Use of the mini-mental state examination in research on the elderly in Brazil: a systematic review

The Mini-Mental State Examination (MMSE) is the most widely used cognitive screening test around the world. In Brazil, different MMSE versions and many cut-off points have been used. A systematic review of papers indexed in Scielo was conducted in order to analyze use of the MMSE in Brazilian empirical studies with elderly people. To search for these texts, the complete name of the instrument and its abbreviation were used. A growth trend in the scientific production during the 1998 to 2013 period was observed. Eleven versions of the MMSE were identified and the Bertolucci et al. version was the most cited. Over half of the studies used schooling as the criteria to establish cut-off points. The studies were predominantly conducted using samples recruited from large cities in the Southeastern region and in the community. Despite the growing trend of research with the elderly using the MMSE, the psychometric properties of this scale of measurement have been the subject of little investigation. Despite the widespread use of the MMSE in Brazil, there is a lack of standardization and evidence of validity for this this scale of measurement.O Mini Exame do Estado Mental (MEEM) é o teste de rastreio cognitivo mais utilizado no mundo. No Brasil, diferentes versões e pontos de corte do MEEM têm sido usados. Para analisar seu uso em estudos empíricos brasileiros com idosos, efetuou-se uma revisão sistemática de artigos indexados na SciELO. Foram utilizados o nome completo do instrumento e sua abreviação para recuperar os textos. Observou-se uma tendência de crescimento da produção científica analisada, no período de 1998 a 2013. Foram mencionadas 11 versões do MEEM, destacando-se a de Bertolucci et al. Mais da metade das investigações fizeram uso da escolaridade como critério para estabelecer pontos de corte. Os estudos têm sido realizados predominantemente com amostras recrutadas em grandes cidades da região Sudeste e na comunidade. Não obstante a tendência de crescimento de pesquisas com idosos que utilizam o MEEM, as propriedades psicométricas dessa medida têm sido pouco investigadas. Apesar da ampla utilização do MEEM no Brasil, faltam padronização e evidências de validade para essa medida

Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team.

The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sample of 1415 caretakers and their 2048 children aged under 5 years was visited using a cluster sampling technique. The survey documented the levels of literacy and health education awareness of the caretakers, measured the vaccination coverage levels for children and women of childbearing age, and determined treatment practices for diarrhoea and malaria. Of the 637 women who reported having given birth in the previous 12 months, 96% had visited an antenatal clinic, but only 49% had had two or more doses of tetanus toxoid, and 13% took weekly chemoprophylaxis against malaria. The vaccination coverage for measles was 16% for children aged 12-23 months. Oral rehydration therapy (ORT) was given to 16% of children with diarrhoea; however, only 43% of those who were administered ORT at home were treated according to standard guidelines. Of children with diarrhoea, 51% were given antidiarrhoeal or antimicrobial drugs by caretakers. Fever was treated at home for 79% of the febrile children, and 43% of those with fever also visited health units. The use of injectable antimalarials and prolonged treatments with chloroquine were common. Combining findings from a population-based community study with an assessment of practices in health facilities can provide reliable information for the implementation and monitoring of selective components of primary health care