Prevalence of cognitive impairment and associated factors in older people

BACKGROUND

Older people are the fastest-growing age group, with the highest risk of cognitive impairment. This study assessed the prevalence and associated factors with cognitive impairment in community-dwelling older people.

METHODS

Older people were interviewed and accomplished through sociodemographic and health questionnaires. The quantitative variables were described by mean and standard deviation or median and interquartile range. The significance level adopted was 5 % (p < 0.05). The association between the quantitative variables was evaluated using the Pearson or Spearman correlation coefficients.

RESULTS

The research population comprised 165 long-lived adults aged ≥80. The youngest one was 80, and the oldest one was 94 years old. The participants were 84.8 ± 3.6 years old, female (63 %) with a mean of education of 2.9 ± 1.8 years. A poor performance in the Mini-Mental State Examination (MMSE) was found in 58 (35.2 %) individuals when adjusted for educational level. After adjustment for confounding factors, body mass index (BMI) (p = 0.09), total older adults' income (up to 1 minimum wage [mw], p = 0.023; over 1 to 2 mw, p = 0.023), functional disability (Moderate dependence 75 %, p = 0.038; Moderate dependence 50 %, p = 0.081; Moderate dependence 25 %, p = 0.054), and the anxiety scale (p = 0.032), remained associated with cognitive impairment.

CONCLUSIONS

This study showed that BMI, total older adults' income, functional disability, and anxiety are related to cognitive impairment in long-lived adults. This study has some limitations, such as the fact that it is a cross-sectional study, the reduced number of individuals, and the fact that there were no comparisons among different ages and populations.

The effects of academic unprofessional behaviour on disciplinary action by medical boards: Systematic review and meta-analysis

OBJECTIVE

The objective of this study is to evaluate the association of disciplinary actions by regulatory councils and unprofessional behaviour during medical graduation.

METHODS

A search strategy was developed using the terms: 'physicians', 'disciplinary action', 'education', 'medical', 'undergraduate' and their synonyms, subsequently applied to the electronic databases MEDLINE, Embase, Cochrane Library, LILACs and grey literature, with searches up to November 2023. The risk of bias was assessed using the Newcastle-Ottawa scale and statistical analysis was performed using the RevMan software.

RESULTS

A total of 400 studies were found in the databases, and 15 studies were selected for full-texting reading. Four studies met the inclusion criteria and were included, bringing together a total of 3341 evaluated physicians. Three studies were included in the meta-analysis, showing a greater chance of disciplinary actions among physicians who exhibited unprofessional behaviour during medical graduation (OR: 2.54; 95%CI: 1.87-3.44; I2 : 0%; P < 0.0001; 3077 participants; physicians with disciplinary action: 107/323; control physicians: 222/2754).

CONCLUSIONS

There is a statistically significant association between unprofessional behaviour during medical undergraduate study and subsequent disciplinary actions by Medical Councils. The tools for periodic assessments of student behaviour during undergraduate studies can be a perspective for future studies aimed at reducing disciplinary actions among physicians.

University indigenous students' perspectives on climate change and survival of indigenous peoples in Brazil: a concept mapping study

Introduction

This study aimed to identify what indigenous university students in Brazil perceived to be important and feasible actions to protect the survival of indigenous peoples from climate change-related impacts.

Methods

Concept mapping, which is a participatory mixed methodology, was conducted virtually with 20 indigenous students at two universities in Brazil. A focus prompt was developed from consultations with indigenous stakeholders and read "To protect the survival of the Indigenous Peoples from climate change, it is necessary to…". Students brainstormed 46 statements, which they then sorted into clusters based on conceptual similarity. They rated each statement for importance and feasibility. Quantitative multivariate analyses of clusters and ratings were conducted to produce multiple visual maps of perceived actionable priorities. These analyses used the Group Wisdom TM software.

Results

Students agreed on 8 clusters that reflect the factors that influence the survival of indigenous peoples-preservation of lands 0.16 (SD 0.13), protection of demarcated lands 0.31 (SD 0.10), indigenous health and wellbeing 0.35 (SD 0.14), ancestral customs 0.46 (SD 0.04), global and national actions 0.61 (SD 0.13), indigenous rights 0.64 (SD 0.23), collective living 0.71 (SD 0.21), and respect 0.75 (SD 0.14).

Discussion

The most actionable priorities are related to the respect for their lands and customs, educational initiatives in schools about the importance of indigenous peoples to society, guarantees for basic health rights, and culturally appropriate provision of care, with specific mention of mental healthcare. The findings aligned closely with the concept of indigenous self-determination, which is rooted in autonomy and respect for cultural diversity, and the right to make decisions that impact their lives, land, and resources.

Climate change and mental health of Indigenous peoples living in their territory: a concept mapping study

Background

The alarming increase in annual deforestation rates has had devastating consequences in climate change, and it is affecting Indigenous people, who depend entirely on the land for survival and has also weakened the rainforest's crucial role in stabilizing the global climate. Recognizing and respecting Indigenous people's needs and social, economic, and historical conditions influence health and healthcare. This study aimed to conduct online concept mapping workshops with university students to identify perceived important and feasible actions for improving the mental health of Indigenous people living in their territory in association with climate change.

Methods

Concept mapping, a participatory mixed methodology, was conducted virtually with 20 Indigenous students at two universities in Brazil. A focus prompt was developed from consultations with Indigenous stakeholders and read-"To improve the mental health of Indigenous peoples in their territory during climate change crises, it is necessary to…."

Results

University students organized 42 unique statements in 6 clusters that cover a wide range of topics: family support, 0.68 (SD 0.19); respect and understanding, 0.37 (SD 0.08); improvement actions, 0.52 (SD 0.07); public policies in favor of Indigenous people's mental health, 0.24 (0.09); health actions, 0.15 (SD 0.08); Indigenous training in health and its importance in improving mental health 0.32 (SD 0.07).

Conclusion

These clusters range from community initiatives, public policies, health actions, and strengthening professional services in Indigenous communities. These all provide numerous concrete ideas for developing interventions designed to address mental health challenges associated with climate change.

Gut and Vaginal Microbiota in the Endometriosis: Systematic Review and Meta-Analysis

Background

Endometriosis is a clinical condition associated with genetic, endocrine, and immunological factors, present in 6 to 10% of women of reproductive age. Currently, the human microbiota has been studied and associated with the evolution of diseases due to its influence on pathogenesis, indicating that changes in the colonization of microorganisms in the genitourinary and gastrointestinal systems can promote physiological changes that can trigger inflammatory and immunological processes and hormonal dysregulation, which can be linked to endometriosis. Thus, this systematic review and meta-analysis evaluated microbiota changes in women with endometriosis.

Methods

The following electronic databases were searched up to April 2022: Medline, Embase, Web of Science, Cochrane Library, and gray literature (Google Scholar), using the keywords "dysbiosis", "microbiome" and "endometriosis", combined with their synonyms. The observational studies conducted with women diagnosed with endometriosis and women without endometriosis as controls were included. For the analyses, a standard mean difference with a 95% confidence interval was used using RevMan software (version 5.4), and for methodological quality assessment, the Newcastle-Ottawa scale was used.

Results

A total of 16 studies were found in the literature assessing the composition of the microbiota in women with endometriosis, and no significant difference were found for changes in alpha diversity analysis in gut microbiota (SMD = -0.28; 95% CI = -0.70 to 0.14; P = 0.19; I2 = 52%; four studies, 357 participants) or vaginal microbiota (SMD = -0.68; 95% CI = -1.72 to 0.35; P = 0.19; I2 = 66%; two studies, 49 participants).

Conclusion

In intestinal and vaginal samples from women with endometriosis, alpha-diversity did not present a significant difference when compared to the control population. However, each study individually showed a possible relationship between the female microbiota and endometriosis. This trial is registered with CRD42021260972.

Centrais de Regulação e Consórcios Intermunicipais de Saúde: a Percepção de Gestores Catarinenses

Objetivo: Analisar a percepção dos gestores dos consórcios intermunicipais de saúde e das comissões intergestores regionais do sul de Santa Catarina sobre a incorporação das centrais de regulação nos procedimentos eletivos de média e alta complexidade, inseridos nos consórcios intermunicipais de saúde do estado. Métodos: Trata-se de um estudo descritivocom abordagem mista, realizado com representantes legais de consórcios intermunicipais de saúde e gestores municipais representantes da Comissão Intergestores Regional do sul de Santa Catarina, totalizando 6 participantes. A coleta de dados se deu através de entrevista semiestruturada. A análise ocorreu por método de condensação de significados com auxílio do programa SPSS versão 23.0. Resultados: Foi possível obter a percepção dos representantes legais e gestores acerca dos mecanismos de regulação, legislação vigente, sua eficácia e seu conhecimento prévio a respeito dos mesmos. Além disso, conseguiu-se traçar as características do perfil profissional dos respectivos indivíduos. Conclusões: Os resultados obtidos apontam uma percepção positiva dos gestores acercada regulação e o auxílio que a mesma trouxe aos municípios em relação à continuidade na linha de cuidado e a garantia do acesso aos pacientes com critérios clínicos mais graves. Evidenciou-se também a necessidade de melhorias na eficiência e fiscalização das legislações vigentes além da necessidade dos gestores receberem capacitações acerca de características pontuais dos mecanismos legais.

Integração ensino-serviço: possibilidades de uma Universidade Comunitária em meio à pandemia da covid-19

O cenário da pandemia da COVID-19 convoca à rápidas mudanças no modo de trabalho, as Instituições de Ensino Superior (IES), além de potencializar as ações no campo da pesquisa reafirmam seu papel para a comunidade, especialmente quando se trata de Universidades comunitárias. Este artigo caracteriza-se como relato de experiência sobre as ações utilizadas para o enfrentamento da COVID-19 pela Universidade do Extremo Sul Catarinense (UNESC), do município de Criciúma – SC, uma Universidade comunitária. As ações da UNESC foram intensificadas durante o cenário pandêmico, trazendo ações inovadoras como implantação de Sala de Situação Covid-19, teleatendimentos como SOS UNESC Covid-19 e Acolher UNESC Covid-19, Programa de Rastreamento do Coronavírus, Comitê e Análise de Gestão da Covid-19 e várias ações realizadas para além dos espaços da IES. Este artigo marca o importante papel das Universidades comunitárias e seu compromisso com o desenvolvimento regional, ações, intervenções e parcerias com impacto direto na saúde da população local. A UNESC, enquanto Universidade comunitária desenvolve ações pautadas nas melhores evidências científicas e valoriza o cuidado com a vida das pessoas.Palavra-chave: Coronavírus, Epidemiologia, Gestão de Riscos, Vigilância em Saúde Pública, Instituições de Ensino Superior.

ATENÇÃO DOMICILIAR: PERCEPÇÃO DO USUÁRIO QUE APRESENTA CONDIÇÃO CRÔNICA SOBRE O CUIDADO OFERTADO PELA ATENÇÃO PRIMÁRIA À SAÚDE

Nas últimas décadas os princípios que orientam a atenção à saúde vêm produzindo mudanças no cenário de prática em saúde, focalizado na atenção primaria à saúde. A assistência domiciliar no sistema público de saúde aponta para a necessidade de novas tecnologias de cuidados continuo e de forma multiprofissional. Dessa forma, o presente estudo tem por objetivo verificar a percepção do usuário acamado e/ou domiciliado relacionada ao cuidado ofertado a domicilio na atenção básica. O estudo é caracterizado por uma abordagem quantitativa de natureza descritiva e observacional, em que foram aplicados questionários estrutura dos com 33 usuários de uma Unidade Básica de Saúde do Extremo Sul Catarinense. A pesquisa destacou que o crescimento da atenção domiciliar e do número de doenças crônicas está associado ao envelhecimento populacional. A escassez de atendimentos multiprofissionais se torna falho no contexto da promoção em saúde, onde muitos dos indivíduos vem o cuidado domiciliar como indiferente. É importante destacar o reconhecimento da atenção domiciliar como possibilidade de superar as dificuldades de acesso na rede, indicando que ela atende a um conjunto de necessidades referentes às ofertas de cuidado.

Implantação de um serviço de teletriagem para atendimento de casos suspeitos de COVID-19: relato de experiência

Objetivo: O objetivo desse artigo é apresentar um relato de experiência sobre a implantação de um serviço de teletriagem para orientação da população sobre COVID-19. Métodos: O Programa SOS UNESC – Covid-19 é um serviço ofertado pela Universidade do Extremo Sul Catarinense, localizada em Criciúma/SC. Consiste em um serviço de triagem referenciada virtual, que utiliza uma plataforma de mensagens instantâneas para tirar dúvidas e dar encaminhamentos adequados às demandas relacionadas a COVID-19 à população da região sul catarinense. Resultados: Durante o período entre 23 de março a 14 de maio de 2020 foram realizados 1.337 autoatendimentos e atendimentos por residentes e/ou médicos, prestados a mais de 20 cidades catarinenses. Além disso, tem estabelecido um canal de comunicação com a comunidade, transmitindo informações com credibilidade e segurança. Conclusões: O uso da tecnologia se mostra eficiente ao ofertar informação correta e segura à população. É uma ferramenta importante para manutenção da população em suas casas, com acesso a profissionais de saúde, permitindo-lhes decidir com segurança a necessidade de procura de um serviço de saúde presencialmente. Ferramentas como o SOS UNESC COVID-19 apoiam a gestão do cuidado e enfrentamento da pandemia. 

Vitamin D3 as adjuvant in the treatment of type 2 diabetes mellitus: modulation of genomic and biochemical instability

Type 2 diabetes mellitus has undergone a worldwide growth in incidence in the world and has now acquired epidemic status. There is a strong link between type 2 diabetes and vitamin D deficiency. Because vitamin D has beneficial effects on glucose homeostasis, the aim of this study was to evaluate the influence of vitamin D3 supplementation on the modulation of glycaemic control and other metabolic effects, as well as modulation of genomic instability in patients with type 2 diabetes. We evaluated 75 patients with type 2 diabetes, registered in the Integrated Clinics of the University of Southern Santa Catarina. Participants received 4000 IU of vitamin D3 (25(OH)D) supplementation daily for 8 weeks. Blood samples were collected at the beginning and at the end of the supplementation, and 4 weeks after the end of supplementation. The glycidic and lipid profiles [total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglycerides], oxidative stress, DNA damage and 25(OH)D levels were evaluated. Vitamin D3 supplementation for 8 weeks showed enough to significantly increase blood levels of 25(OH)D. A significant difference in lipid profile was observed only in non-HDL cholesterol. Significant changes were observed in glucose homeostasis (fasting glucose and serum insulin) and, in addition, a reduction in the parameters of oxidative stress and DNA damage. There was a significant reduction in the values of 25(OH)D 4 weeks after the end of the supplementation, but levels still remained above baseline. Use of vitamin D supplementation can be an ally in the health modulation of patients with type 2 diabetes mellitus.

FAMILY HEALTH STRATEGY PROFESSIONAL SATISFACTION IN BRAZIL: A QUALITATIVE STUDY

ABSTRACT Objective: To identify work aspects that generate satisfaction for the professionals who work in the Family Health Strategy. Method: This was a qualitative, descriptive study that involved five geographical regions of Brazil, and 27 Family Health Teams from six municipalities. The data were collected from 76 health professionals using semi-structured interviews, and were analyzed articulating the three phases of content analysis using Atlas.ti software resources. Results: The findings showed 129 statement excerpts, with 14 codes, grouped into three categories related to satisfaction. The category, Job Identification and Family Health Strategy Principles, represented 40.3%, with the codes: team work, job affinity, health model, completeness of care, and longitudinality of care. The category, Relationship with Family Health Strategy patients, represented 32.6%, with the following codes: bonding with patient, resoluteness of care, patient satisfaction, and patient care. Finally, the category, Professional and Working Aspects related to the Family Health Strategy, represented 27.1%, with the following codes: relationship with professionals, work recognition, enjoying the profession, team organization, and employment relationship. Conclusion: Professional satisfaction is associated with the work principles of the Family Health Strategy, and with the relationships that are established between patients, professionals and health management. It also has a subjective dimension, with a strong relationship with characteristics of the work process, how it is organized, and under what conditions and relationships this work occurs.

Meta-Analysis of the Sensitivity of Decision Support Systems in Diagnosing Diabetic Retinopathy

Diabetic Retinopathy (DR) is one of the most common microvascular complications presenting by patients diagnosticated with diabetic diseases. Uncontrolled hyperglycemia may manifest as visual impairment and blindness. The early detection of DR is essential to minimize the risk and consequence of visual diminishing. The standard gold diagnoses tool relies on different imaging modalities and requires a judgment of expert photographers, which are not available in most of the primary care centers or remote location. In that scenario, an automate or semiautomated DR screening systems can contribute to improving the accuracy of the diagnostic. Thus, we performed a Systematic Review and Meta-Analysis to evaluate the Decision Support Systems (DSS) in diagnosing DR. The overall Diagnostic Odds Ratio was 73.15 (95%CI: 37.54-142.50), sensitivity was 97.70 (95%CI: 97.50-97.90) and specificity was 90.30 (95%CI: 90.00-90.60). Our results corroborate with the concept of usefulness of DSSs in early diagnosis, screening and preliminary evaluation of suspicious images of DR.

Plumb, Guyton and path: polysemy of health from the perspective of college students

ABSTRACT Purpose: to identify the understanding of health of college students enrolled in health programs of a university in the South of Brazil. Methods: a qualitative, descriptive and exploratory research conducted by means of an online questionnaire with students of health programs. The data were analyzed according to the thematic content analysis with the aid of Atlas.ti software. Results: there were 233 answers, structured in 20 codes, 7 subcategories and 3 categories: health associated with well-being, balance and quality of life; health connected with the biological and absence of diseases; and health related to the capacity to act and the notion of wholesomeness. Conclusion: the understanding of health for college students is expressed in a polysemic way, but with a predominating comprehension linked to the notion of well-being and balance.

Mental health in underground coal miners

As mental health goes beyond the simple absence of mental disorders, this paper characterized mental health components in 89 underground coal miners in southern Brazil. This is a cross-sectional study, that detected a low prevalence of depression; light or moderate anxiety in 13% of the workers; self-perception of good health; life quality and good psychological capacity in most of the participants; poor sleep quality in half of them; reverse correlations between anxiety and life quality, and anxiety and psychological capital; positive correlations between psychological capital and life quality; associations between self-perception of health, time, and sleep quality; associations between anxiety and sleep duration and quality; and between alcohol consumption and location at work (front, rear, or variable). The results suggest vulnerabilities regarding anxiety and sleep quality. However, there is a potential coping of determinants that impact on mental health.

Meta-analysis of magnetic resonance imaging accuracy for diagnosis of oral cancer

Objective

To establish the diagnostic accuracy of magnetic resonance imaging (MRI) as an auxiliary means for the diagnosis of oral cancer through a systematic review and meta-analysis.

Methods

An exhaustive search of publications from 1986 to 2016 was performed of Medline, Embase and Cochrane (and related databases), including grey literature. Primary diagnostic accuracy studies that assessed oral cancer (target condition) using MRI (index test) were included. Diagnostic threshold, sensitivity and meta-regression analyses were performed. A meta-analysis was performed using Meta-DiSc® v. 1.4 software.

Results

A total of 24 primary studies were assessed, comprising 1,403 oral cancer lesions. Nine studies used diffusion-weighted MRI, with a diagnostic odds ratio (DOR) of 30.7 (95% confidence interval [CI]: 12.7–74.3) and area under the curve (AUC) of 0.917 (95% CI: 0.915–0.918); seven studies used dynamic contrast-enhanced MRI, with a DOR of 48.1 (95%CI: 22.4–103.2) and AUC of 0.936 (95% CI: 0.934–0.937); and 13 studies used traditional MRI, with a DOR of 23.9 (95%CI: 13.2–43.3) and AUC of 0.894 (95% CI: 0.894–0.895). Meta-regression analysis indicated that the magnetic field strength may have influenced the heterogeneity of the results obtained (p = 0.0233) using traditional MRI. Sensitivity analysis revealed a discrete reduction of inconsistency in some subgroups.

Conclusion

The three types of MRI assessed exhibited satisfactory accuracy compared to biopsy. Considering the relevance of early treatment and screening and that better health care results in improved survival rates and quality of life for oral cancer patients, we suggest the use of MRI as a part of the pre-treatment and monitoring protocol at public health services.

Accuracy of Decision Support Systems for Breast Cancer - Initial Results

The aim of this study was to evaluate the accuracy of decision support systems in the diagnosis of breast cancer by means of a systematic review and meta-analysis of studies of diagnostic accuracy. The first step of the research, which consisted of the initial research of abstracts and titles identified from the research strategy in the databases was performed by two researchers independently. In this stage, 622 references were retrieved in the databases and, through a consensus meeting, 183 articles were selected for full reading.

Data Mining Applied to Analysis of Contraceptive Methods Among College Students

The aim of this study was to use the Data Mining to analyze the profile of the use of contraceptive methods in a university population. We used a database about sexuality performed on a university population in southern Brazil. The results obtained by the generated rules are largely in line with the literature and epidemiology worldwide, showing significant points of vulnerability in the university population. Validation measures of the study, as such, accuracy, sensitivity, specificity, and area under the ROC curve were higher or at least similar as compared to recent studies using the same methodology.

Increased BDNF levels after electroconvulsive therapy in patients with major depressive disorder: A meta-analysis study

OBJECTIVE

We performed a systematic review and meta-analysis to estimate brain-derived neurotrophic factor (BDNF) level in patients with major depressive disorder (MDD) after electroconvulsive therapy (ECT).

METHOD

A comprehensive search of the Cochrane Library, MEDLINE, LILACS, Grey literature, and EMBASE was performed for papers published from January 1990 to April 2016. The following key terms were searched: "major depressive disorder", "unipolar depression", "brain-derived neurotrophic factor", and "electroconvulsive therapy".

RESULTS

A total of 252 citations were identified by the search strategy, and nine studies met the inclusion criteria of the meta-analysis. BDNF levels were increased among patients with MDD after ECT (P value = 0.006). The standardized mean difference was 0.56 (95% CI: 0.17-0.96). Additionally, we found significant heterogeneity between studies (I² = 73%).

CONCLUSION

Our findings suggest a potential role of BDNF as a marker of treatment response after ECT in patients with MDD.

Auditoria Concorrente no Centro Cirúrgico: Concepções dos Enfermeiros

A auditoria hospitalar desenvolveu-se com objetivo de responder às necessidades de calcular e analisar os custos da assistência prestada. Porém, atualmente, passou a ser compreendida como recurso gerencial, utilizado para qualificar a assistência. Pesquisa com objetivo de analisar as concepções dos enfermeiros sobre a auditoria concorrente realizada no Centro Cirúrgico. Pesquisa de abordagem qualitativa, descritiva, exploratória e de campo, a qual foi desenvolvida no Centro Cirúrgico e setor de Auditoria Interna de um hospital privado do sul de Santa Catarina através de entrevista semiestruturada com 05 enfermeiras auditoras. Concluiu-se que a auditoria concorrente no Centro Cirúrgico é uma ferramenta que visa auxiliar o processo de gestão, identificando e prevenindo possíveis falhas, bem como avaliando a qualidade da assistência prestada, proporcionando maior segurança e diminuição de gastos, o que beneficia tanto paciente quanto equipe profissional e instituição.

Incidence of hepatitis C in Brazil

INTRODUCTION

Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012.

METHODS

An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases.

RESULTS

Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences.

CONCLUSIONS

Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.

Depressive disorders and comorbidities among the elderly: a population-based study

Objective The present study assessed the prevalence of depressive disorders and associated factors in a sample of elderly persons in the south of Santa Catarina. Methods A cross-sectional study based on population data was performed, evaluating 1021 elderly individuals aged between 60 and 79 years. Home interviews were carried out using the Portuguese version of the Mini International Neuropsychiatric Interview (MINI), in order to collect demographic data, information on hypertension and reports of acute myocardial infarction. The disorders studied were current depressive episode, dysthymia and a comorbidity of a depressive episode and dysthymia, representing double depression. The comparison of mean age and prevalence was made with the t-test and other associations were analyzed using the Chi-squared test. Results The prevalence of depression was 26.2%, while 5.5% of the sample suffered from dysthymia and 2.7% experienced double depression. Risk factors for depression were: nine or more years of schooling [PR = 1.44 (1.17 to 1.77); p <0.05] and being a current smoker [OR = 1.63 (1.30-2.05); p <0.05]. Dysthymia was associated with the male gender [OR = 6.46 (3.29 to 12.64); p <0.05], reports of hypertension [OR = 2.55 (1.53 to 4.24); p <0.05] and being either a current [OR = 1.86 (1.02 to 3.42); p <0.05] or past or former [OR = 2.89 (1.48 to 5.65); p <0.05] smoker. The same risk factors as for dysthymia were found for double depression: male [OR = 4.21 (1.80 to 9.81); p <0.05], reports of hypertension [OR = 8.11 (3.32 to 19.80); p <0.05], and being either a current [OR = 5.72 (1.64 to 19.93); p <0.05] or past [PR = 13.11 (3.75 to 45.86); p <0.05] smoker. Conclusions The present study shows that depressive disorders are a common phenomenon among the elderly. The results not only corroborated with other studies, but found slightly higher levels of depressive disorders among the elderly population.

The quality and characteristics of sleep of hypertensive patients

OBJECTIVEAnalyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients.METHODSA cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI).RESULTSThe prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01).CONCLUSIONIndividuals with high blood pressure have a negative association with sleep quality.

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

Objetivo Avaliar a associação entre a qualidade de vida e a adesão a medicação de indivíduos hipertensos. Métodos Estudo transversal, realizado com 432 hipertensos cadastrados em sistema informatizado público federal. Os dados foram coletados no domicilio por entrevista estruturada com questões relacionadas a variáveis socioeconômicas, clínicas, avaliação da adesão ao tratamento e o WHOQOL-BREF para a qualidade de vida. Utilizou-se o teste de H de Kruskal-Wallis para medir a associação entre as escalas da qualidade de vida e a classificação da adesão ao tratamento. Resultados Os escores mais baixos estavam presente no domínio autoavaliação e os mais altos foram encontrados no social. Os indivíduos que possuíam adesão extrema ao tratamento anti-hipertensivo apresentaram escores mais altos na avaliação da qualidade de vida em comparação com indivíduos classificados como não adesão extrema ao tratamento anti-hipertensivo. Conclusão A associação entre a qualidade de vida e adesão a medicação em indivíduos hipertensos não foi preditiva, sendo que os melhores escores estavam presentes nos indivíduos hipertensos que apresentaram alta adesão a medicação e os piores escores da qualidade de vida se apresentaram nos indivíduos de não adesão extrema e limítrofe a não adesão total.

Sobrecarga no cuidado, estresse e impacto na qualidade de vida de cuidadores domiciliares assistidos na atenção básica

ResumoTrata-se de um estudo transversal, descritivo com abordagem quantitativa, com população configurada como censitária. Os instrumentos utilizados foram o Inventário dos Sintomas de Estresse para Adultos de Lipp (ISSL), a Medida de Independência Funcional (MIF), a Versão Brasileira do Questionário de Qualidade de Vida SF-36 e o Questionário de Avaliação da Sobrecarga do Cuidador Informal (QASCI). Possui o objetivo de avaliar a sobrecarga, a qualidade de vida e a presença de estresse em cuidadores das Estratégias de Saúde da Família (ESFs) de Criciúma, no Estado de Santa Catarina. A maior proporção dos cuidadores foram do gênero feminino (90,9%), com idade média de 51,7 (±11,0) Em relação ao grau de parentesco, 45,5% eram filhos(as), e a MIF Global dos sujeitos ao qual era dedicado o cuidado foi de 70,2 (±40,1). Entre os cuidadores, 81,8% apresentaram presença de estresse e evidenciaram sobrecarga elevada. Foi observada uma correlação positiva moderada (rs=0,571) entre a MIF Global e Dor (SF-36), considerada estatisticamente significativa (p=0,001). Voltar à atenção aos cuidadores, entendendo as barreiras físicas, sociais e emocionais envolvidas no ato de cuidar, torna-se imprescindível no âmbito da saúde coletiva, tanto para proporcionar maior qualidade de vida e menor sobrecarga nos cuidadores quanto a quem é cuidado.

Incidence of tuberculous meningitis in the State of Santa Catarina, Brazil

INTRODUCTION

The aim of this study was to estimate the incidence of tuberculous meningitis in the State of Santa Catarina (SC), Brazil, during the period from 2001 to 2010.

METHODS

Ecological, temporal, and descriptive methods were employed using data obtained from the Information System on Disease Notification (Sistema de Informação de Agravos de Notificação).

RESULTS

One hundred sixteen reported cases of tuberculous meningitis occurred from 2001 to 2010, corresponding to 1.2% (0.2 cases/100,000 inhabitants) of all meningitis cases reported in SC. There was a predominance of new cases in males, corresponding to 56.9% of new cases (0.2 cases/100,000 inhabitants; males vs. females; p=0.374), in patients aged 20-39 years, corresponding to 52.6% of new cases (0.5 cases/100,000 inhabitants; 20-39 years versus others; p<0.001), and in urban areas, corresponding to 91.4% of new cases (0.2 cases/100,000 inhabitants; urban vs. rural; p=0.003). In 48.3% of cases, the outcome was death.

CONCLUSIONS

The incidence rate of tuberculous meningitis in SC has increased within the last decade, with the most affected population comprising young adult white males with an average education. Thus, tuberculous meningitis remains a serious disease, emphasizing the need for disease prevention with vaccination campaigns against tuberculosis, the development of faster and more accurate diagnostic methods, and the use of current epidemiological knowledge regarding the disease to facilitate the establishment of early treatment.

A Data Mining Approach to Identify Sexuality Patterns in a Brazilian University Population

This paper presents the profile and experience of sexuality generated from a data mining classification task. We used a database about sexuality and gender violence performed on a university population in southern Brazil. The data mining task identified two relationships between the variables, which enabled the distinction of subgroups that better detail the profile and experience of sexuality. The identification of the relationships between the variables define behavioral models and factors of risk that will help define the algorithms being implemented in the data mining classification task.

A Comparative Study of Bayes Net, Naive Bayes and Averaged One-Dependence Estimators for Osteoporosis Analysis

This paper presents an evaluation of the accuracy of the Bayesian classifiers: Bayes Net, Naive Bayes and Averaged One-Dependence Estimator, to support diagnoses of osteopenia and osteoporosis. All classifiers showed good results, thus, given data, it is possible to produce a reasonably accurate estimate of the diagnosis.

Detection of the Hepatitis C virus in a population of adults

The objective of this study was to determine the prevalence of Hepatitis C virus (HCV) in adults from Criciuma-SC and to search factors associated with the viral transmission. METHODS: During a health campaign, a questionnaire about factors associated to HCV transmission and tests to detect HCV were applied. A representative sample of the population was considered with 300 voluntaries. Fisher's Exact test, Mann-Whitney and Kappa tests were performed (p values < 0.05 were considered significant). RESULTS: HCV was detected in 7/ 457 (1.53 %) voluntaries. Subjects with positive HCV had a mean of 5.7 (+/- 4.1 SD) sexual partners in the last 10 years, which was significantly higher than those with negative anti-HCV (mean sexual partners 2 +/- 2.5 SD) (p= 0.01). CONCLUSION: The prevalence of HCV in a voluntary population of adults from Criciuma-SC was high and there was significant association between positive anti-HCV and higher number of sexual partners.