November 2012). We included randomised controlled trials evaluating interventions aimed at optimising prescribing for older people (aged 65 years or older) living in institutionalised care facilities. Studies were included if they measured one or more of the following primary outcomes, adverse drug events; hospital admissions;mortality; or secondary outcomes, quality of life (using validated instrument); medication-related problems; medication appropriateness (using validated instrument); medicine costs. Two authors independently screened titles and abstracts, assessed studies for eligibility, assessed risk of bias and extracted data. A narrative summary of results was presented. The eight included studies involved 7653 residents in 262 (range 1 to 85) care homes in six countries. Six studies were cluster-randomised controlled trials and two studies were patient-randomised controlled trials. The interventions evaluated were diverse and often multifaceted. Medication review was a component of seven studies, three studies involved multidisciplinary case-conferencing, two studies involved an educational element for care home staff and one study evaluated the use of clinical decision support technology. Due to heterogeneity, results were not combined in a meta-analysis. There was no evidence of an effect of the interventions on any of the primary outcomes of the review (adverse drug events, hospital admissions and mortality). No studies measured quality of life. There was evidence that the interventions led to the identification and resolution of medication-related problems. There was evidence from two studies that medication appropriateness was improved. The evidence for an effect on medicine costs was equivocal. Robust conclusions could not be drawn from the evidence due to variability in design, interventions, outcomes and results. The interventions implemented in the studies in this review led to the identification and resolution of medication-related problems, however evidence of an effect on resident-related outcomes was not found. There is a need for high-quality cluster-randomised controlled trials testing clinical decision support systems and multidisciplinary interventions that measure well-defined, important resident-related outcomes.