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Search Results: 1 - 10 of 608400 matches for " Josélia O. A.;Lima-Costa "
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An anthropologic study on strategies for addressing health problems among the elderly in Bambuí, Minas Gerais State, Brazil
Uch?a, Elizabeth;Firmo, Josélia O. A.;Lima-Costa, Maria Fernanda;Corin, Ellen;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500007
Abstract: this paper explores the contribution of anthropological perspectives for clarifying the mechanisms through which socioeconomic circumstances influence the strategies developed by elderly for addressing their health problems in a small brazilian city. interviews with 20 key-informants explored the community's broad perception of the health situation of the elderly. life histories collected from 30 elderly women examined their own perception of their health status and their health strategies. narratives converge in emphasising the important role played by financial factors in accessing health services and medication. life histories also describe some damaging strategies resorted to by the elderly to deal with their lack of resources. elderly women emphasize the crucial support they receive from their family and/or neighbours to overcome health problems. thus, the issue of poverty is not only a matter of socioeconomic circumstances, but also the poverty of broader social networks.
The Bambuí Cohort Study of Aging: methodology and health profile of participants at baseline
Lima-Costa, Maria Fernanda;Firmo, Josélia O. A.;Uch?a, Elizabeth;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500002
Abstract: the cohort study was initiated in 1997 to investigate the incidence and predictors of health outcomes in an elderly population with low socio-economic level. the eligible population consisted of all 1,742 residents in bambuí, minas gerais state, brazil, aged 60 years and over (1,606 participated). during 10 years of follow-up, 641 participants died and 96 were lost, leading to 13,739 person-years of observation. the baseline health profile of participants revealed a double burden of diseases with high prevalence of chronic non-transmissible diseases and widespread trypanosoma cruzi infection. the most common health condition was hypertension (61.5%), followed by chronic knee or hand symptoms (43.6%), common mental disorders (38.5%), t. cruzi infection (38.1%), and insomnia (36.7%). in general, the baseline prevalence of mental symptoms and cardiovascular diseases or risk factors was comparable to those found in populations in high income countries.
Balking blood pressure "control" by older persons of Bambuí, Minas Gerais State, Brazil: an ethno-epidemiological inquiry
Nations, Marilyn;Firmo, Josélia O. A.;Lima-Costa, Maria Fernanda;Uch?a, Elizabeth;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500008
Abstract: this ethno-epidemiological inquiry aims to comprehend hypertension-related experiences in the elderly population of bambuí, in the state of minas gerais, brazil. it combines ethnographic descriptions with statistical data. the subjective significance of factors associated with adequate arterial pressure control is explored. a baseline cohort of 26 people with hypertension, randomly selected from a total number of 1,494 residents over the age of 60, was interviewed utilizing signs, meanings and actions methodology. multivariate analysis shows an association (p < 0.001) between female gender and monthly household income and treatment of hypertension and adequate blood pressure control. the number of doctor visits is associated with treatment but not with adequate blood pressure control. conflicting cultural construction of "blood pressure problems" contributes to "non-adherence" to treatment. there is a fine line between blood pressure "control" and what is perceived as health professionals "controlling" patients' lives. doctor-prescribed regimes are perceived as "prohibiting life's pleasures" and "controlling" personal liberty and free choice. giving elderly people a voice regarding their social context can promote autonomy, well-being and happiness in later life.
Projeto Bambuí: um estudo de base populacional da prevalência e dos fatores associados à necessidade de cuidador entre idosos
Giacomin, Karla C.;Uch?a, Elizabeth;Firmo, Josélia O. A.;Lima-Costa, Maria Fernanda;
Cadernos de Saúde Pública , 2005, DOI: 10.1590/S0102-311X2005000100010
Abstract: the objective of this study was to determine the prevalence and factors associated with the needs of caregivers for older adults living in the community. all residents (n = 1,742) of bambuí, minas gerais state, brazil (15,000 inhabitants) aged > 60 years were selected. of these, 92% were interviewed and 86% were examined. the dependent variable "need for a caregiver" was defined as the inability to perform at least one of the basic activities of daily living and/or a mini mental score under 13. some 23% of the elderly required caregivers. after adjustment for confounding, independent and positive associations with the need for a caregiver were found for: age, single marital status, history of alcohol abuse, hypertension, obesity, and use of > 2 prescription drugs. independent and negative associations were found for: level of schooling, familiar income, living alone, total cholesterol > 240mmhg, and having a private health plan. those requiring caregivers presented evidence of worse socioeconomic and health status. the study provides evidence that care of the dependent elderly is a public health problem.
A estrutura da auto-avalia??o da saúde entre idosos: projeto Bambuí
Lima-Costa,Maria Fernanda; Firmo,Josélia O A; Uch?a,Elizabeth;
Revista de Saúde Pública , 2004, DOI: 10.1590/S0034-89102004000600011
Abstract: objective: to determine factors associated with self-rated health among older adults, considering five dimensions: sociodemographic variables, social support, lifestyle risk factors, health status, and access to/use of healthcare services. methods: of the 1,742 older adults (>60 years) living in the town of bambuí (southeastern brazil), 1,516 (87.0%) participated in the study. information was obtained by means of standardized interviews and physical and laboratory exams. results: self-rated health as good/very good, reasonable, and poor/very poor was reported by 24.7%, 49.2%, and 26.1% of subjects, respectively. the following characteristics showed independent positive associations with worse self-rated health: social ties (dissatisfaction with social network, attendance to clubs and associations), health status (symptoms of depression/anxiety in the last two weeks, sleeplessness in the last 30 days, greater number of prescribed medications used in the last 30 days), and access to/use of healthcare services (complaints when seeking medical care, greater number of medical appointments in the last 12 months, greater number of hospital admissions in the last 12 months). an independent negative association was found with monthly family income (<2.0 vs. >4 minimum wages). conclusions: our results show that self-rated health among older adults is multidimensional in structure, being influenced by socioeconomic conditions, social support, health status (with emphasis on mental health), and access to/use of healthcare services. this structure resembles the definition of health adopted by the world health organization (an individual's "physical, mental and social well-being").
The Bambuí Health and Aging study (BHAS): prevalence of risk factors and use of preventive health care services
Lima-Costa Maria Fernanda,Barreto Sandhi M.,Uch?a Elizabeth,Firmo Josélia O. A.
Revista Panamericana de Salud Pública , 2001,
Abstract: Objective. To describe, for the first time in Brazil, the prevalence of risk factors and the use of preventive health care services among adults 60 years and older. Methods. This population-based study was conducted during 1996-1997 in the state of Minas Gerais, in the town of Bambuí, which is located in the municipality of the same name. In 1996 the town had 14 950 inhabitants. For the study, all the town's residents aged > or = 60 years were selected, along with a comparison sample of persons aged 18-59 years. Data were gathered using interviews and physical examinations. Results. Of the 1 742 inhabitants of the town of Bambuí aged > or = 60 years, 1 606 (92.2%) participated in the interview and 1 495 (85.8%) were examined (blood pressure, anthropometric measurements, and blood tests). Among the 1 020 younger adults selected for the survey, 909 of them (89.1%) participated in the interview, and 820 of them (80.4%) underwent the physical examination. The prevalence of the following risk factors was higher among older adults than among younger adults: physical inactivity (47.7% vs. 28.0%); blood pressure 140-159 mmHg (systolic) or 90-99 mmHg (diastolic) (25.8% vs. 8.7%); blood pressure > or = 160 mmHg (systolic) or > or = 100 mmHg (diastolic) (19.1% vs. 4.1%); total cholesterol > or = 240 mg/dL (40.6% vs. 9.8%); and blood glucose > or = 126 mg/dL (12.4% vs. 2.2%). The daily consumption of fruits and vegetables was similar among the older adults and the younger ones (51.9% and 51.7%), as was also body mass index > or = 25 kg/m2 (51.6% and 56.2%). Smoking was lower among the older adults (18.7%) than among the younger ones (31.1%). The proportion of participants whose blood pressure had been checked in the preceding year was high (86.8% among the older adults and 61.2% among the younger ones), suggesting that the high prevalence of uncontrolled hypertension was not due to limited access to health care. Conclusions. For a long time it was believed that the kinds of risk factors that we found in the urban section of the municipality of Bambuí were public health problems only in large Brazilian cities. Around 72% of the municipalities in Brazil have<= 20 000 inhabitants, and these smaller municipalities contain some 19% of the country's entire population. The high prevalence of various risk factors among the older and younger adults in Bambuí indicates a great need for health promotion and disease prevention actions. More research is needed to find out whether our results in Bambuí reflect the reality of other small towns in Brazil.
Projeto Bambuí: um estudo de base populacional da prevalência e dos fatores associados à necessidade de cuidador entre idosos
Giacomin Karla C.,Uch?a Elizabeth,Firmo Josélia O. A.,Lima-Costa Maria Fernanda
Cadernos de Saúde Pública , 2005,
Abstract: Este estudo tem por objetivo determinar a prevalência e os fatores associados com a necessidade de cuidador entre idosos residentes na comunidade. Foram selecionados todos os residentes na cidade de Bambuí, Minas Gerais, Brasil, com > 60 anos de idade (n = 1.742). Destes, 92% foram entrevistados e 86% examinados. A variável dependente - necessidade de cuidador - foi definida como: (1) relato de incapacidade para realizar pelo menos uma das atividades da vida diária e/ou (2) escore inferior a 13 no Mini Mental State Examen. A prevalência da necessidade de cuidador foi de 23%. Apresentaram associa es positivas e independentes com a necessidade de cuidador: idade, ser solteiro, história de alcoolismo prévio, hipertens o arterial, obesidade e uso de medicamentos prescritos. Observaram-se associa es negativas e independentes para: escolaridade, renda familiar, viver só, colesterol total > 240mmHg e ter plano privado de saúde. Assim, a necessidade de cuidador em Bambuí estava associada a piores condi es sócio-econ micas e de saúde. O cuidado dos idosos dependentes é um problema de saúde pública.
Predictors of 10-year hospital use in a community-dwelling population of Brazilian elderly: the Bambuí cohort study of aging
Macinko, James;Camargos, Vitor;Firmo, Josélia O. A.;Lima-Costa, Maria Fernanda;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500003
Abstract: we use data from a population-based cohort of elderly brazilians to assess predictors of hospitalizations during ten years of follow-up. participants were 1,448 persons aged 60 years and over at baseline (1997). the outcome was self-reported number of hospitalizations per year. slightly more than a fifth (23%) experienced no hospitalizations during the 10 year follow-up. about 30% had 1-2 events, 31% had between 3 and 7 events, and about 18% had 8 or more events during this time. results of multivariable hurdle and cox proportional hazards models showed that the risk of hospitalization was positively associated with male sex, increased age, chronic conditions, and visits to the doctors in the previous 12 months. underweight was a predictor of any hospitalization, while obesity was an inconsistent predictor of hospitalization.
The Bambuí Health and Aging Study (BHAS): factors associated with hospitalization of the elderly
Guerra, Henrique L.;Firmo, Josélia O. A.;Uchoa, Elizabeth;Lima-Costa, Maria Fernanda F.;
Cadernos de Saúde Pública , 2001, DOI: 10.1590/S0102-311X2001000600018
Abstract: this study aimed to identify factors associated with hospital admissions of the elderly. all residents of bambuí, minas gerais state 3 60 years (n = 1,742) were selected. some 1,606 of these (92.2%) participated in the study. the dependent variable was the number of hospital admissions (none, one, and two or more) during the previous 12 months. independent variables were grouped as enabling, predisposing, and need-related factors. the strongest associations with multiple hospital admissions were: living alone; financial constraints to purchase of medication; and various indicators of need (worse self-perceived health, more visits to physician, greater use of prescription medications, and history of coronary heart disease). such variables could help identify older adults at greatest risk and thus prevent hospitalization.
Socioeconomic position and health in a population of Brazilian elderly: the Bambuí Health and Aging Study (BHAS)
Lima-Costa,Maria Fernanda; Barreto,Sandhi M.; Firmo,Josélia O.A.; Uchoa,Elizabeth;
Revista Panamericana de Salud Pública , 2003, DOI: 10.1590/S1020-49892003000500007
Abstract: objective: despite the vast scientific literature on the social determinants of health, there is still a debate on the extent to which this relationship remains in old age. the objective of this study was to examine the association between socioeconomic circumstances and health among older adults in a small town in brazil. methods: the study was carried out in bambuí, a town of around 15 000 inhabitants that is located in the state of minas gerais, which is in southeastern brazil. from 1 177 residents aged 65 years or older, 1 074 of them (91.2%) were interviewed and 997 (84.7%) were examined (physical measurements and blood tests). those in the lowest third of the distribution of total household monthly income, with an income of less than us$ 240 per month, were compared with those who had an income above that level. results: lower family income was independently associated with: (1) some lifestyle risk factors (less consumption of fresh fruits or vegetables and less frequent exercise during leisure time in the preceding 30 days), (2) several indicators of worse health status (general health questionnaire score, self-rated health, self-rated visual acuity, level of difficulty in walking 300 meters, inability to perform routine activities because of a health problem in the preceding 2 weeks, and seropositivity for trypanosoma cruzi), (3) a higher number of nonprescribed medications used in the preceding 3 months, and (4) a higher number of hospitalizations in the preceding 12 months. obesity was more frequent in the higher-income group. conclusions: the results of this study do not confirm observations in some developed countries of a lack of association between socioeconomic status and health among the aged. our results showed that a small difference in monthly family income was sufficiently sensitive to identify elderly persons in worse health, even within a community that appears to be uniformly poor.
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