Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 305.156
Filtrar
Mais filtros

Intervalo de ano de publicação
1.
PLoS One ; 19(5): e0302592, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38717998

RESUMO

OBJECTIVE: This study aimed to investigate the economics of three different gargles in the treatment of chronic periodontitis. METHODS: A total of 108 patients with periodontitis received one of the following three gargles: xipayi, compound chlorhexidine, or Kangfuxin gargle. The basic information of the patients, the costs of the gargles, the periodontal indexes before and after treatment, and the scores of the 3-level version of the EuroQol Five Dimensions Questionnaire were collected. The cost-effectiveness and cost-utility of the various gargles were determined. RESULTS: The cost-effectiveness ratios (CER) of the three groups after treatment were 1828.75, 1573.34, and 1876.92 RMB, respectively. The utility values before treatment were 0.92, 0.90, and 0.91, respectively, and the utility values after treatment were 0.98, 0.98, and 0.97, respectively. The cost-utility ratios (CURs) were 213.43, 195.61, and 301.53 RMB, respectively. CONCLUSIONS: For each increase in effective rate and quality-adjusted life years, the treatment cost of periodontitis patients was lower than the gross domestic product per capita of Jiangsu Province, indicating that the treatment cost is completely worth it. The CER and CUR results were the same, and the compound chlorhexidine group was the lowest, demonstrating that when the same therapeutic effect was achieved, it cost the least.


Assuntos
Clorexidina , Periodontite Crônica , Análise Custo-Benefício , Humanos , Feminino , Masculino , Periodontite Crônica/economia , Periodontite Crônica/tratamento farmacológico , Periodontite Crônica/terapia , Pessoa de Meia-Idade , Adulto , Clorexidina/uso terapêutico , Clorexidina/economia , Anos de Vida Ajustados por Qualidade de Vida , Qualidade de Vida , Inquéritos e Questionários
2.
PLoS One ; 19(5): e0302864, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38718022

RESUMO

BACKGROUND: Health administrations require evidence, meaning robust information, data, and research, on health services and systems. Little is known about the resources and processes available within administrations to support evidence-informed policymaking. This study assessed Swiss health administrations' capacity for evidence use and investigated civil servants' needs and perspectives regarding the role and use of evidence in health services management and planning. METHODS: In this mixed-method study, we interviewed civil servants from Swiss German-speaking cantonal health administrations. We quantitatively assessed administrations' organization-level capacity by applying six structured interviews using an existing measurement tool (ORACLe). Individual-level needs and perspectives regarding evidence use and capacity were qualitatively explored with twelve in-depth interviews that were analyzed using the framework method. FINDINGS: Respondents indicated moderate evidence-use capacity in all administrations. Administrations displayed a similar pattern of high and low capacity in specific capacity areas, generally with considerable variation within administrations. Most administrations indicated high capacity for producing or commissioning evidence and close relationships with research. They showed limited capacity in the documentation of processes and availability of tools, programs, or training opportunities. Administrations place the responsibility for engagement with evidence at the level of individual civil servants rather than at the organizational level. Although administrations highly value evidence-informed policymaking and consider it vital to effective health services management and planning, they face significant constraints in accessing evidence-specific resources and receive little organizational support. Administrations rely on external capacity to compensate for these limitations and engage with evidence pragmatically. CONCLUSION: Our findings indicate moderate and improvable capacity for evidence use in Swiss health administrations that place limited value on organizational support. Besides strengthening organizational support, leadership buy-in, particular staff needs, and balancing the implementation of specific measures with the provision of more general resources should be considered to unlock the potential of strengthened engagement with evidence.


Assuntos
Administração de Serviços de Saúde , Suíça , Humanos , Feminino , Entrevistas como Assunto , Masculino , Prática Clínica Baseada em Evidências , Adulto , Pessoa de Meia-Idade , Formulação de Políticas
3.
PLoS One ; 19(5): e0303144, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38718035

RESUMO

Charitable fundraising increasingly relies on online crowdfunding platforms. Project images of charitable crowdfunding use emotional appeals to promote helping behavior. Negative emotions are commonly used to motivate helping behavior because the image of a happy child may not motivate donors to donate as willingly. However, some research has found that happy images can be more beneficial. These contradictory results suggest that the emotional valence of project imagery and how fundraisers frame project images effectively remain debatable. Thus, we compared and analyzed brain activation differences in the prefrontal cortex governing human emotions depending on donation decisions using functional near-infrared spectroscopy, a neuroimaging device. We advance existing theory on charitable behavior by demonstrating that little correlation exists in donation intentions and brain activity between negative and positive project images, which is consistent with survey results on donation intentions by victim image. We also discovered quantitative brain hemodynamic signal variations between donors and nondonors, which can predict and detect donor mental brain functioning using functional connectivity, that is, the statistical dependence between the time series of electrophysiological activity and oxygenated hemodynamic levels in the prefrontal cortex. These findings are critical in developing future marketing strategies for online charitable crowdfunding platforms, especially project images.


Assuntos
Emoções , Obtenção de Fundos , Espectroscopia de Luz Próxima ao Infravermelho , Humanos , Emoções/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Obtenção de Fundos/métodos , Feminino , Masculino , Adulto , Instituições de Caridade , Córtex Pré-Frontal/fisiologia , Córtex Pré-Frontal/diagnóstico por imagem , Intenção , Adulto Jovem , Mapeamento Encefálico/métodos , Crowdsourcing , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem
4.
PLoS One ; 19(5): e0298933, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38718079

RESUMO

Ambulance services around the world vary according to regional, cultural and socioeconomic conditions. Many countries apply different health policies locally. In Turkey, transportation from hospital to home has started to form an important part of ambulance services in recent years. The increase in the number of patients whose treatment has been completed and waiting to be referred may hinder the work of the emergency services. The aim of this study was to examine the costs, indications, and impact on workload of patients sent home by ambulance. Patients were divided into two groups according to the reasons for referral. The distance to home, transport time and cost were calculated according to the reasons for transport. Patients who were transferred to other clinics or hospitals by ambulance were excluded from the study. The findings showed that the hospital-to-home transfer rate during the study period was 11.4%. Although 9.7% of all cases transferred from our hospital to home were due to social indications, these cases accounted for 16.26% of the total costs. These results suggest that providing home transport services to selected patient groups for medical reasons should be seen as part of the treatment. However, the indications for home transport should not be exceeded and an additional burden should not be placed on the fragile health service.


Assuntos
Serviços Médicos de Emergência , Humanos , Serviços Médicos de Emergência/economia , Feminino , Masculino , Pessoa de Meia-Idade , Turquia , Adulto , Ambulâncias/estatística & dados numéricos , Ambulâncias/economia , Idoso , Transporte de Pacientes/economia , Transporte de Pacientes/estatística & dados numéricos , Serviços de Assistência Domiciliar/economia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Adolescente
5.
Sci Adv ; 10(19): eadg9674, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38718116

RESUMO

Prenatal opioid exposure is an established public health problem, in particular among Medicaid-covered births. Yet, existing prevalence rates are plausibly underestimated. We leverage extensive linked longitudinal administrative data for all Medicaid-covered live births in Wisconsin from 2010 to 2019 to estimate a range of prevalence rates using an innovative strategy that jointly accounts for both likelihood of exposure and potential risk to prenatal development. We find that 20.8% of infants may have been prenatally exposed to opioids, with 1.7% diagnosed with neonatal abstinence syndrome and an additional 1.2% having a high combined likelihood of exposure and potential risk to prenatal development, 2.6% a moderate combined likelihood and risk, and 15.3% a low or uncertain combined likelihood and risk. We assess improvements in prevalence estimates based on our nuanced classification relative to those of prior studies. Our strategy could be broadly used to quantify the scope of the opioid crisis for pregnant populations, target interventions, and promote child health and development.


Assuntos
Analgésicos Opioides , Medicaid , Efeitos Tardios da Exposição Pré-Natal , Humanos , Wisconsin/epidemiologia , Gravidez , Feminino , Estados Unidos/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Analgésicos Opioides/efeitos adversos , Recém-Nascido , Síndrome de Abstinência Neonatal/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Prevalência , Adulto , Fatores de Risco
6.
JCO Glob Oncol ; 10: e2300308, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38723218

RESUMO

PURPOSE: Desmoid fibromatosis (DF) is a locally aggressive tumor with low mortality but significant morbidity. There is a lack of standard of care, and existing therapies are associated with significant barriers including access, cost, and toxicities. This study aimed to explore the efficacy and safety of the metronomic therapy (MT) in DF in a large, homogenous cohort from India. PATIENTS AND METHODS: This study involved histologically confirmed DF cases treated with MT comprising vinblastine (6 mg) and methotrexate (15 mg) both once a week, and tamoxifen (40 mg/m2) in two divided doses once daily between 2002 and 2018. RESULTS: There were 315 patients with a median age of 27 years; the commonest site was extremity (142 of 315; 45.0%). There were 159 (50.1%) male patients. Of the 123 (39.0%) prior treated patients, 119 had surgery. Of 315 patients, 263 (83.5%) received treatment at our institute (MT-151, 77-local treatment, 9-tyrosine kinase inhibitor, and 26 were observed). Among the MT cohort (n = 163, 61.2%), at a median follow-up of 36 (0.5-186) months, the 3-year progression-free and overall survival were 81.1% (95% CI, 74.3 to 88.4) and 99.2% (95% CI, 97.6 to 100), respectively. There were 35% partial responses. Ninety-two patients (56.4%) completed 1-year therapy, which was an independent prognosticator (P < .0001; hazard ratio, 0.177 [95% CI, 0.083 to 0.377]). MT was well tolerated. Predominant grade ≥3 toxicities were febrile neutropenia, 12 (7.4%) without any chemotoxicity-related death. The annual cost of MT was $130 US dollars. CONCLUSION: The novel, low-cost MT qualifies as one of the effective, less toxic, sustainable, standard-of-care options for the treatment of DF with global reach and merits wide recognition.


Assuntos
Administração Metronômica , Fibromatose Agressiva , Metotrexato , Centros de Atenção Terciária , Humanos , Masculino , Feminino , Adulto , Fibromatose Agressiva/tratamento farmacológico , Fibromatose Agressiva/mortalidade , Fibromatose Agressiva/economia , Índia , Centros de Atenção Terciária/estatística & dados numéricos , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Metotrexato/economia , Padrão de Cuidado , Criança , Vimblastina/administração & dosagem , Vimblastina/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Tamoxifeno/administração & dosagem , Tamoxifeno/economia , Tamoxifeno/uso terapêutico , Estudos Retrospectivos
7.
Eat Weight Disord ; 29(1): 36, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38733540

RESUMO

INTRODUCTION: With increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O). METHOD: After a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories. RESULTS: CFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity. CONCLUSION: The Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity. LEVEL OF EVIDENCE: V, descriptive research.


Assuntos
Comportamento Alimentar , Obesidade , Psicometria , Humanos , Feminino , Masculino , Obesidade/psicologia , Adulto , Grécia , Comportamento Alimentar/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto Jovem , Análise Fatorial , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Adolescente , Dependência de Alimentos/psicologia , Dependência de Alimentos/diagnóstico
8.
Crit Care Explor ; 6(5): e1090, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38736901

RESUMO

OBJECTIVES: To determine the impact of telementoring on caregiver performance during a high-fidelity medical simulation model (HFMSM) of a critically ill patient in a resource-limited setting. DESIGN: A two-center, randomized, controlled study using a HFMSM of a patient with community-acquired pneumonia complicated by acute respiratory distress syndrome. SETTING: A notional clinic in a remote location staffed by a single clinician and nonmedical assistant. PARTICIPANTS: Clinicians with limited experience managing critically ill patients. INTERVENTIONS: Telemedicine (TM) support. MEASUREMENTS: The primary outcome was clinical performance as measured by accuracy, reliability, and efficiency of care. Secondary outcomes were patient survival, procedural quality, subjective assessment of the HFMSM, and perceived workload. MAIN RESULTS: TM participants (N = 11) performed better than non-TM (NTM, N = 12) in providing expected care (accuracy), delivering care more consistently (reliability), and without consistent differences in efficiency (timeliness of care). Accuracy: TM completed 91% and NTM 42% of expected tasks and procedures. Efficiency: groups did not differ in the mean (± sd) minutes it took to obtain an advanced airway successfully (TM 15.2 ± 10.5 vs. NTM 22.8 ± 8.4, p = 0.10) or decompress a tension pneumothorax with a needle (TM 0.7 ± 0.5 vs. NTM 0.6 ± 0.9, p = 0.65). TM was slower than NTM in completing thoracostomy (22.3 ± 10.2 vs. 12.3 ± 4.8, p = 0.03). Reliability: TM performed 13 of 17 (76%) tasks with more consistent timing than NTM. TM completed 68% and NTM 29% of procedural quality metrics. Eighty-two percent of the TM participants versus 17% of the NTM participants simulated patients survived (p = 0.003). The groups similarly perceived the HFMSM as realistic, managed their patients with personal ownership, and experienced comparable workload and stress. CONCLUSIONS: Remote expertise provided with TM to caregivers in resource-limited settings improves caregiver performance, quality of care, and potentially real patient survival. HFMSM can be used to study interventions in ways not possible with real patients.


Assuntos
Cuidadores , Telemedicina , Humanos , Telemedicina/métodos , Cuidadores/educação , Cuidadores/psicologia , Masculino , Feminino , Adulto , Competência Clínica , Síndrome do Desconforto Respiratório/terapia , Pessoa de Meia-Idade , Estado Terminal , Reprodutibilidade dos Testes , Pneumonia/terapia
9.
J Med Life ; 17(1): 67-72, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38737658

RESUMO

In the context of health care reform, the primary task is to ensure the delivery of high-quality medical services and good end results in the performance of individual physicians, structural units, and general medical services. The healthcare sector is one of the most socially significant spheres of functioning in every country. The problem of conflicts presents special social importance in this field, as a result of the rather close relationship between doctor and patient. The main objective of this study was to determine patients' satisfaction with the quality of healthcare at the primary level. The survey was conducted using an electronic questionnaire. The sample consisted of 1,146 residents of Chernivtsi and the Chernivtsi region, aged 18-56 and older. Almost half of the respondents (42.5%) offered a neutral overall rating of the quality of medical services at the primary care level. Only 25.5% gave a positive valuation of the quality of health care services they received, while 32% gave a negative evaluation. Patients' actions, opinions, and ideas shape and complement industry policies and the way they are implemented. In this context, if a dialogue is established among the main actors in the healthcare system, improvements in the system can be achieved, which will lead to better health and quality of life for people in the future.


Assuntos
Satisfação do Paciente , Qualidade da Assistência à Saúde , Humanos , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Masculino , Adolescente , Feminino , Adulto Jovem , Ucrânia , Atenção Primária à Saúde/normas
10.
J Biomed Opt ; 29(6): 065001, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38737791

RESUMO

Significance: Type 2 diabetes mellitus (T2DM) is a global health concern with significant implications for vascular health. The current evaluation methods cannot achieve effective, portable, and quantitative evaluation of foot microcirculation. Aim: We aim to use a wearable device laser Doppler flowmetry (LDF) to evaluate the foot microcirculation of T2DM patients at rest. Approach: Eleven T2DM patients and twelve healthy subjects participated in this study. The wearable LDF was used to measure the blood flows (BFs) for regions of the first metatarsal head (M1), fifth metatarsal head (M5), heel, and dorsal foot. Typical wavelet analysis was used to decompose the five individual control mechanisms: endothelial, neurogenic, myogenic, respiratory, and heart components. The mean BF and sample entropy (SE) were calculated, and the differences between diabetic patients and healthy adults and among the four regions were compared. Results: Diabetic patients showed significantly reduced mean BF in the neurogenic (p=0.044) and heart (p=0.001) components at the M1 and M5 regions (p=0.025) compared with healthy adults. Diabetic patients had significantly lower SE in the neurogenic (p=0.049) and myogenic (p=0.032) components at the M1 region, as well as in the endothelial (p<0.001) component at the M5 region and in the myogenic component at the dorsal foot (p=0.007), compared with healthy adults. The SE in the myogenic component at the dorsal foot was lower than at the M5 region (p=0.050) and heel area (p=0.041). Similarly, the SE in the heart component at the dorsal foot was lower than at the M5 region (p=0.017) and heel area (p=0.028) in diabetic patients. Conclusions: This study indicated the potential of using the novel wearable LDF device for tracking vascular complications and implementing targeted interventions in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 2 , Pé Diabético , , Fluxometria por Laser-Doppler , Microcirculação , Dispositivos Eletrônicos Vestíveis , Humanos , Pé Diabético/fisiopatologia , Pé Diabético/diagnóstico por imagem , Masculino , Microcirculação/fisiologia , Feminino , Fluxometria por Laser-Doppler/métodos , Diabetes Mellitus Tipo 2/fisiopatologia , Pessoa de Meia-Idade , Pé/irrigação sanguínea , Idoso , Análise de Ondaletas , Adulto
11.
Front Public Health ; 12: 1329768, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38737867

RESUMO

Objectives: This study aimed to analyze the influencing factors of hospitalization cost of hypertensive patients in TCM (traditional Chinese medicine, TCM) hospitals, which can provide a scientific basis for hospitals to control the hospitalization cost of hypertension. Methods: In this study, 3,595 hospitalized patients with a primary diagnosis of tertiary hypertension in Tianshui City Hospital of TCM, Gansu Province, China, from January 2017 to June 2022, were used as research subjects. Using univariate analysis to identify the relevant variables of hospitalization cost, followed by incorporating the statistically significant variables of univariate analysis as independent variables in multiple linear regression analysis, and establishing the path model based on the results of the multiple linear regression finally, to explore the factors influencing hospitalization cost comprehensively. Results: The results showed that hospitalization cost of hypertension patients were mainly influenced by length of stay, age, admission pathways, payment methods of medical insurance, and visit times, with length of stay being the most critical factor. Conclusion: The Chinese government should actively exert the characteristics and advantages of TCM in the treatment of chronic diseases such as hypertension, consistently optimize the treatment plans of TCM, effectively reduce the length of stay and steadily improve the health literacy level of patients, to alleviate the illnesses pain and reduce the economic burden of patients.


Assuntos
Hospitalização , Hipertensão , Medicina Tradicional Chinesa , Humanos , Feminino , Hipertensão/economia , Masculino , Pessoa de Meia-Idade , Medicina Tradicional Chinesa/economia , Medicina Tradicional Chinesa/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , China , Idoso , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/economia , Adulto , Custos Hospitalares/estatística & dados numéricos
12.
Front Public Health ; 12: 1348416, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38737866

RESUMO

Background: The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen. Methods: Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university. Results: ① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (ß = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (ß = -0.12, P < 0.001). ③ Stress management (ß = -0.104, P < 0.05; ß = -0.087, P < 0.05), self-actualization (ß = -0.282, P < 0.01; ß = -0.260, P < 0.05), health responsibility (ß = -0.057, P < 0.05; ß = -0.088, P < 0.05), and interpersonal relations (ß = 0.068, P < 0.01; ß = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (ß = -0.437, P < 0.001), exercise (ß = 0.048, P < 0.001), nutrition (ß = 0.044, P < 0.001), and interpersonal relations (ß = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen. Conclusion: The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.


Assuntos
Emoções , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Estudantes , Humanos , Masculino , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Feminino , Universidades , Estudos Longitudinais , Adulto Jovem , Adolescente , Ansiedade/psicologia , Inquéritos e Questionários , Depressão/psicologia , Estresse Psicológico/psicologia , Adulto
13.
Ig Sanita Pubbl ; 80(2): 30-40, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38739439

RESUMO

Falls are a widespread concern in hospitals settings. In Italy, falls are the fourth frequent damage claim type after surgical, diagnostic and therapeutic error and 90% of falls are avoidable. The first necessary action for the prevention of falls consists in identifying the possible risk factors, in relation to the characteristics of the patient and those of the environment and the structure that hosts him, in terms of safety, organization and adequacy of the process welfare. In this work we wanted to evaluate the extent, frequency and characteristics of the phenomenon of falls in the population hospitalized at the Local Health Authority called "Roma 2", with the aim of analyzing the critical issues to allow the identification of possible preventive and improvement interventions as well as reducing the risk of falls.


Assuntos
Acidentes por Quedas , Gestão de Riscos , Humanos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Itália , Gestão de Riscos/métodos , Idoso , Masculino , Feminino , Fatores de Risco , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adulto
14.
J Prev Med Hyg ; 65(1): E73-E82, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38706772

RESUMO

Background: The increasing prevalence of obesity and overweight among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners' workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI). Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7). Results: Most respondents were male (70.7%). Their mean age was 38 ± 7.4 years. During their last workhours, 84.1% had lunch, and 46.4% took sugary drinks. Usually, 41.7% source their lunch from the hospital canteen, and 18.7% patronize their canteen at least weekly. Most reported healthy behaviour towards alcohol consumption (99.7%), fruit and vegetable consumption (54.8%) and smoking (98.4%). However, only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8 ± 0.7 and 26.1 ± 4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were years of practice (< 10 y) and use of antihypertensive medications. Conclusions: Obesity and overweight rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners' lifestyle behaviour and curtail obesity and overweight are needed.


Assuntos
Índice de Massa Corporal , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Nigéria , Adulto , Estudos Transversais , Feminino , Pessoa de Meia-Idade , Comportamento Alimentar , Médicos , Obesidade/epidemiologia , Sobrepeso/epidemiologia
15.
Int J Public Health ; 69: 1606664, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38707870

RESUMO

Objectives: This study aims to assess the impact of care consumption patterns and individual characteristics on the cost of treating differentiated thyroid carcinoma (DTC), in France, with a specific emphasis on socioeconomic position. Methods: The methodology involved a net cost approach utilising cases from the EVATHYR cohort and controls from the French National Health Insurance database. Care consumption patterns were created using Optimal Matching and clustering techniques. The individual characteristics influence on patterns was assessed using multinomial logistic regression. The individual characteristics and patterns influence on care costs was assessed using generalised estimating equations. Results: The findings revealed an average cost of €13,753 per patient during the initial 3 years. Regression models suggested the main predictors of high DTC specific care consumption tended to include having a high risk of cancer recurrence (OR = 4.97), being a woman (OR = 2.00), and experiencing socio-economic deprivation (OR = 1.26), though not reaching statistical significance. Finally, high DTC-specific care consumers also incurred higher general care costs (RR = 1.35). Conclusion: The study underscores the increased costs of managing DTC, shaped by consumption habits and socioeconomic position, emphasising the need for more nuanced DTC management strategies.


Assuntos
Fatores Socioeconômicos , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/economia , Neoplasias da Glândula Tireoide/terapia , Feminino , Masculino , Pessoa de Meia-Idade , França , Adulto , Idoso , Custos de Cuidados de Saúde/estatística & dados numéricos
17.
PeerJ ; 12: e17373, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38708348

RESUMO

Background: Chronic time pressure represents a prevalent concern within modern society, and effective measurement is crucial for research advancement. The Chronic Time Pressure Inventory (CTPI) has thus far demonstrated adequate psychometric properties. However, only two studies have examined the measure and evidence of its validity is limited. Accordingly, the current investigation, via two independent studies, assessed the factorial composition and validity (convergent/discriminant) of the CTPI. Methods: Study 1 (N = 398) examined competing factorial models and validity in relation to the Big Five personality traits (Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness). Study 2 (N = 358) replicated the analysis of factor structure and assessed validity in comparison with five time perspectives (Past Negative, Present Fatalistic, Future, Past Positive, Present Hedonistic). Participants across both studies completed standardized self-report measures capturing the variables. Results: Comparison of confirmatory factor analysis (CFA) and exploratory structural equation modelling (ESEM) factor solutions indicated that an ESEM bifactor model provided the strongest data-model fit. This included a general chronic time pressure component alongside specific subfactors of Feeling Harried and Cognitive Awareness of Time Shortage. All scale items reflected the general factor; however, some items loaded weakly on the intended specific factor. The CTPI is thus a robust indicator of chronic time pressure but needs refinement as a measure of the specific factors. Convergent/discriminant validity analyses inferred that the CTPI captured chronic time pressure as a related, but distinct, construct to perceived stress, and evidenced a relationship with theoretically associated constructs (Big Five personality traits and time perspective). Overall, the CTPI is a sound measure of chronic time pressure and has the potential to further cohesive research efforts on the contribution of this construct to various life domains.


Assuntos
Psicometria , Humanos , Masculino , Feminino , Psicometria/métodos , Análise Fatorial , Adulto , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Personalidade , Adulto Jovem , Inventário de Personalidade , Autorrelato , Adolescente , Estresse Psicológico/diagnóstico , Idoso
18.
Health Aff (Millwood) ; 43(5): 682-690, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38709960

RESUMO

Women who are pregnant or recently gave birth are significantly more likely to be killed by an intimate partner than nonpregnant, nonpostpartum women of reproductive age, implicating the risk of fatal violence conferred by pregnancy itself. The rapidly increasing passage of state legislation has restricted or banned access to abortion care across the US. We used the most recent and only source of population-based data to examine the association between state laws that restrict access to abortion and trends in intimate partner violence-related homicide among women and girls ages 10-44 during the period 2014-20. Using robust difference-in-differences ecologic modeling, we found that enforcement of each additional Targeted Regulation of Abortion Providers (TRAP) law was associated with a 3.4 percent increase in the rate of intimate partner violence-related homicide in this population. We estimated that 24.3 intimate partner violence-related homicides of women and girls ages 10-44 were associated with TRAP laws implemented in the states and years included in this analysis. Assessment of policies that restrict access to abortion should consider their potential harm to reproductive-age women through the risk for violent death.


Assuntos
Aborto Induzido , Homicídio , Violência por Parceiro Íntimo , Humanos , Feminino , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/legislação & jurisprudência , Homicídio/estatística & dados numéricos , Homicídio/legislação & jurisprudência , Estados Unidos , Adolescente , Gravidez , Adulto , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Criança , Adulto Jovem , Governo Estadual , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Aborto Legal/legislação & jurisprudência , Aborto Legal/estatística & dados numéricos
19.
Health Aff (Millwood) ; 43(5): 725-731, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38709963

RESUMO

Policy responses to the March 31, 2023, expiration of the Medicaid continuous coverage provision need to consider the difference between self-reported Medicaid participation on government surveys and administrative records of Medicaid enrollment. The difference between the two is known as the "Medicaid undercount." The size of the undercount increased substantially after the continuous coverage provision took effect in March 2020. Using longitudinal data from the Current Population Survey, we examined this change. We found that assuming that all beneficiaries who ever reported enrolling in Medicaid during the COVID-19 pandemic public health emergency remained enrolled through 2022 (as required by the continuous coverage provision) eliminated the worsening of the undercount. We estimated that nearly half of the 5.9 million people who we projected were likely to become uninsured after the provision expired, or "unwound," already reported that they were uninsured in the 2022 Current Population Survey. This finding suggests that the impact of ending the continuous coverage provision on the estimated uninsurance rate, based on self-reported survey data, may have been smaller than anticipated. It also means that efforts to address Medicaid unwinding should include people who likely remain eligible for Medicaid but believe that they are already uninsured.


Assuntos
COVID-19 , Cobertura do Seguro , Medicaid , Pessoas sem Cobertura de Seguro de Saúde , Humanos , Estados Unidos , Medicaid/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Adulto , Feminino , Pandemias , Pessoa de Meia-Idade , SARS-CoV-2
20.
Health Aff (Millwood) ; 43(5): 701-706, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38709970

RESUMO

Remote physiologic monitoring use increased more than 1,300 percent from 2019 to 2021, and use varied by state. This increase was driven by a small number of (predominantly internal medicine) providers. Female beneficiaries, residents of metropolitan areas, and people diagnosed with diabetes or hypertension had the highest rates of use.


Assuntos
Medicaid , Humanos , Estados Unidos , Feminino , Medicaid/estatística & dados numéricos , Masculino , Monitorização Fisiológica/métodos , Pessoa de Meia-Idade , Adulto , Idoso , Telemedicina/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA