Orientador: Maria de Lourdes Morales Horiguela / Banca: Gilsenir Maria P. Almeida Dátilo / Banca: Jorge Antonio de Almeida / Banca: Maria Alves de Toledo Bruns / Banca: Maria Cândida Soares del Masso / Resumo: Nas sociedades contemporâneas é constante a preocupação das áreas de educação e saúde, referentes ao envelhecimento humano, isso pela dificuldade de inserção social dessa faixa etária. Dados estatísticos comprovam o envelhecimento populacional do Brasil, com aumento da expectativa de vida; porém existem e devem ser consideradas as implicações biológicas, psicológicas, econômicas e sociais do envelhecimento. Nosso objetivo neste trabalho foi analisar a influência da escola e das práticas pedagógicas na construção dos conceitos de 'envelhecimento humano' e 'sujeito idoso', além de investigar se elas oferecem uma educação favorável à inserção social. Foram avaliadas as concepções e representações sociais acerca do envelhecimento humano, através de questionários aplicados aos professores, alunos, seus pais e funcionários de várias escolas públicas e particulares da cidade de Marília (SP). Foi analisado o material didático utilizado nessas escolas, e constatado que nele, em geral, não é contemplado o tema envelhecimento humano. Também foram objeto de análise os documentos oficiais que norteiam a educação formal, como os Parâmetros Curriculares Nacionais. Os resultados mostraram também que alguns professores abordam o tema ao explanar doenças, ciclo vital, hábitos alimentares e ainda através da interdisciplinaridade com o ensino religioso, utilizando-se de estratégias didáticas como trabalhos em grupo, pesquisas, leitura de textos e observação de idosos. De forma geral, os professores julgam importante o enfoque do tema em aulas, pois isso pode promover mudanças de comportamento em relação aos idosos. Os professores, os pais e os alunos definem idosos como pessoas com experiência de vida e sabedoria, enquanto os funcionários os definem como pessoas carentes que precisam de atenção, respeito e carinho... (Resumo completo, clicar acesso eletrônico abaixo). / Abstract: In contemporany societies, the educational and health areas are constantly concerned about the human aging because the social insertion of ederly people is really difficult. Statistical data confirm the population aging in Brazil with an increase in life expectancy; nevertheless, there are biological, psychological, economical and social implications of aging that must be considered. This paper was aimed at analyzing the influence of school and pedagogical practices on the construction of "human aging" and "elderly subject" concepts and also at investigating if these practices offer a favorable education for social insertion. Social concepts and representations related to human aing were evaluated by means of questionnaires answered by teachers, students, parents and employees in several public and private schools in Marília city (SP). The educational material used in these schools was analyzed and it was verified that, in general, it does not include the human aging topic. Official documents that direct the formal education, such as National Curricular Parameters, were also analysed. The results also showed that some teachers broach the topic by giving information about diseases, vital cycle, eating habits and thorugh interdiscipline with religious teaching, using educational strategies such as group assignments, research, reading of texts and observation of elderly people. Teachers, in general, consider it important to focus the topic during the classes because this can cause behavuir changes concerned to elderly people. Teachers, parents and studentes define elderly people as who have life experience and wisdom, while employees define them as people who need attention, respect and affction. Teachers point the family, the society itself and architectural barriers as social exclusion factors for elderly people. Students mention bank and... (Complete abstract, click electronic address below). / Doutor

Objetivo: Estimar a prevalência de fraturas vertebrais investigando os fatores de risco associados com esta última condição em idosos brasileiros da comunidade. Métodos: Este estudo de corte transversal incluiu 769 indivíduos idosos com 65 anos ou mais (462 mulheres e 307 homens) residentes em São Paulo, Brasil. Radiografias de coluna torácica e lombar foram obtidas e fraturas vertebrais foram avaliadas usando o método semiquantitativo de Genant. Densidade mineral óssea (DMO) foi mensurada por DXA e parametros bioquímicos foram também avaliados. Mulheres e homens foram analisados separadamente, e cada gênero foi dividido em 2 grupos com base na presença de fraturas vertebrais. Resultados: A prevalência de fraturas vertebrais foi de 16,7% (95% CI 13,3-20,1) nas mulheres e 21,2% (95% CI 16,6-25,7) nos homens. Análise de regressão logística usando as variáveis significantes na análise univariada no grupo feminino mostrou que a idade (OR=1,12, 95% CI 1,06-1,18; p<0,001) e o Tscore do colo femoral (OR=0,61, 95% CI 0,46-0,88; p=0,006) foram fatores de risco independentes na predição de fraturas vertebrais. No grupo masculino, a análise de regressão logística demonstrou que a condição de caidor crônico (OR=2,54 95% CI 1,1-5,9; p=0,031) e T-score do colo femoral (OR=0,72, 95% CI 0,53-0,96; p=0,025) foram independentes parâmetros na predição de fraturas vertebrais. Conclusão: Nossos resultados sugerem que fraturas vertebrais são comuns em idosos brasileiros e que o T-score do colo femoral baixo foi um importante fator de risco para esta condição em ambos homens e mulheres. Idade também foi significantemente correlacionada com a presença de fraturas vertebrais em mulheres, e a condição de caidor crônico foi correlacionada com fraturas vertebrais em homens. / Purpose: To estimate the prevalence of radiographic vertebral fracture and investigate factors associated with this condition in Brazilian communitydwelling elderly. Methods: This cross sectional study included 769 elderly subjects 65 years old and over (462 women and 307 men) living in São Paulo, Brazil. Thoracic and lumbar spine radiographs were obtained and vertebral fractures were evaluated using Genant´s semi-quantitative method. Bone mineral density (BMD) was measured by DXA and bone biochemical markers were also evaluated. Female and male subjects were analyzed independently, and each gender was divided into 2 groups, based on whether vertebral fractures were present. Results: The prevalence of vertebral fracture was 16.7% (95% CI 13.3-20.1) in women and 21.2% (95% CI 16.6-25.7) in men. Logistic regression analyses using variables that were significant in the univariate analysis, in female group showed that age (OR=1.12, 95% CI 1.06-1.18; p<0.001) and femoral neck T-score (OR=0.61, 95% CI 0.46-0.88; p=0.006) were independently factors in predicting vertebral fracture. In the male group, logistic regression analyzes demonstrated that chronic faller condition (OR=2.54 95% CI 1.1-5.9; p=0.031) and femoral neck T-score (OR=0.72, 95% CI 0.53-0.96; p=0.025) were independent parameters in predicting vertebral fractures. Conclusions: Our results suggest that radiographic vertebral fractures are common in Brazilian community-dwelling elderly and that a low femoral neck T-score was an important risk factor for this condition in both males and females. Age was also significantly correlated with the presence of vertebral fractures in women, and chronic faller was correlated with vertebral fractures in men.

O objetivo da pesquisa foi analisar o processo de aprendizagem de idosos sobre os benefícios da atividade física (AF). Participaram da pesquisa 42 sujeitos, com idade acima de 60 anos, integrantes do Programa Autonomia para a Atividade Física (PAAF). Ao final da primeira fase do PAAF foi realizada uma entrevista semi-estruturada para avaliar a aprendizagem sobre a importância da AF e a percepção do aprendizado pelos sujeitos. Os resultados mostram que os alunos: (1) relacionaram o conhecimento sobre os benefícios da AF com seus efeitos fisiológicos nos sistemas de um corpo inativo ou em processo de envelhecimento; (2) associaram a importância da AF à aspectos afetivos como a melhora na auto-confiança e no auto-conhecimento das próprias capacidades e limitações; (3) identificaram a melhora no relacionamento social e na satisfação pessoal como efeito positivo da participação no PAAF; (4) reconstruíram o conceito de velhice; (5) valorizaram a aprendizagem de conhecimentos sobre a AF e (6) mostraram interesse em divulgá-los. Verificou-se, também, elementos que predispuseram a aprendizagem como: interesse em aprender, associação do aprendido com atividades cotidianas e utilização de conhecimentos prévios. Os fatores que dificultaram a aprendizagem ou a sua expressão foram: conceitos prévios inadequados, diminuição da memória, baixa escolaridade e falta de domínio com a linguagem oral. Pode-se concluir que os benefícios da AF relatados foram além dos efeitos fisiológicos ensinados no PAAF e que a elaboração pessoal do conhecimento se deu com base em aspectos da experiência de vida de cada idoso. / The aim of this research was to analyze the learning process of elderly people about the benefits of physical activity (PA). The research was composed by 42 people over 60 years old. All of them members of the Physical Activity Autonomy Program (PAAP). At the end of first stage of PAAP, the students were interviewed in order to evaluate their learning about the importance of PA and their perception of the learning process. The results revealed that the students: (1) linked their knowledge about PA benefits with physiological effects over their body systems or with the growing older process; (2) associated the importance of PA with improvement of self-steam and self-knowledge of their own abilities and limitations; (3) identified a significant improvement over their social relationship and personal satisfaction as a positive effect, as result of the participation of PAAP; (4) changed the concept of aging; (5) valued the learning about PA and (6) manifested interest to divulge it. The facilitate factors to learning were: interest in learning, association with diary activities and use of prior knowledge. The elements that made the learning difficult were the inadequate spontaneous concepts, decrease of memory, low educational level and lack of oral language. The conclusion was that the students refer to other PA benefits, beside physiologic effects and the knowledge construction was based in aspects of life experience of each elderly.

The aim was to investigate the effects of an intervention, based on education given to staff and implementation of an individualized nutritional programme given to the residents, to compare assessments on admission with a previous study, and to perform diagnostic test and inter-rater reliability of the Mini Nutritional Assessment (MNA). A further aim was to identify and describe factors with regard to appetite among the residents. Upon admission, and after a four month intervention period, residents were classified as being either protein energy malnourished (PEM), or not, based on anthropometry and biochemical measurements. On both occasions, the Activity Index and the Mini Mental State Examination were used. In order to identify individuals in need of nutritional care, the MNA was performed. Information about medical data was obtained. A total of 127 residents were consecutively admitted to eight resident homes in a municipality in Sweden. Three resident homes constituted the experimental unit (n = 68) and five the control unit (n = 59). Fifteen residents were interviewed using a qualitative method, to investigate what affects their appetite. On admission 32 % of the residents were classified as PEM, which was similar to in the previous study. A higher frequency of residents in the present study had severe medical diseases and cognitive impairment, compared with the previous study, indicating changed admission criteria in the present study. Between the experimental and the control groups, no differences were seen in any specific anthropometric or biochemical variable. Within the groups, statistically significant differences were seen, as the number of PEM residents in the experimental group decreased, and motor activity and overall cognitive function improved. In the control group, motor activity deteriorated. This indicates that the intervention improved nutritional status and functional capacity in the residents. Diagnostic sensitivity was 73 % regarding MNA versus PEM, and 89 % regarding MNA short form (MNA-SF) versus MNA, which indicates a rather high degree of sensitivity in both tests. Inter-rater reliability of MNA, carried out by simultaneous assessments by registered nurses and researcher showed a moderate agreement of 62 % (kappa 0.41). The interview study showed that the willingness to eat was what affected the residents´ appetite. The willingness to eat contains internal factors, dependent on mood and personal values, as well as external factors, dependent on wholesomeness, food, eating environment and meal fellowship. When planning and realizing residents´ nutritional care, factors affecting the residents´ appetite have to be taken into consideration. In conclusion, the results show that it is important to implement and develop strategies for individual nutritional care, in order to prevent and treat malnutrition in elderly people, which is in line with recommendations given by the European Society of Parenteral and Enteral Nutrition (ESPEN) and with the Swedish goal of nursing actions.

In the recent past, people were used to consult health care professionals or textbooks in order to find answer to health related questions. Now, the availability of medical information through electronic resources has changed people&lsquo / s information-seeking behaviors and, as a result, electronic information resources have become very popular and frequently used for health related searches. This study examines the online health information-seeking behaviors of middle aged and older people from Middle East Technical University and 100. Yil neighbourhood, specially demographic and other factors effecting online health information seeking, the types of sought online health information, assessment of the online health information, and reliability criteria of middle aged and older online health information seekers. A cross-sectional design was used to collect data. Self-administered questionnaires were distributed to participants. The final sample was 248 middle aged and older people. Findings show that middle aged and older employees from Middle East Technical University and 100. Yil neighbourhood are searching for health information especially for specific illnesses. They are using this information to self-treat or self-diagnose. Worse health conditions, expertise level in internet usage associates with searching behavior. Majority of the participants trust in information they found online but they do not share it with any health care professional.

Atsižvelgiant į Lietuvos gyventojų amžiaus struktūros pokyčius ir prognozuojamas tendencijas ateityje – vyriausiųjų gyventojų gausėjimą, vidurinės ir jauniausios dalies mažėjimą – Lietuvą galima priskirti prie labiausiai senėjančių šalių pasaulyje, taip pat galima prognozuoti vyresnio amžiaus asmenų ilgalaikės socialinės globos poreikio augimą. Tyrimas, analizuojantis socisaliai globojamų vyresnio amžiaus asmenų gyvenimo kokybę institucinės socialinės globos kontekste, atliktas laikantis konstruktyvistinės grindžiamosios teorijos nuostatų (Charmaz, 2006). Sukurta grindžiamoji teorija atskleidžia socialiai globojamų vyresnio amžiaus asmenų, gyvenančių ilgalaikės socialinė globos įstaigose, subjektyvios gyvenimo kokybės veiksnius. Siekiant suprasti lietuviškos ilgalaikės socialinės globos specifiką, buvo tiriama, kaip kinta gyvenimo kokybės vertinimas gyvenant ilgalaikės socialinės globos įstaigoje, kaip yra išgyvenama krizės patirtis, susijusi su gyvenimo vietos ir būdo pasikeitimu. Grindžiamojoje teorijoje atskleisti septyni gyvenimo kokybės veiksniai. „Galėjimas“ yra ašinė kategorija, suprantama kaip galėjimo atlikti svarbias veiklas, galėjimo palaikyti santykius su reikšmingais asmenimis reali išraiška ar pojūtis. Rezultatus lyginant su artimos metodologijos rėmuose atliktais tyrimais užsienio šalyse, nustatyta, kad kai kurie atskleisti gyvenimo kokybės veiksniai iš dalies sutampa, tačiau taip pat buvo atskleisti gyvenimo kokybės elementai, išskiriantys Lietuvos atvejį iš... [toliau žr. visą tekstą] / Lithuanian society is aging and need for social services is contsanly increasing. Therefore it is important to understand the increasing role of care services for elderly people, which allows living longer and enjoying better quality of life. Elderly people (+65) who become socially dependent have possibility to move to the residential care institution. The scenario of moving into long-term care institution has big impact on life quality of elderly person. Constructivist grounded theory methodology (Charmaz, 2006) allows to reach field of long-term residential care and analyse subjective quality of life, values and attitudes of elderly socially dependent residents. In the process of constructing grounded theory seven factors of life quality were identified. In the process of data analysis three models of adaptation to new status of socially dependent person and resident of residential home were identified. Research participants experience crisis while changing the living place and moving into residential care home. “Capability” is the main analytical category. Social care institutions and care professional should be aware of the need of methods and skills to effectively manage crises. Results show that such factors as are found in most foreign research areas despite of cultural and social contexts. In Lithuanian society specific factors of life quality is identified.

The number of studies investigating computer use or other technologies used by senior citizens has progressively increased in the last twenty years. The interest stems from a diverse range of research disciplines including human computer interaction, education, and many others. However, this group of people is less likely to use technology compared to younger groups. Senior citizens generally have a positive attitude towards technology, and they are willing to use the product if they need it. Positive attitudes are also more likely to be expressed towards devices used every day at home, such as the television, microwave etc. Even if those devices are now typically digital, senior citizens are familiar and comfortable with them. A common reason for not wanting to learn different technologies was the feeling that it may be too difficult for them or not having access to a computer or tablet. These characteristics drive us to offer a solution by rethinking the use of some existing technologies and making them more affordable and accessible to older people. It is offered on a TV, something that senior citizens are familiar and comfortable with and which most of them have it at home. As the first step, we identified different requirements and factors that affect senior citizens' daily lives, the things that they do most during the day. Based on these requirements, we had to find services that will fulfill them. The system is constructed from four major services such as video conferencing, news, books and different recreation videos (e.g.: tips about exercise, hunting, cooking or gardening.) Each one of these sections is identified by a review of previous research using a literature survey. These services were chosen, among others, for their effects on senior citizens' quality of life. Thus, our goal was to provide them with an adequate set of required services. The working environment (Smart TV) is based on the different reasons stated below in the research. Some of them are a) a Smart TV is an integrated system which offers features of both a traditional TV and a personal computer, b) it provides a large screen, is easy to use and always ready, and most importantly, c) the TV, the most-user friendly electronic device, is a basic activity of senior citizens in their daily life. Design perspectives and functional requirements are presented. Finally, we describe some scenarios and assessment methods of the proposed system with the target group (senior citizens). Based on the findings, we can conclude that there was great acceptance from senior citizens for the support of daily living and the ability to control their daily activities provided by this service.

People in developed countries are living longer with the help of medical advances. Literature has shown that older people prefer to stay independent and live at home for as long as possible. Therefore, it is important to find out how to best accommodate and assist them in maintaining quality of life and independence as well as easing human resources. Researchers have claimed that assistive devices assist in older people’s independence, however, only a small number of studies regarding the efficiency of assistive devices have been undertaken of which several have stated that devices are not being used. The overall aim of this research was to identify whether the disuse and ineffectiveness of assistive devices are related to change in abilities or related to the design of the devices. The objective was to gather information from the elderly; to identify what assistive devices are being used or not used and to gain an understanding on their attitudes towards assistive devices. Research was conducted in two phases. The initial phase of the research was conducted with the distribution of questionnaires to people over the age of fifty that asked general questions and specific questions on type of devices being used. Phase One was followed on by Phase Two, where participants from Phase One who had come in contact with assistive devices were invited to participate in a semi-structured interview. Questions were put forth to the interviewee on their use of and attitudes towards assistive devices. Findings indicated that the reasons for the disuse in assistive devices were mostly design related; bulkiness, reliability, performance of the device, difficulty of use. The other main reason for disuse was socially related; elderly people preferred to undertake activities on their own and only use a device as a precaution or when absolutely necessary. They would prefer not having to rely on the devices. Living situation and difference in gender did not affect the preference for the use of assistive devices over personal assistance. The majority strongly supported the idea of remaining independent for as long as possible. In conclusion, this study proposes that through these findings, product designers will have a better understanding of the requirements of an elderly user. This will enable the designers to produce assistive devices that are more practical, personalised, reliable, easy to use and tie in with the older people’s environments. Additional research with different variables is recommended to further justify these findings.

Made available in DSpace on 2014-06-11T19:30:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-04-28Bitstream added on 2014-06-13T20:21:07Z : No. of bitstreams: 1 silva_rcp_dr_arafcf.pdf: 589886 bytes, checksum: 8d1dcbaa39e5f7b7dba3c600e6b4850c (MD5) / Universidade Estadual Paulista (UNESP) / O objetivo deste estudo foi analisar os fatores de risco relacionados às doenças cardiovasculares, em idosos diabéticos do tipo 2 e verificar a associação desses fatores, segundo sexo e faixa etária. O estudo observacional foi feito com 100 idosos atendidos no Centro Regional de Reabilitação de Araraquara (CRRA), São Paulo, Brasil, de março a dezembro de 2004. O estudo incluiu as características sociodemográficas da população. A idade média da população de estudo foi 71 anos, sendo a maioria formada por indivíduos casados, do sexo feminino, brancos e economicamente inativos. Cerca de 59% dos indivíduos possuíam menos de sete anos de estudo, 38% tinham renda familiar per capita de até um salário mínimo, caracterizando uma população de baixa renda e baixa escolaridade. Quanto aos hábitos e estilo de vida, predominaram os indivíduos que mantinham dietas adequadas, sedentários, não fumantes e não etilistas. Prevaleceram os antecedentes pessoais de hipertensão arterial, obesidade e hipercolesterolemia e os antecedentes familiares foram diabetes, doenças cardiovasculares e hipertensão arterial. A população apresentou, 42% de sobrepeso e 38% de obesidade classe I e II e valores inadequados de circunferência de cintura (71%) e de razão cintura-quadril (84%). Em relação aos fatores de risco para doenças cardiovasculares, mais da metade eram hipertensos, possuíam hipercolesterolemia, hipertrigliceremia, tinham valores elevados de LDL-colesterol (84%) e 59% níveis de HDLcolesterol, abaixo dos valores de referência. A maioria apresentou valores elevados de glicemia de jejum, hemoglobina glicada, fibrinogênio e foram categorizados como de risco cardiovascular. Os resultados, portanto, mostraram uma freqüência elevada de fatores de risco cardiovasculares na população estudada, com diferenças segundo o sexo e a idade. / The aim of this study was to analyze the risk factors related to the cardiovascular illnesses in diabetic type 2 elderly people and to verify the association of these factors according to sex and age group. An observational study was carried out on 100 elderly persons, attended at the Rehabilitation Center of Araraquara (CRRA), São Paulo, Brazil, from march to december 2004. The social demographic characteristics of the population was also studied. The average age of the study population was 71 years, the majority married, feminine, white and economically inactive. About 59% of them had less than 7 years of study, 38% held a minimum wage per capita familiar income, characterizing a population of low income and of low educational level. As to the habits and style of life, the individuals had an adjusted diet, were sedentary, non smoking and non alcoholics. The personal antecedents were arterial hypertension, obesity and hypercholesterolemia and the familiar antecedents were diabetes, cardiovascular illnesses and arterial hypertension. The population not only presented 42% of overweight and 38% of obesity class I and II, but also inadequate values of circumference of waist (71%) and waist-to-hip ratio (84%). In relation to the risk factors for cardiovascular diseases, it was observed that more than half had hypertension, hypercholesterolaemia, hypertriglyceridaemia. 84% had high values of LDL-cholesterol and 59% HDL-cholesterol levels below the values of reference. The majority presented high levels of fasting glycemia, glycohemoglobin, fibrinogen and was categorized as of cardiovascular risk. The results showed the high frequency of cardiovascular risk factors in the studied population, with differences according to sex and the age.

Este trabalho versa sobre a hipótese de reparação civil por abandono afetivo que decorre da infração ao dever de cuidado do idoso. Analisa-se a tutela dos direitos dos idosos no ordenamento jurídico brasileiro através de um retrospecto legal com sutil referência ao contexto histórico mundial e ao Direito Comparado. Contextualiza-se a interpretação dos direitos dos idosos em face do fundamento do Direito pátrio na dignidade da pessoa humana a partir da Constituição Federal de 1988 e a transposição desta no Direito Civil e no Direito de Família. Adiante é apreciado o abandono afetivo, seu conceito e expansão pela a adoção do modelo atual eudemonista da família que importou na inclusão do dever de cuidado como elemento do afeto. A seguir o cuidado é abordado enquanto infração ao dever que dele decorre para identificação da conduta omissiva. Por fim, é explorado o instituto da responsabilidade civil, através do estudo de cada um dos seus requisitos, para conclusão quanto ao cabimento do dever de reparação pela constatação da ocorrência do ato ilícito de infração ao dever de cuidado que implica abandono afetivo em razão do dano que dele resulta e da extensão deste, isto valorado no caso concreto. / This paper deals with the hypothesis of civil reparation for affective abandonment of the elderly that results from the violation of the duty of care of the elderly. It analyzes the protection of the rights of the elderly in the Brazilian legal system through a legal retrospect with subtle reference to the world historical context and Comparative Law. The interpretation of the rights of the elderly in the face of the foundation of the patrimony right in the dignity of the human being is contextualized from the Federal Constitution of 1988 and the transposition of this one in the Civil Law and in the Right of Family. Above, affection abandonment, its concept and its expansion are appreciated by the adoption of the current eudemonist model of the family that has imported the inclusion of the duty of care as an element of affection. Care is then approached as an infraction of the duty derived from it to identify the omissive conduct. Finally, the institute of civil responsibility is explored, through the study of each one of its requirements, to conclude on the compliance of the duty to make reparation for the finding of the occurrence of the illicit act of infraction to the duty of care that implies affective abandonment due to the damage that results from it and the extent of it, that is valued in the concrete case.