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1.
J Med Internet Res ; 26: e53369, 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39116424

RESUMO

BACKGROUND: Digitization shall improve the secondary use of health care data. The Government of the Kingdom of Saudi Arabia ordered a project to compile the National Master Plan for Health Data Analytics, while the Government of Estonia ordered a project to compile the Person-Centered Integrated Hospital Master Plan. OBJECTIVE: This study aims to map these 2 distinct projects' problems, approaches, and outcomes to find the matching elements for reuse in similar cases. METHODS: We assessed both health care systems' abilities for secondary use of health data by exploratory case studies with purposive sampling and data collection via semistructured interviews and documentation review. The collected content was analyzed qualitatively and coded according to a predefined framework. The analytical framework consisted of data purpose, flow, and sharing. The Estonian project used the Health Information Sharing Maturity Model from the Mitre Corporation as an additional analytical framework. The data collection and analysis in the Kingdom of Saudi Arabia took place in 2019 and covered health care facilities, public health institutions, and health care policy. The project in Estonia collected its inputs in 2020 and covered health care facilities, patient engagement, public health institutions, health care financing, health care policy, and health technology innovations. RESULTS: In both cases, the assessments resulted in a set of recommendations focusing on the governance of health care data. In the Kingdom of Saudi Arabia, the health care system consists of multiple isolated sectors, and there is a need for an overarching body coordinating data sets, indicators, and reports at the national level. The National Master Plan of Health Data Analytics proposed a set of organizational agreements for proper stewardship. Despite Estonia's national Digital Health Platform, the requirements remain uncoordinated between various data consumers. We recommended reconfiguring the stewardship of the national health data to include multipurpose data use into the scope of interoperability standardization. CONCLUSIONS: Proper data governance is the key to improving the secondary use of health data at the national level. The data flows from data providers to data consumers shall be coordinated by overarching stewardship structures and supported by interoperable data custodians.


Assuntos
Atenção à Saúde , Arábia Saudita , Estônia , Humanos , Disseminação de Informação/métodos
2.
Cancer Control ; 31: 10732748241266491, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39092882

RESUMO

BACKGROUND: Despite the relatively low breast cancer incidence in Estonia, mortality remains high, and participation in mammography screening is below the recommended 70%. The objective of this register-based study was to evaluate incidence-based (IB) breast cancer mortality before and after the introduction of organized mammography screening in 2004. METHODS: Breast cancer deaths individually linked to breast cancer diagnosis were obtained from the Estonian Cancer Registry and used for calculating IB mortality. We compared age-specific IB mortality rates across 5-year birth cohorts and 5-year periods. Poisson regression was used to compare IB mortality for one age group invited to screening (50-63) and three age groups not invited to screening (30-49, 65-69, and 70+) during two periods before and after screening initiation (1993-2003 and 2004-2014). Joinpoint regression was used for age-standardized incidence and IB mortality trends. RESULTS: Age-standardized IB mortality has been decreasing since 1997. Age-specific IB mortality for birth cohorts never exposed to screening showed a continuous increase with age, while in cohorts exposed to organized screening the mortality curve flattened or declined after the age of first invitation. Significant decreases in mortality from 1993-2003 to 2004-2014 were seen in the 30-49 (age-adjusted rate ratio 0.51, 95% CI 90.42-0.63) and 50-63 (0.65, 95% CI 0.56-0.74) age groups, while no decline was seen in the 65-69 and 70+ age groups. CONCLUSIONS: The age specific IB mortality curves in birth cohorts exposed to screening and the significant mortality decline in the target age group after the initiation of the organized program suggest a beneficial effect of screening. Improved treatment without screening has not reduced mortality in older age groups. Our results support raising the upper screening age limit to 74 years.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Mamografia , Sistema de Registros , Humanos , Estônia/epidemiologia , Feminino , Neoplasias da Mama/mortalidade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/diagnóstico , Pessoa de Meia-Idade , Idoso , Incidência , Detecção Precoce de Câncer/métodos , Adulto , Programas de Rastreamento/métodos , Fatores Etários
4.
J Environ Radioact ; 278: 107508, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39121676

RESUMO

In June 2020, observations of anthropogenic radionuclides in Estonia, Finland, and Sweden that were not related to any acknowledged environmental release led to a comprehensive investigation on the source and cause of the unusual emissions. Several of the observed radionuclides were on the list of Comprehensive Nuclear-Test-Ban Treaty (CTBT) relevant radionuclides as an indicator of a potential nuclear test, and warranted detailed investigation. While analysis of aerosol samples coupled with Atmospheric Transport and Dispersion Modelling (ATDM) is a standard approach for environmental particulate releases, several new techniques were employed to better characterize the samples that allowed for useful inferences to be made. These inferences were crucial in forming the ultimate hypothesis for determining the facility type and location of the release.


Assuntos
Poluentes Radioativos do Ar , Monitoramento de Radiação , Finlândia , Suécia , Monitoramento de Radiação/métodos , Poluentes Radioativos do Ar/análise , Radioisótopos/análise , Estônia
5.
Nat Commun ; 15(1): 5801, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987242

RESUMO

Obesity is a heritable disease, characterised by excess adiposity that is measured by body mass index (BMI). While over 1,000 genetic loci are associated with BMI, less is known about the genetic contribution to adiposity trajectories over adulthood. We derive adiposity-change phenotypes from 24.5 million primary-care health records in over 740,000 individuals in the UK Biobank, Million Veteran Program USA, and Estonian Biobank, to discover and validate the genetic architecture of adiposity trajectories. Using multiple BMI measurements over time increases power to identify genetic factors affecting baseline BMI by 14%. In the largest reported genome-wide study of adiposity-change in adulthood, we identify novel associations with BMI-change at six independent loci, including rs429358 (APOE missense variant). The SNP-based heritability of BMI-change (1.98%) is 9-fold lower than that of BMI. The modest genetic correlation between BMI-change and BMI (45.2%) indicates that genetic studies of longitudinal trajectories could uncover novel biology of quantitative traits in adulthood.


Assuntos
Adiposidade , Índice de Massa Corporal , Registros Eletrônicos de Saúde , Estudo de Associação Genômica Ampla , Obesidade , Polimorfismo de Nucleotídeo Único , Humanos , Adiposidade/genética , Masculino , Feminino , Obesidade/genética , Pessoa de Meia-Idade , Adulto , Idoso , Reino Unido , Fenótipo , Estônia , Estados Unidos , Predisposição Genética para Doença
6.
BMC Med ; 22(1): 294, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39020289

RESUMO

BACKGROUND: Endometriosis, defined as the presence of endometrial-like tissue outside of the uterus, is one of the most prevalent gynecological disorders. Although different theories have been proposed, its pathogenesis is not clear. Novel studies indicate that the gut microbiome may be involved in the etiology of endometriosis; nevertheless, the connection between microbes, their dysbiosis, and the development of endometriosis is understudied. This case-control study analyzed the gut microbiome in women with and without endometriosis to identify microbial targets involved in the disease. METHODS: A subsample of 1000 women from the Estonian Microbiome cohort, including 136 women with endometriosis and 864 control women, was analyzed. Microbial composition was determined by shotgun metagenomics and microbial functional pathways were annotated using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Partitioning Around Medoids (PAM) algorithm was performed to cluster the microbial profile of the Estonian population. The alpha- and beta-diversity and differential abundance analyses were performed to assess the gut microbiome (species and KEGG orthologies (KO)) in both groups. Metagenomic reads were mapped to estrobolome-related enzymes' sequences to study potential microbiome-estrogen metabolism axis alterations in endometriosis. RESULTS: Diversity analyses did not detect significant differences between women with and without endometriosis (alpha-diversity: all p-values > 0.05; beta-diversity: PERMANOVA, both R 2 < 0.0007, p-values > 0.05). No differential species or pathways were detected after multiple testing adjustment (all FDR p-values > 0.05). Sensitivity analysis excluding women at menopause (> 50 years) confirmed our results. Estrobolome-associated enzymes' sequence reads were not significantly different between groups (all FDR p-values > 0.05). CONCLUSIONS: Our findings do not provide enough evidence to support the existence of a gut microbiome-dependent mechanism directly implicated in the pathogenesis of endometriosis. To the best of our knowledge, this is the largest metagenome study on endometriosis conducted to date.


Assuntos
Endometriose , Microbioma Gastrointestinal , Humanos , Endometriose/microbiologia , Feminino , Microbioma Gastrointestinal/fisiologia , Adulto , Estudos de Casos e Controles , Estônia/epidemiologia , Estudos de Coortes , Pessoa de Meia-Idade , Metagenômica , Disbiose/microbiologia , Adulto Jovem
7.
BMC Psychiatry ; 24(1): 481, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956493

RESUMO

BACKGROUND: Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services. METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.


Assuntos
Registros Eletrônicos de Saúde , Serviços de Saúde Mental , Humanos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estônia , Noruega , Finlândia , Serviços de Saúde Mental/estatística & dados numéricos , Suécia , Inquéritos e Questionários , Adulto Jovem , Idoso , Acesso dos Pacientes aos Registros , Adolescente
8.
Eur J Gen Pract ; 30(1): 2368557, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38958064

RESUMO

BACKGROUND: The shortage of general practitioners (GPs) is a worsening problem in many countries and poses a threat to the services provided by primary care and by extension for the entire healthcare system. Issues with GP workforce recruitment and retention can be reasons for this shortage. OBJECTIVES: To describe GP trainees and newly qualified GPs experiences and perceptions on how their training and early experiences of work influence their career intentions in primary care in Estonia. METHODS: A qualitative study with GP trainees (n = 12) and newly qualified GPs (n = 13) using semi-structured group interviews (n = 6) was conducted. Interviews were conducted from October until November 2020. Data were analysed using thematic analysis with NVivo Software. RESULTS: Although early-career GPs in Estonia envision their future roles as GP practice owners with patient list, this is often postponed due to various reasons. Early-career GPs expressed a sense of unpreparedness to fill all the roles of GPs' and found the process of establishing a GP practice and taking on a patient lists very complicated. They value work-life balance and prefer workplaces, which offer flexible working conditions. CONCLUSION: Potential strategies were identified to enhance the willingness of early-career GPs to continue their career as GP practice owners with patient list: improving the GP training program by placing more emphasis on managing skills and making the process of establishing GP practice and taking on a patient list less bureaucratic and more accessible.


This study highlights the career intentions of GP trainees and newly qualified GPs in Estonia.Participants of this study perceive the many different roles of being a GP as very challenging.Understanding early-career GPs ideas about the future work environments can be helpful in shaping future workforce strategies.


Assuntos
Atitude do Pessoal de Saúde , Escolha da Profissão , Clínicos Gerais , Pesquisa Qualitativa , Humanos , Clínicos Gerais/psicologia , Estônia , Feminino , Masculino , Adulto , Equilíbrio Trabalho-Vida , Entrevistas como Assunto , Atenção Primária à Saúde , Medicina Geral
9.
Euro Surveill ; 29(30)2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39056201

RESUMO

IntroductionObtaining epidemiological data on chronic hepatitis C virus (HCV) infection is essential to monitor progress towards the hepatitis C elimination targets.AimWe aimed to estimate the prevalence of chronic HCV and the seroprevalence of HCV in the adult general population in Estonia.MethodsThis cross-sectional study, conducted between 12 July and 6 December 2022, included anonymised residual sera collected prospectively from patients 18 years and older visiting a general practitioner in all counties of Estonia. Specimens were considered HCV-seropositive if they tested positive for HCV antibodies by enzyme-linked immunoassay, confirmed by line-immunoblot assay. Chronic HCV infection was determined by positive RT-qPCR.ResultsWe tested a total of 4,217 specimens. The estimated HCV seroprevalence and prevalence of chronic HCV infection were 1.8% (95% CI: 1.4-2.2) and 0.8% (95% CI: 0.5-1.1), respectively, with ca 8,100 persons estimated to have chronic HCV infection in the general adult population of Estonia. No statistically significant differences in the prevalence of chronic HCV infection were observed between sexes, counties or age groups, with the highest prevalence rates observed in men (sex ratio: 1.7), Ida-Virumaa County (1.8%; 95% CI: 0.8-3.6) and the age group 40-49 years (1.7%; 95% CI: 0.9-2.9).ConclusionThis study found an overall low prevalence of chronic HCV infection in Estonia. Continued efforts should be made for the targeted screening, diagnosis and treatment of individuals with chronic HCV infection to achieve hepatitis elimination targets.


Assuntos
Hepacivirus , Anticorpos Anti-Hepatite C , Hepatite C Crônica , Humanos , Estônia/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hepatite C Crônica/epidemiologia , Estudos Transversais , Prevalência , Estudos Soroepidemiológicos , Idoso , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Hepacivirus/imunologia , Adolescente , Adulto Jovem , Anticorpos Anti-Hepatite C/sangue , Ensaio de Imunoadsorção Enzimática , Distribuição por Idade , Distribuição por Sexo
10.
Prev Vet Med ; 230: 106283, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39024920

RESUMO

This study aimed to describe the attitudes and personalities of farm managers (FMs) in large Estonian dairy herds and analyse the potential associations with calf mortality. The study included FMs from 114 free-stall farms with at least 100 cows. Each participant completed a questionnaire that comprised questions about the respondent and various statements to reveal their attitudes towards calves, calf mortality, and farming in general. A 7-point Likert scale was used to record the responses. The data on the number of live births and deaths and animal movement data were gathered from farm records and the Estonian Agricultural Registers and Information Board. The yearly calf mortality risk (%) during the first 21 days (YAG) and mortality rate between 22-90 days of age (OAG) adjusted for the animal time-at-risk were then calculated for each herd. Univariate negative binomial regression analysis was used to identify associations between calf mortality risk/rate, and the studied statements and variables with a p-value < 0.25 were included in a k-modes clustering analysis. The mean calf mortality risk was determined to be 5.9 % (range 0.0-26.8 %) during the first 21 days and mean calf mortality rate was 1.8 (range 0.0-9.2) deaths per 100 calf-months during 22-90 days of age. In both age group analyses, two FMs´ clusters formed based on 17 pre-selected statements. The FMs of the high-mortality cluster were found to be dissatisfied with the calf mortality levels. In the YAG analysis, FMs from high-mortality cluster gave lower priority to the issue of calf mortality, placed high importance on the influence of workers on calf mortality, and were more satisfied with the staff's performance compared to FMs of the cluster of herds with lower calf mortality. They were additionally less satisfied with their own performance and felt less recognized by the farm staff. They were also more inclined to try new products and practices on the farm and demonstrated greater empathy towards cattle. In the OAG analysis, the FMs from the higher-mortality cluster viewed reducing calf mortality more costly, had a less ambitious and target-driven management style, and rated their self-performance lower. This study determined that FMs working in herds with high calf mortality were dissatisfied and did not prioritize addressing calf mortality compared to managers working in farms with lower calf mortality. FMs' attitudes and management styles were associated with calf mortality, while the respondents' personality traits had little influence.


Assuntos
Indústria de Laticínios , Fazendeiros , Animais , Bovinos , Indústria de Laticínios/métodos , Estônia/epidemiologia , Fazendeiros/psicologia , Feminino , Mortalidade , Humanos , Personalidade , Criação de Animais Domésticos/métodos , Inquéritos e Questionários , Doenças dos Bovinos/mortalidade , Doenças dos Bovinos/psicologia , Masculino
11.
J Pers Soc Psychol ; 126(4): 676-693, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38869872

RESUMO

Despite numerous meta-analyses, the true extent to which life satisfaction reflects personality traits has remained unclear due to overreliance on a single method to assess both and insufficient attention to construct overlaps. Using data from three samples tested in different languages (Estonian, N = 20,886; Russian, N = 768; English, N = 600), we combined self- and informant-reports to estimate personality domains' and nuances' true correlations (rtrue) with general life satisfaction (LS) and satisfactions with eight life domains (DSs), while controlling for single-method and occasion-specific biases and random error, and avoiding direct construct overlaps. The associations replicated well across samples. The Big Five domains and nuances allowed predicting LS with accuracies up to rtrue ≈ .80-.90 in independent (sub)samples. Emotional stability, extraversion, and conscientiousness correlated rtrue ≈ .30-.50 with LS, while its correlations with openness and agreeableness were small. At the nuances level, low LS was most strongly associated with feeling misunderstood, unexcited, indecisive, envious, bored, used, unable, and unrewarded (rtrue ≈ .40-.70). Supporting LS's construct validity, DSs had similar personality correlates among themselves and with LS, and an aggregated DS correlated rtrue ≈ .90 with LS. LS's approximately 10-year stability was rtrue = .70 and its longitudinal associations with personality traits mirrored cross-sectional ones. We conclude that without common measurement limitations, most people's life satisfaction is highly consistent with their personality traits, even across many years. So, satisfaction is usually shaped by these same relatively stable factors that shape personality traits more broadly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Satisfação Pessoal , Personalidade , Humanos , Feminino , Masculino , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Idoso , Estônia
12.
BMC Health Serv Res ; 24(1): 714, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858705

RESUMO

INTRODUCTION: This study examines the association between healthcare indicators and hospitalization rates in three high-income European countries, namely Estonia, Latvia, and Lithuania, from 2015 to 2020. METHOD: We used a sex-stratified generalized additive model (GAM) to investigate the impact of select healthcare indicators on hospitalization rates, adjusted by general economic status-i.e., gross domestic product (GDP) per capita. RESULTS: Our findings indicate a consistent decline in hospitalization rates over time for all three countries. The proportion of health expenditure spent on hospitals, the number of physicians and nurses, and hospital beds were not statistically significantly associated with hospitalization rates. However, changes in the number of employed medical doctors per 10,000 population were statistically significantly associated with changes of hospitalization rates in the same direction, with the effect being stronger for males. Additionally, higher GDP per capita was associated with increased hospitalization rates for both males and females in all three countries and in all models. CONCLUSIONS: The relationship between healthcare spending and declining hospitalization rates was not statistically significant, suggesting that the healthcare systems may be shifting towards primary care, outpatient care, and on prevention efforts.


Assuntos
Gastos em Saúde , Hospitalização , Humanos , Hospitalização/estatística & dados numéricos , Hospitalização/economia , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Masculino , Feminino , Produto Interno Bruto/estatística & dados numéricos , Países Bálticos , Letônia , Estônia , Pessoa de Meia-Idade , Lituânia
14.
Environ Microbiol ; 26(6): e16671, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38863081

RESUMO

The environmental bacterium, Pseudomonas putida, possesses a broad spectrum of metabolic pathways. This makes it highly promising for use in biotechnological production as a cell factory, as well as in bioremediation strategies to degrade various aromatic pollutants. For P. putida to flourish in its environment, it must withstand the continuous threats posed by bacteriophages. Interestingly, until now, only a handful of phages have been isolated for the commonly used laboratory strain, P. putida KT2440, and no phage defence mechanisms have been characterized. In this study, we present a new Collection of Environmental P. putida Phages from Estonia, or CEPEST. This collection comprises 67 double-stranded DNA phages, which belong to 22 phage species and 9 phage genera. Our findings reveal that most phages in the CEPEST collection are more infectious at lower temperatures, have a narrow host range, and require an intact lipopolysaccharide for P. putida infection. Furthermore, we show that cryptic prophages present in the P. putida chromosome provide strong protection against the infection of many phages. However, the chromosomal toxin-antitoxin systems do not play a role in the phage defence of P. putida. This research provides valuable insights into the interactions between P. putida and bacteriophages, which could have significant implications for biotechnological and environmental applications.


Assuntos
Especificidade de Hospedeiro , Pseudomonas putida , Pseudomonas putida/virologia , Pseudomonas putida/genética , Pseudomonas putida/metabolismo , Prófagos/genética , Fagos de Pseudomonas/genética , Fagos de Pseudomonas/isolamento & purificação , Estônia , Bacteriófagos/genética , Bacteriófagos/isolamento & purificação
15.
Artigo em Inglês | MEDLINE | ID: mdl-38928990

RESUMO

It is recognized that the time adolescents spend on physical activity, and the corresponding physical fitness indicators, have diminished over time. However, the exact impact of the COVID-19 pandemic restriction period on physical activity and health-related physical fitness indicators remains unclear. This study sought to determine if and to what degree the primary indicators of physical activity (exercise frequency, exercise intensity, and outdoor physical activity) and health-related physical fitness (strength and endurance) among schoolchildren have shifted, by comparing data from before and after the coronavirus pandemic period. Students aged 12-17 years took part in the study. The physical activity questionnaire and fitness tests were conducted in the autumn of 2017 and spring of 2022. The main results show that moderate- and vigorous-intensity physical activity time and time spent actively outdoors have decreased among adolescents (p < 0.05). There were no significant changes in exercise frequency (p > 0.05). However, there was a statistically significant decline in strength (standing broad jump, bent arm hang) (p < 0.05) and endurance (20 m shuttle run, curl-up) (p < 0.01) when comparing results from before and after the COVID-19 pandemic restriction period. In conclusion, restricted mobility had the greatest impact on the time spent outdoors and, in turn, on physical fitness.


Assuntos
COVID-19 , Exercício Físico , Aptidão Física , Humanos , COVID-19/epidemiologia , Adolescente , Criança , Masculino , Feminino , Estônia/epidemiologia , SARS-CoV-2 , Pandemias , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
16.
Artigo em Inglês | MEDLINE | ID: mdl-38929007

RESUMO

The aim of this research is to find out to what extent the special qualifications of physical education teachers and the physical environment of kindergartens influence the physical development of preschoolers. Forty-four kindergartens across Estonia participated in the study, half of which had a physical education teacher (PEt), whereas the remaining 22 kindergartens were taught by non-qualified kindergarten teachers (NoPEt). Six Eurofit fitness tests were used to assess the physical development of children (n = 704; aged 6-7 years old, with an average age of 6.55 ± 0.5 years). An analysis of variance was used to compare the mean values of the fitness test results of the two groups. Linear regression analysis was applied to clarify the influence of individual and environmental factors on children's fitness scores. In kindergartens where the position of a PEt had been created, the results of children's physical fitness were statistically significantly better, more specifically in handgrip strength (m = 12.0, 95% CI = 11.8-12.3 vs. m = 11.5, 95% CI = 11.2-11.7) and in speed tests (m = 23.0, 95% CI = 22.8-23.2 vs. m = 23.6, 95% CI = 23.3-23.8). According to the teacher interviews, these kindergartens also had more rooms and areas specially created for physical exercises. The study revealed that the physical development of children is, when controlling for other individual and environmental factors, influenced by the professional qualification of the PE teacher (95% CI = 0.06-0.56) as well as children's participation in sports training (95% CI = 0.29-0.83). These findings are important for preschool institutions and municipalities in designing the optimal physical environment for facilitating children's physical fitness.


Assuntos
Educação Física e Treinamento , Aptidão Física , Humanos , Masculino , Feminino , Criança , Estônia , Instituições Acadêmicas , Desenvolvimento Infantil , Pré-Escolar , Professores Escolares , Meio Ambiente , Força da Mão
17.
Microbiologyopen ; 13(3): e13, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38825966

RESUMO

The factors that influence the distribution of bacterial community composition are not well understood. The role of geographical patterns, which suggest limited dispersal, is still a topic of debate. Bacteria associated with hosts face unique dispersal challenges as they often rely on their hosts, which provide specific environments for their symbionts. In this study, we examined the effect of biogeographic distances on the bacterial diversity and composition of bacterial communities in the gastrointestinal tract of Ampullaceana balthica. We compared the effects on the host-associated bacterial community to those on bacterial communities in water and sediment. This comparison was made using 16S ribosomal RNA gene sequencing. We found that the bacterial communities we sampled in Estonia, Denmark, and Northern Germany varied between water, sediment, and the gastrointestinal tract. They also varied between countries within each substrate. This indicates that the type of substrate is a dominant factor in determining bacterial community composition. We separately analyzed the turnover rates of water, sediment, and gastrointestinal bacterial communities over increasing geographic distances. We observed that the turnover rate was lower for gastrointestinal bacterial communities compared to water bacterial communities. This implies that the composition of gastrointestinal bacteria remains relatively stable over distances, while water bacterial communities exhibit greater variability. However, the gastrointestinal tract had the lowest percentage of country-specific amplicon sequence variants, suggesting bacterial colonization from local bacterial communities. Since the overlap between the water and gastrointestinal tract was highest, it appears that the gastrointestinal bacterial community is colonized by the water bacterial community. Our study confirmed that biogeographical patterns in host-associated communities differ from those in water and sediment bacterial communities. These host-associated communities consist of numerous facultative symbionts derived from the water bacterial community.


Assuntos
Bactérias , Trato Gastrointestinal , Sedimentos Geológicos , RNA Ribossômico 16S , Caramujos , Sedimentos Geológicos/microbiologia , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , RNA Ribossômico 16S/genética , Trato Gastrointestinal/microbiologia , Animais , Caramujos/microbiologia , Alemanha , Dinamarca , Microbioma Gastrointestinal/genética , Microbiologia da Água , Biodiversidade , Estônia , Filogenia , DNA Bacteriano/genética , Análise de Sequência de DNA
18.
Nurse Educ Today ; 139: 106261, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38796897

RESUMO

BACKGROUND: Collaborative and innovative educational approaches are essential to building nurses' competencies in responding to healthcare challenges and to enhance high-quality nursing practice. Nurses are increasingly learning in various contexts, and thus, the understanding and organising of collaborative learning needs further exploration. AIM: To describe collaborative learning in nursing practice and education from the point of view of nurses, involved as students and teachers in master's education in nursing. DESIGN AND METHODS: Qualitative study using semi-structured focus groups involving 33 nurses as master's students and teachers from Estonia and Norway. The data were analysed using inductive content analysis. FINDINGS: The essence of collaborative learning in the context of nursing practice and education was identified as the aggregation of diverse learners' skills and reflections while working towards shared aims. This fostered the development of workplace competencies, professional attitudes, and personal growth. Organising collaborative learning requires careful planning and synchronisation between clinical and educational organisations. CONCLUSIONS: Collaborative learning is an inclusive method, aiding nurses at different phases of their career to gain knowledge and enhance their soft skills, and potentially reducing professional hierarchies. Further research is needed to develop methods for evaluating the outcomes of collaborative learning.


Assuntos
Comportamento Cooperativo , Educação de Pós-Graduação em Enfermagem , Docentes de Enfermagem , Grupos Focais , Pesquisa Qualitativa , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Educação de Pós-Graduação em Enfermagem/métodos , Docentes de Enfermagem/psicologia , Noruega , Estônia , Aprendizagem , Feminino , Adulto , Masculino , Competência Clínica/normas , Entrevistas como Assunto/métodos
19.
Econ Hum Biol ; 54: 101400, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38744103

RESUMO

The paper investigates whether exposure to a famine in the Russian Tsarist Province of Livland in 1844-1846 in early life negatively affected survival at later ages, using individual data from two rural parishes. We follow 18 birth cohorts born between 1834-1852 until age 75 and differentiate between timing and length of exposures. We find that relative to individuals born in pre- or post- crisis years, there were no significant differences in survival from age 21-75. Cohorts with longer exposure to famine conditions had increased mortality only in short term, up to age 20. Males were more vulnerable in younger ages than females. The negative effect of adverse early life exposure on survival in later life was constrained to lower social group - the landless, but for the better-off groups the effect was constrained to younger ages. The paper highlights the importance of accounting for sex and socio-economic differences in studies exploring the effects of early life conditions on later-life survival.


Assuntos
Fome Epidêmica , Mortalidade , Humanos , Masculino , Feminino , História do Século XIX , Pessoa de Meia-Idade , Adulto , Fome Epidêmica/estatística & dados numéricos , Mortalidade/tendências , Mortalidade/história , Idoso , Estônia/epidemiologia , Fatores Socioeconômicos , Adulto Jovem , Fatores Sexuais , Fatores Etários , Inanição/mortalidade , Inanição/história
20.
Health Educ Behav ; 51(4): 502-511, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38712912

RESUMO

Despite the proven effectiveness of COVID-19 vaccines in preventing severe illness, many individuals, including older adults who are most susceptible to the virus, have opted against vaccination. Various factors could shape vaccination decisions, including seeking health information (HI). The internet is the primary source of HI today; however, older adults are often referred to as those missing out on digital benefits. The study explores the correlations between information and communication technology (ICT) use, online HI seeking, socioeconomic factors, and COVID-19 vaccination readiness among individuals aged 50 and above in Estonia. The survey data were gathered from 501 people aged 50 and older after the first lockdown in 2020. The outcomes revealed that vaccination readiness positively correlated with factors such as higher educational attainment, greater income, male gender, access to ICT, a readiness to employ digital technologies for health-related purposes, a greater demand for HI, and a higher frequency of seeking it online. There was some discrepancy in the preference of HI sources; for example, vaccination consenters preferred online versions of professional press publications and specific health portals. Based on the findings, it is advisable to encourage older adults to utilize the internet and new technology for health-related purposes. This practice expands the range of information sources available to them, ultimately enabling better decision-making regarding their health behaviors.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Comportamento de Busca de Informação , Fatores Socioeconômicos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , População do Leste Europeu , Estônia , Internet , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricos
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