Variables associated with sedentary leisure time in the elderly in Campinas, São Paulo State, Brazil

The objective of this study was to identify the prevalence of sedentary leisure time (no type of leisure-time exercise once a week or more) among the elderly in the city of Campinas, S?o Paulo State, Brazil, according to demographic and socioeconomic factors, other health-related behaviors, and the presence of morbidity. This was a population-based cross-sectional study with multiple-stage sampling. Data analysis considered the sample design. Prevalence of sedentary leisure time was 70.9%, and the prevalence ratio was significantly higher than 1.0 for the elderly with lower socioeconomic status (1.31: 1.11-1.55), smokers (1.39: 1.23-1.57), those with common mental disorders (1.20: 1.04-1.39), and females (1.16: 1.00-1.35). Prevalence of walking was 23.5%, followed by fitness or bodybuilding programs (3.8%), and swimming or water aerobics (3.6%). The results show the need to develop global action for health-related behaviors in order for this approach to succeed. Attention should focus on the elderly with common mental disorders and those with lower socioeconomic status to ensure equity in health promotion practices.     

Survival in gastric cancer patients in Campinas, São Paulo, Brazil

This study analyzes the survival of gastric cancer patients in the city of Campinas, S?o Paulo State, Brazil. Data from the Campinas Population-Based Cancer Registry (RCBP) related to gastric cancer cases diagnosed from 1991 to 1994 were analyzed. Observed and relative survival rates were calculated, and to compare rates between different groups and international populations, the relative mortality risk was used. One-year relative survival rate for patients with gastric cancer was 33%, and five-year relative survival was 9%, confirming the poor prognosis of gastric cancer. Gender had no influence on survival, while the prognosis was better for young people. There was a gradient of severity from the localized to the metastatic state, not statistically significant. The group with undifferentiated adenocarcinomas had longer survival, with 47% of patients alive after the first year, whereas only 7% of those without a histological classification survived the first year after diagnosis. Compared with international results like the pool of European registries, the risk was greater, especially considering the five-year survival rates.     

Self-rated health in the elderly: a population-based study in Campinas, São Paulo, Brazil

This study analyzed self-rated health in the elderly according to demographic, socioeconomic, and health-related behavior. This was a cross-sectional, population-based study with a cluster sample using data from a survey in Campinas, S?o Paulo State, Brazil (ISACamp 2008-2009). Adjusted prevalence ratios were estimated using multiple Poisson regression. The study enrolled 1,432 elderly. Prevalence of excellent/very good health was 24.6% and was significantly higher in the elderly with more schooling, higher income, no religion, living alone, home computer, alcohol consumption 1-4 times a month, physical activity during leisure-time, no obesity, and fruit and vegetable consumption ≥ 4 times a week. Some of the findings are scarce in the literature and indicate relevant topics for further investigation. The results highlight the need for greater attention to socially vulnerable groups and the development of strategies to promote healthy habits in the elderly.     

Work, violence and death in Campinas, São Paulo, Brazil

In this epidemiological study, deaths resulting from external causes in 1999 and 2000 among males (age 15-64 years) in Campinas, S?o Paulo State were analyzed through interviews with their relatives. We attempted to correlate this incidence with individual occupational history, allowing the characterization of these events as work-related injuries. The proportional death rate due to work-related injuries was estimated at 27% in this group. None of the death certificates we analyzed had "yes" specified in the appropriate work-related injury field. Based on these results, official data from the Brazilian Ministry of Labor on the number of deaths resulting from work-related injuries in this period in the State of S?o Paulo is underestimated by 83.4%. The vast majority of fatal work-related injuries were homicides and traffic accidents, reflecting an increase in violence in this Brazilian city.     

Spotted fever in Campinas region,State of São Paulo,Brazil

Brazilian spotted fever was detected for the first time in the State of S o Paulo in 1929. However, there is no systematic reporting of the disease in the State. In 1985, three cases of the disease occurred in the municipality of Pedreira, located in the Campinas Region, belonging to the 5th Administrative Region, in the Northeast part of the State, including 88 municipalities. An investigation was conducted at the time, but the lack of case registry limited its scope. The present study was undertaken with the aim of recovering the history of the disease in the Region. Data recovered from several public health services for 1985-2000 were used to analyze incidence patterns. It was observed that the transmission area expanded and the number of suspected cases increased, especially after 1996, when mandatory reporting was established. Deaths due to spotted fever were observed in most of the years under study. The study concluded that spotted fever incidence is increasing in the Campinas Region. Complementary bio-ecological studies are currently under way to better understand the epidemiology of this disease, recognized worldwide as an emerging public health problem.     

Analysis of seniors vaccination programme in Campinas, São Paulo State, Brazil

This study examines the planning, operations and assessment of a Seniors Vaccination Program in Campinas, S?o Paulo State, from the standpoint of practices adopted by central, district and local authorities and intended to ensure influenza vaccination coverage. The case study method was used, with work-health process benchmarks. The primary data source was semi-structured interviews, with institutional documents and records serving as secondary sources. The field of study was the municipal coordination of this Program in two Health Districts and one Basic Healthcare Unit. The choice of these Districts was based on differing vaccination coverage, while the Unit choice was guided by its outstanding campaign organization. At the district and local levels, the program was coordinated by nurses who assigned high priority to following routines and rules instead of pursuing the purpose of the campaign. Insufficient analysis capacities were identified, with poorly networked actions, incipient communications methods and ineffective use of information for planning purposes. The results underscore the importance of adopting management practices tailored to the purposes of healthcare efforts, ushering in responsible autonomy among workers and fostering ongoing reflection on these practices.     

Nursing practice and public health policy in Campinas, São Paulo, Brazil

Redemocratization in the 1970s brought about changes in the public health system in Brazil. The Unified National Health System (SUS) was implemented in 1988, based on local and regional administrative systems. This was an important step that resulted in greater local control and the introduction of new technologies. This study focuses on the local health system in Campinas, a relatively affluent and technologically advanced region some 100km from the city of S?o Paulo in Southeast Brazil. Qualitative and quantitative methods were used to evaluate the work of 233 nurses in the local health system. The first nurse was hired in 1977, and now there are 53 nurses working in specific areas: 10 in the central health administration, 36 in district administrations, and the rest in local services. Nursing services are organized in six main areas: administration, coordination of human resources, education, information technology, health surveillance, and health administration. Nursing intervention may be found in various areas, but it generally focuses on medical consultations, and there is little emphasis on collective activities and health promotion. Local health objectives can only be achieved by creating new practices that promote collective health.     

Income inequality and elderly self-rated health in São Paulo,Brazil

PurposeTo test the association between income inequality and elderly self-rated health and to propose a pathway to explain the relationship.MethodsWe analyzed a sample of 2143 older individuals (60 years of age and over) from 49 distritos of the Municipality of São Paulo, Brazil. Bayesian multilevel logistic models were performed with poor self-rated health as the outcome variable.ResultsIncome inequality (measured by the Gini coefficient) was found to be associated with poor self-rated health after controlling for age, sex, income and education (odds ratio, 1.19; 95% credible interval, 1.01–1.38). When the practice of physical exercise and homicide rate were added to the model, the Gini coefficient lost its statistical significance (P > .05). We fitted a structural equation model in which income inequality affects elderly health by a pathway mediated by violence and practice of physical exercise.ConclusionsThe health of older individuals may be highly susceptible to the socioeconomic environment of residence, specifically to the local distribution of income. We propose that this association may be mediated by fear of violence and lack of physical activity.     

Meningococcal disease diagnostic criteria in Greater Metropolitan Campinas, São Paulo State, Brazil

The aim of this article is to evaluate confirmatory criteria: culture, latex agglutination, counter immunoelectrophoresis, microscopic examination, and clinical/epidemiological criteria for cases of meningococcal disease reported in Greater Metropolitan Campinas, S?o Paulo State, Brazil, from 1993 to 2002 (568 cases). The following variables were also studied: clinical features, gender, age, city, hospital, case fatality, seasonality, and Neisseria meningitidis serogroup. Culture as a confirmatory criterion was the dependent variable in univariate analysis. The mean proportion of confirmatory criterion by culture was 68.7%. Clinical features of meningococcal disease -- meningitis without septicemia (OR = 2.87; CI: 1.89-4.38) and septicemia without meningitis (OR = 0.26; CI: 0.17-0.45) -- were associated with confirmation by culture. Case fatality rates were different among all diagnostic criteria. More attention should be given to etiological diagnostic confirmation in more severe cases. Diagnostic methods such as PCR may improve etiological confirmation of meningococcal disease in cases with negative cultures.     

Dengue: sero-epidemiological survey and virological surveillance in Campinas, São Paulo, Brazil

The epidemiology of dengue in the municipality of Campinas, S?o Paulo, Brazil, was studied in 1998 using a randomized sero-epidemiological survey. Epidemiological surveillance data from 1996-2003 were also analyzed, with an emphasis on virological surveillance. 1,260 individuals participated in the survey and had blood samples drawn by finger stick on filter paper. Blood samples were tested by EIA-ICC, an enzyme immunoassay using infected cells as antigen. Dengue antibody prevalence (14.79%) was lower than in other surveys in other States of Brazil, but higher than in two other serological surveys in S?o Paulo State. Dengue antibody prevalence was far higher than the reported case incidence during the 1996, 1997, and 1998 epidemics. Antibody prevalence and reported case incidence in different health districts were disproportional. The article concludes by recommending further research on the significance of transmission rates during epidemics and more intensive virological surveillance, especially in years with few reported cases.     

Urban schistosomiasis and social and epidemiological heterogeneity in Campinas, São Paulo, Brazil

This study deals with the relationship between schistosomiasis and urbanization, particularly the urbanization process experienced by cities in dependent capitalist countries, with large groups of people in precarious living conditions. Six hundred and ten notified autochthonous cases in Campinas during the period from 1970 to 1990 are analyzed through notification files with regard to patients socio-economic conditions. Autochthonous cases of schistosomiasis were demonstrated as having a more heterogeneous geographical distribution within the urban area than could be inferred from previous studies that correlate the occurrence of transmission with precarious sanitary conditions.     

Arterial hypertension in the elderly: prevalence, associated factors, and control practices in Campinas, São Paulo, Brazil

The objective of this study was to assess the prevalence of reported hypertension among the elderly in Campinas, S?o Paulo, Brazil, identifying related factors, the use of healthcare services, and knowledge and practices related to treatment options. This was a cross-sectional population-based study, with stratified clustered multiple-stage sampling. Data analysis for the 426 individuals (60 years of age and older) considered the sampling design and outlining effect. Hypertension prevalence was 51.8% (46.4% in men and 55.9% in women) and was higher among the elderly with less education (55.9%), immigrants from other States (60.2%), and the overweight or obese (57.2%). The results indicate that healthcare services are ensuring access to medical care (71.6% have regular physician appointments) and medication (86.7% take their routine medication), without distinction as to socioeconomic status. However, social inequalities persist in knowledge and use of other measures to control blood pressure, like appropriate diet and exercise, which are also underused by more privileged socioeconomic strata.     

Anthropometry of elderly residents in the city of São Paulo, Brazil

The article presents gender and age-specific selected anthropometric data for a representative sample of elderly Brazilians in the city of S?o Paulo. This was a cross-sectional, population-based household survey. A total of 1,894 older adults (men and women, > 60 years) were examined from January to March 2001. Data were presented as means and percentiles for body mass (BM); height or stature (ST); body mass index (BMI); waist (WC), hip (HC), arm (AC), and calf (CC) circumferences; triceps skinfold thickness (TST); and arm muscle circumference (AMC), and differences were described according to age (all variables) and gender (BMI). Except for HC (men), all anthropometric variables were lower in the oldest than in the youngest individuals (p < 0.01) in both genders. BMI was significantly higher (p < 0.01) in women than men (all age groups). The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (both genders). The data can be used in clinical practice and epidemiological studies based on interpretation of anthropometric measurements in the elderly in S?o Paulo.     

Municipalization of vaccination in Ribeirão Preto, São Paulo, Brazil

The object of this study is the organization of activities in the vaccination program in Ribeir?o Preto, S?o Paulo, during the process of municipalization of health services, analyzing changes and estimating results. The methodology included a survey performed during supervisory visits and questionnaires with 20 nurses and 39 vaccination workers in all the vaccination rooms at the municipal primary health care unit in this city, a survey of storage conditions for immunobiological products at the municipal level and a questionnaire for the section head, and interviews with five health professionals responsible for vaccination at the State, regional, and municipal levels. It followed that since implementation of the so-called Integrated Health Actions proposal there has been an expansion of primary health care services, including vaccination services; there has also been a technical and administrative centralization of decisions involving vaccination activities, including training of human resources by the Municipal Epidemiological Surveillance division. The study points out that although this activity is dealt with carefully by those responsible for the State, municipal, and district levels, the same is not true at the local level.     

Traffic accidents: a qualitative approach from Campinas,São Paulo,Brazil

This article takes an interdisciplinary qualitative approach to the problem of traffic accidents in Campinas, S?o Paulo, Brazil. The authors begin by analyzing the "municipalization" (i.e., decentralization to the municipal level) of transport and traffic management in Campinas based on social representations by members of the local government's technical staff. Data demonstrate a significant drop in traffic accident mortality in Campinas in the last ten years. The findings illustrate how new transport and traffic policies had several positive effects. Special attention is given to the objectives, strategies, and obstacles dealt with by local government in the "municipalization" of traffic. The paper concludes by emphasizing the need for specific public policies to revitalize urban mass transportation, including special traffic safety educational programs.     

Oral health in adults and the elderly in Rio Claro, São Paulo, Brazil

The aim of this study was to verify the prevalence of dental caries, edentulism, and use of and need for complete dental prostheses in adults and the elderly in Rio Claro, S?o Paulo State, Brazil. The total sample included 202 subjects, 101 elderly (64 to 75 year-olds) and 101 adults (35 to 44 year-olds), who were examined by four examiners according to who criteria. Edentulism was 74.25% in the elderly and 8.91% in adults, and present teeth rates were 3.19 and 22.10, respectively. In the elderly and adults, DMFT was 31.09 and 22.86, respectively. MT was the major component of the DMFT index in the elderly group (92.64%), as compared to FT in the adult group (57%), followed by MT (40.54%). complete upper and lower dental prostheses were needed by only 1% of the adults; however, 48.5% of the elderly required complete upper prostheses and 45.5% complete lower prostheses. the data suggest that preventive and educational programs are needed for both the elderly group and adults in order for adults to enjoy good oral health when they reach old age.     

Prevalence of hypovitaminosis a in children of peripheral districts of Campinas São Paulo, Brazil

The prevalence of hypovitaminosis A among children of the peripheral districts of the city of Campinas, S o Paulo, Brazil, was estimated by determining serum retinol levels by High Performance Liquid Chromatography (HPLC) in a sample of 131 children aged between three and ten years, between April 1991 and February 1992. A prevalence of 17.6% and retinol concentrations in the range of 0.35 to 0.70 micromol/L were found (CI=11.1-24.1; 95%), indicating the existence of public health risk Ophthalmological examinations, however, failed to detect any cases of xerophthalmy. Additional characterization of the sample was obtained from 341 children. The per capita income of the average household was surprisingly high for low-income areas. According to FAO-WHO standards, food consumption was adequate only for protein (133.96%). Adequacy levels were low for energy (87.76%) and particularly for vitamin A (66.13%) and iron (42.14%). Height for-age and weight-for-height anthropometric indices revealed that many children were located below -1 standard deviation.