Orientador: Mario Jose Abdalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T11:08:54Z (GMT). No. of bitstreams: 1 Bellinazzi_VeraRegina_M.pdf: 1059560 bytes, checksum: bdf226ffce821be677b9c8439cc32fdd (MD5) Previous issue date: 2006 / Resumo: Apesar dos mecanismos da longevidade não serem totalmente conhecidos, sabe-se que mutações em genes que reduzem a sinalização intracelular de insulina/IGF-1 são capazes de aumentar a sobrevida de animais invertebrados e mamíferos Na mosca Drosophila Melanogaster, mutações no receptor de insulina (similar ao gene do receptor de insulina humano) e no gene chico (similar ao gene do IRS-1 humano) levam ao aumento da sobrevida do animal. Em roedores, estudos sobre restrição calórica e diversas mutações tem relacionado a via de sinalização insulina/IGF-1 com longevidade. Em humanos, a sensibilidade à insulina normalmente declina com o envelhecimento, porém existem evidências que idosos longevos apresentam ação da insulina preservada e nível de IGF-1 sérico reduzido, o que sugere que a resposta à insulina tem impacto na longevidade humana. Evidências recentes que reforçam esta teoria demonstram que polimorfismos de genes da via de sinalização de insulina/IGF-1( IGF-1R e PI3K), afetam o IGF-1 sérico e a longevidade humana, sugerindo que este mecanismo esteja conservado através da evolução das espécies. Baseada nestas evidências, nosso estudo investigou a prevalência do polimorfismo mais comum do IRS-1, a substituição de glicina por arginina no códon 972 (Gly972Arg), numa amostra da população longeva brasileira, e a sua associação com diversos fenótipos e com a longevidade. Foram incluídos no estudo 94 idosos, de ambos os sexos, com idades entre 80 e 100 anos. Como grupo controle foram incluídos 194 recém-nascidos da mesma região brasileira. A freqüência genotípica encontrada nos idosos foi: Gly/GIy 80,85%, Gly/Arg 19,15%, e Arg/Arg 0%. Não foi encontrada diferença estatística entre a prevalência do polimorfismo em longevos e em neonatos brasileiros. Também não houve associação deste polimorfismo com resistência à insulina, hipertensão, diabetes, ou com alterações no IMC, circunferência da cintura, e lípides nessa população. Nossos achados indicam que não há associação do polimorfismo Gly972Arg do IRS-1 com longevidade em humanos. E possível que esta falta de relação esteja relacionada ao seu efeito neutro tanto na sensibilidade à insulina quanto no nível de IGF-1. / Abstract: Although the underlying mechanisms of longevity are not fully understood, it is known that mutations in genes that decrease the insulin/IGF-1 signal response pathway are capable of extending life span in a variety of model systems from invertebrates to mammals. In Drosophila Melanogaster, mutations of either the insulin receptor gene (similar of human insulin receptor gene) or the Chico (similar of human IRS-1 gene) led to enhanced longevity. In humans, insulin sensitivity normally declines during aging. Although there are evidences that long-lived subjects have decreased plasma IGF-1 levels and preserved insulin action, thus indicating that insulin responsiveness impacts on human longevity. Recent findings also provide novel and intriguing indications for the involvement of insulin and IGF-1 in the control of aging and longevity in humans. In particular, it has been demonstrated that polymorphic variants of IGF-1 receptor (IGF-IR) and phosphatidylinositol 3-kinase (PI3K) genes affect IGF-1 plasma levels and human longevity, indicating that the impact of these genes on species longevity is an evolutionary conserved property. On the basis of the above-mentioned literature, we investigate the prevalence of a most common IRS-1 variant, a Gly --> Arg substitution at codon 972 (GIy972Arg) in a population-based sample of Brazilian elderly, its association with phenotypes and longevity. Ninety-four Brazilian subjects (men and women), from 80-100 yr. of age, volunteered for this study. As a control population we studied 194 newborn children from our University Hospital. Genotype frequencies were Gly/Gly 80,85%, Gly/Arg 19,15%, and Arg/Arg 0%, which are in Hardy-Weinberg equilibrium In addition, no significant differences among allele and genotype distribution were found between Brazilian elderly and Brazilian newborns Also, the Arg variant was not associated with insulin resistance, hypertension, diabetes, detrimental values for body mass index, waist circumference, and lipids in the Brazilian elderly. Our findings indicate that the IRS-1 Gly972Arg variant is not related with longevity. It is possible that the lack of this association might be related to its neutral effect on insulin sensitivity and on IGF-1 levels. / Mestrado / Clinica Medica / Mestre em Clinica Medica

Orientador: Olga Rodrigues de Moraes Von Sinsom / Dissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T11:24:18Z (GMT). No. of bitstreams: 1 Braido_CristianeAparecida_M.pdf: 4774510 bytes, checksum: 6c39ae5d9ba507bf8c7de910d42c3b53 (MD5) Previous issue date: 2009 / Resumo: Através da presente pesquisa pretendemos descobrir iniciativas de protagonismo em idosos integrantes de Comissões Gestoras na comunidade, observando como se mobilizam e se organizam em parceria com diferentes profissionais, em busca do atendimento de suas demandas visando um processo de envelhecimento saudável. O conceito de protagonismo que procuramos construir diz respeito à uma ação propositiva de reflexão, discussão e ação que faz parte do processo de planejamento das ações desenvolvidas nos respectivos projetos para idosos. As instituições definidas como campo de pesquisa foram o Centro Comunitário do Jardim Santa Lucia e o SESI Amoreiras. Ambas contam com a parceria de uma Comissão Gestora formada por idosos e profissionais, para a realização das atividades oferecidas, partindo do pressuposto que a representação pode trazer maiores garantias de sucesso no atendimento das demandas da comunidade. Buscando atingir os objetivos a pesquisadora utilizou a metodologia de história oral ao entrevistar 06 idosos e 2 profissionais das respectivas Comissões Gestoras, além de observar as atividades propostas e a realização das reuniões de planejamento. Concluímos que o protagonismo entre idosos esta fortemente relacionado à objetivos comuns, à criação de vínculos e à força grupal e comunitária que as pessoas criam e recriam ao longo da vida, buscando a realização de um projeto de felicidade. E que o impacto social dos projetos desenvolvidos através do empenho dos idosos das Comissões Gestoras, de seu envolvimento e do uso de suas habilidades pessoais, contribui significativamente com o desenvolvimento da auto-estima, da autoconfiança, do autoconceito, da visão do futuro, do senso de identidade e do nível de aspiração vital dos idosos e possibilitam a conquista de um espaço diferenciado de atuação, de busca de novos papéis sociais como atores responsáveis pela organização, mobilização e fortalecimento do segmento por eles representado / Abstract: Through the present study we intend to find out initiatives role in the elderly members of the Management Commission community, watching how they mobilize and organize themselves into partnerships with different professionals in search of care their demands aimed at an aging process healthy. The concept of the role of elderly that we try to build, refers to a propositional action reflection, discussion and actions that is part of actions developed in their projects for the elderly. Those Institutions defined as a field of research were Community Center Garden Santa Lucia and SESI Amoreiras. Both rely on a partnership with Management Commission formed by elders and professionals to carry out activities offered on the assumption that the representation can provide greater assurance of success in meet the demand of the community. Seeking to achieve the goals, the researcher used the methodology of oral history by interviewing 06 elderly men/women and 02 professionals of the corresponding management commission, and comply with the proposed activities and the meeting planning. We conclude that the role of older people is strongly related to common goals, the creation of linkages and the strength group and community that people create and recreate along of life, seeking to carry out a project of happiness. Also the social impact of projects developed by commitment of elderly Management Commission, its involvement and the use of their personal skills, helps significantly with the development of self-esteem, self-confidence, self-concept, the vision of the future, the sense of identity and level of aspiration vital the elderly and enables achievement of a differentiated area of operation, the search new social roles as actors responsible for organizing, mobilization and strengthening of the segment they represented / Mestrado / Gerontologia / Mestre em Gerontologia

Class of 2011 Abstract / OBJECTIVES: To design and evaluate a dosing schedule pictogram in an elderly population. To identify possible reasons for misunderstanding of a dosing schedule pictogram and, if appropriate, redesign the pictogram to reflect reasons for misunderstanding. METHODS: Through a modified focus group analysis involving residents of a retirement community in Tucson, Arizona, the understandability of a morning-noon-night color pictogram was assessed. Residents’ interpretation of the pictogram as correct or incorrect was assessed using a decision-tree analysis. The percentage of correct responses was calculated and compared to established pictogram criteria for acceptability. Lastly, potential reasons for misunderstanding were assessed. RESULTS: Thirteen residents, six males and seven females, participated in the study. The rate of correct interpretation was 84.6%, which nearly satisfies the ANSI criterion of 85% correct and far exceeds the ISO criterion of 67% correct. Two participants incorrectly interpreted the pictogram, but their comments, however, indicated good comprehension of time of day. CONCLUSION: The dosing schedule pictogram was correctly interpreted by a majority of study participants satisfying industry standards. Further analysis of this design is warranted.

No description available.

Class of 2008 Abstract / Objectives: Use of expired and unused prescription medication in the elderly population is not clearly defined. Improper use of medication can lead to serious adverse drug events and poor health outcomes. More information on the actual use of expired and unused medications in the elderly population may help in determining the need for future education of this population on this subject. Methods: A total of 72 people 65 years or older completed an anonymous survey about use of expired and unused medication. The completed survey was returned by mail. The data was extracted into a database and analyzed using chi-squared, averages, and percentages. Results: The data showed that there was no significant difference between the age groups with respect to willingness to share medications with family or friends. The population was predominantly white, and most respondents had completed some level of college education. The results showed 69.4% of respondents would share at least one category of medication with a friend or family member. 56.9% of respondents would share at least one category of medication with a friend, and 66.7% would share at least one with a family member (p=0.23). Respondents indicated they would take 23.4% of the medications listed as being in their possession if they were expired and would only share only 6.9% of the listed medications with a friend or family member. Conclusions: This data demonstrated that this population was reluctant to share medications they actually possessed, but were theoretically willing to share some categories of medications. More research needs to be done to assess use of expired medications and medication sharing in all populations, and especially in the elderly population.

The study reported in the thesis attempted to examine the decision-making process for the institutionalization of older people in homes for the aged. More specifically, it sought to determine who was responsible for the decisions, to discover if this responsibility was related to selected social factors, and to ascertain if it affected the adjustment of older people to the institutional setting.

Orientador: Guita Grin Debert / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas / Made available in DSpace on 2018-08-26T13:00:26Z (GMT). No. of bitstreams: 1 Hora_ThiagoCesarioda_M.pdf: 928355 bytes, checksum: 6d9f1623e9ce1bde1d42103df3780ddb (MD5) Previous issue date: 2014 / Resumo: Apesar de sua escalada natural, o envelhecimento é também um processo socialmente determinado, de modo que seus limites e significados variam de acordo com a conjuntura específica em que ele se insere. Esta pesquisa trata de uma dessas conjunturas: a velhice gerida por um asilo beneficente. Primeiramente, são delimitados os aspectos históricos e discursivos responsáveis pela construção da categoria "velhinho", uma classificação essencialmente desqualificadora, estabelecida na intersecção entre velhice, dependência e beneficência, e na consolidação do asilo enquanto espaço próprio destes indivíduos. No segundo momento, através da etnografia, a intenção é mostrar como a instituição asilar perpetua esta desqualificação, através das moralidades acionadas na prática do cuidado e do voluntariado, ao passo em que, também, proporciona interações intergeracionais determinantes para as alteridades em jogo. Finalmente, a vida no asilo é abordada pela ótica dos próprios moradores, que compartilham significados específicos sobre o envelhecimento e, por meio deles, negociam cotidianamente sua posição relativa diante da instituição e dos outros internos, através de estratégias de subjetivação que têm, na afirmação da autonomia e do direito a autodeterminação, seus objetivos finais. Deste modo, proponho um debate sobre os elementos depreciativos que permeiam a imagem social das pessoas de mais idade, contribuindo assim para sua superação / Abstract: Despite its natural progress, aging is also a socially determined process, so its boundaries and meanings vary according to the specific environment in which it is inserted. This research deals with one of these situations: the aging run by a charitable nursing home. First, the historical and discursive aspects responsible for the construction of the category "velhinho" are delimited. It is an essentially disqualifying classification established at the intersection of old age, dependency, charity, and the consolidation of the nursing homes as these individuals own space. In another moment, through ethnography, the intention is to show how the nursing homes perpetuate this disqualification by the moralities triggered by care practice and volunteering, while this also provides intergenerational interactions decisive for the alterities at stake. Finally, life in the nursing homes is approached from the perspective of the residents, who share specific meanings about aging and, through them, routinely negotiate their relative position within the institution and in relation to the others residents. To accomplish their ultimate goals, they use subjectivity strategies to affirm their autonomy and self-determination. Thereby, I propose a debate about the derogatory elements that permeate the social image of older people, thus contributing to its overcoming / Mestrado / Antropologia Social / Mestre em Antropologia Social

Inpatient falls are a leading cause of fatal and serious injuries among hospitalized elderly patients, often with devastating consequences. This quality improvement project was conducted on a geriatric unit in a large southeastern U. S. hospital, following recognition of an increase in the number of falls with several sustained injuries. After an analysis of the previous fall prevention strategies, a panel of stakeholders who formed a falls prevention committee determined that implementing an evidence-based fall risk assessment tool to help identify risk factors, as well as implementing interventions to address those risk factors, would make fall prevention more patient specific and comprehensive. Guided by the IOWA Model, this project was designed to assess the effectiveness of implementing the Morse Fall Scale for a period of 2 months on the geriatric unit. Nurses were educated on the use of the tool and interventions, and 32 (87.5%) shared their perceptions of the effectiveness of the tool using a 5-item questionnaire following tool implementation. Fall rates based on nursing assessments and incident reports were monitored 6 months prior to, 2 months during implementation, and 2 months after the implementation of the MFS ended. The fall rate on the unit decreased by 50% during the implementation of the Morse Fall Scale; 99% of nurses agreed or strongly agreed that the tool was easy to understand, quick to use, identified and increased awareness of fall risks as well as fall prevention strategies, and decreased falls. Nurses leading fall prevention programs supported by evidence can address the serious patient safety issue of falls to decrease the negative impact on patients, families, and health care systems by reducing falls among elderly patients.

Delirium and delirium superimposed on dementia (DSD) have a high prevalence in elderly populations presenting to the emergency department (ED). Despite their prevalence, diagnosis remains a problem and has led to increased healthcare costs and adverse health outcomes. Various tools and diagnostic screening tests exist to aid clinicians in their diagnosis but the need for a simple, sensitive and specific tool that can be used in a busy ED setting still exists. The objective of this study is to further validate two cognitive screening assessments, the 6-Item Cognitive Impairment Test (6-CIT) and Vigilance A Test, for their use in the ED as a screening test for delirium and DSD. The study will be a prospective cohort study performed at a tertiary academic medical center with elderly patients greater than 65 years old. The diagnostic accuracy of the 6-CIT and Vigilance A tests administered by emergency medicine attending physicians will be compared to a reference standard expert assessment performed by a psychiatrist. Patients will be assessed within 3 hours of presenting to the ED. Sensitivity, specificity, positive and negative predictive values with 95% confidence intervals will be calculated. The goal of the study is to determine whether the 6-CIT and Vigilance A tests can accurately exclude delirium and dementia in elderly ED patients, which would have future implications for their use as a time-efficient screening tool in these populations.

No description available.