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1.
Chemosphere ; 287(Pt 3): 132043, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34543905

RESUMO

With the prevalence of stroke rising due to both aging societies and more people getting strokes at a younger age, a comprehensive investigation into the relationship between urban characteristics and age-specific stroke mortality for the development of a healthy built environment is necessary. Specifically, assessment of various dimensions of urban characteristics (e.g. short-term environmental change, long-term environmental conditions) is needed for healthy built environment designs and protocols. A multifactorial assessment was conducted to evaluate associations between environmental and sociodemographic characteristics with age-stroke mortality in Hong Kong. We found that short-term (and temporally varying) daily PM10, older age and being female were more strongly associated with all types of stroke deaths compared to all-cause deaths in general. Colder days, being employed and being married were more strongly associated with hemorrhagic stroke deaths in general. Long-term (and spatially varying) regional-level air pollution were more strongly associated with non-hemorrhagic stroke deaths in general. These associations varied by age. Employment (manual workers) and low education were risk factors for stroke mortality at younger ages (age <65). Greenness and open space did not have a significant association with stroke mortality. Since a significant connection was expected, this leads to questions about the health-inducing efficacy of Hong Kong's compact open spaces (natural greenery being limited to steep slopes, and extensive impervious surfaces on public open spaces). In conclusion, urban plans and designs for stroke mortality prevention should implement age-specific health care to neighborhoods with particular population segments.


Assuntos
Poluição do Ar , Acidente Vascular Cerebral , Fatores Etários , Idoso , Poluição do Ar/análise , Ambiente Construído , Feminino , Hong Kong/epidemiologia , Humanos
2.
J Sci Food Agric ; 102(1): 417-424, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34143904

RESUMO

BACKGROUND: Thiamethoxam is widely used to control pests in Chinese kale, popularly consumed leafy vegetables. The potential risk to the environment and human health has aroused much public concern. Therefore, it is important to investigate the degradation behavior, residue distribution and dietary risk assessment of thiamethoxam in Chinese kale. RESULTS: A sensitive analytical method for determination of thiamethoxam and its metabolite clothianidin residue in Chinese kale was established and validated through a quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique with ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The recoveries were 85.4-101.2% for thiamethoxam and 79.5-108.1% for clothianidin, with the relative standard deviations (RSDs) of 0.9-10.2% and 1.8-6.0%, respectively. For the dissipation kinetics, the data showed that thiamethoxam in Chinese kale was degraded with the half-lives of 4.1 to 4.5 days. In the terminal residue experiments, the residues of thiamethoxam were 0.017-0.357 mg kg-1 after application 2-3 times with a preharvest interval (PHI) of 7 days under the designed dosages. The chronic and acute dietary exposure assessment risk quotient (RQ) values of thiamethoxam in Chinese kale for different Chinese consumers were 0.08-0.19% and 0.05-0.12%, respectively, and those of clothianidin were 0.01-0.04% and 0.02-0.04%, respectively, all of the RQ values were lower than 100%. CONCLUSION: Thiamethoxam in Chinese kale was rapidly degraded following first-order kinetics models. The dietary risk of thiamethoxam and clothianidin through Chinese kale was negligible to consumers. The results from this study are important reference for Chinese governments to developing criteria for the safe and rational use of thiamethoxam, setting maximum residue levels (MRLs), monitoring the quality safety of agricultural products and protecting consumer health. © 2021 Society of Chemical Industry.


Assuntos
Brassica/química , Cromatografia Líquida/métodos , Guanidinas/metabolismo , Neonicotinoides/metabolismo , Resíduos de Praguicidas/química , Resíduos de Praguicidas/metabolismo , Espectrometria de Massas em Tandem/métodos , Tiametoxam/química , Tiametoxam/metabolismo , Tiazóis/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brassica/metabolismo , Criança , Pré-Escolar , China , Exposição Dietética/efeitos adversos , Exposição Dietética/análise , Feminino , Contaminação de Alimentos/análise , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Medição de Risco , Verduras/química , Verduras/metabolismo , Adulto Jovem
3.
Rev. enferm. UERJ ; 29: e57581, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224578

RESUMO

Objetivo: descrever as características sociodemográficas e de saúde de mulheres e homens com 75 anos ou mais de idade, no baseline e follow-up de quatro anos e verificar para mulheres e homens as mudanças nas condições de saúde. Métodos: estudo longitudinal com 109 idosos de 75 anos ou mais de idade de um município no Triângulo Mineiro. A coleta dos dados, realizada em dois momentos (2014-2018), ocorreu no domicílio com a aplicação de instrumentos validados no Brasil. Procederam-se às análises descritiva e teste t pareado (p<0,05). Os projetos foram aprovados pelo Comitê de Ética e Pesquisa com Seres Humanos. Resultados: verificaram-se, em ambos os sexos, aumento do número de morbidades e diminuição do escore total das atividades instrumentais da vida diária. Entre as mulheres observou-se, ainda, aumento do número de quedas e do escore de fragilidade. Conclusão: ao longo do seguimento houve piora nas condições de saúde dos idosos, sendo mais expressiva entre as mulheres.


Objective: to describe the sociodemographic and health characteristics of women and men aged 75 or over, at baseline and after four years of follow-up, and to ascertain changes in their health status. Methods: in this longitudinal study of 109 elderly people aged 75 or over from a city in the Triângulo Mineiro, data were collected at two points (2014 and 2018), at home, by applying instruments validated for use in Brazil. Descriptive analysis and paired t-tests were performed (p < 0.05). The projects were approved by the human research ethics committee. Results: in both genders, the number of morbidities increased and the total score for instrumental activities of daily living decreased. Among women, the number of falls and frailty score also increased. Conclusion: the older people's health status worsened over the course of follow-up, more so among the women.


Objetivo: describir las características sociodemográficas y de salud de mujeres y hombres de 75 años o más, en la base de referencia y el seguimiento durante cuatro años, y verificar los cambios en las condiciones de salud de mujeres y hombres. Métodos: estudio longitudinal con 109 personas mayores, de 75 años o más, de un municipio del Triângulo Mineiro. La recolección de datos, realizada en dos momentos (2014-2018), se realizó en sus domicilios aplicando instrumentos validados en Brasil. Se realizaron análisis descriptivos y prueba t pareada (p <0.05). Los proyectos fueron aprobados por el Comité de Ética en Investigación con Humanos. Resultados: en ambos os sexos, hubo un aumento en el número de morbilidades y una disminución en la puntuación total de las actividades instrumentales de la vida diaria. Entre las mujeres, se observó asimismo un aumento en el número de caídas y la puntuación de fragilidad. Conclusión: a lo largo del seguimiento, las condiciones de salud de las personas mayores empeoraron, más expresivamente entre las mujeres.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Nível de Saúde , Saúde do Idoso , Seguimentos , Estudos Longitudinais , Determinantes Sociais da Saúde
4.
J Nutr Health Aging ; 25(9): 1064-1069, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725662

RESUMO

OBJECTIVES: To develop and cross-validate self-administered Rapid Geriatric Assessment (SA-RGA) app against administered Rapid Geriatric Assessment (A-RGA) to identify seniors with geriatric syndromes such as frailty, sarcopenia, and anorexia of ageing who may benefit from targeted intervention. DESIGN: Prospective observational study. SETTING: Primary Care and Community. PARTICIPANTS: A-RGA and SA-RGA app were administered to older adults ≥ 60 years old from December 2020 to April 2021. MEASUREMENTS: The RGA app screens for frailty (FRAIL), sarcopenia (SARC-F), anorexia of aging (SNAQ) and cognition (Rapid Cognitive Screen) with assisted management pathway. Patient Health Questionnaire 9 is administered for those who score positive for fatigue. The diagnostic performance of SA-RGA was compared against A-RGA as a reference by calculating the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and positive likelihood ratio (+LR). RESULTS: 123 participants with a mean age of 71 ± 5.9 years completed both the SA-RGA and A-RGA. Questions on fatigue, 5 or more illnesses, loss of weight and falls in the past year performed better with high sensitivity, specificity, NPV and +LR than self-functional assessment where SA-RGA participants reported lower prevalence on the FRAIL scale aerobic and resistance components, and higher prevalence on the SARC-F strength and rising from a chair components. CONCLUSION: The SA-RGA app performed well in certain domains such as assessment for weight loss, falls, number of chronic illness and fatigue. Self-functional assessment can be improved further by removing ambiguity in wordings such as "some" or "a lot" and replacing it with functional difficulty scale. SA-RGA has the potential to be incorporated in the eHEALTH platforms worldwide for early identifications of older adults at risk and to reduce health inequalities, at the same time building community resilience in the era of Covid-19 pandemic.


Assuntos
COVID-19 , Aplicativos Móveis , Sarcopenia , Idoso , Estudos Transversais , Avaliação Geriátrica , Humanos , Pandemias , Reprodutibilidade dos Testes , SARS-CoV-2 , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Inquéritos e Questionários
5.
Acta Orthop Traumatol Turc ; 55(5): 422-427, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34730529

RESUMO

OBJECTIVE: The aim of this study was to compare the efficacy, safety, and cost-effectiveness of combined administration of intravenous and local tranexamic acid with those of either intravenous or local administrations in patients undergoing primary total hip arthroplasty (THA). METHODS: This prospective, blinded, and randomized clinical study was performed on patients undergoing unilateral primary THA from September 2018 to December 2019. A total of 90 patients were included and prospectively allocated to one of three groups: the combined group (n= 30, 14 male, 16 female; mean age = 54.9 ± 12 years), intravenous (IV) group (n = 30, 13 male, 17 female; mean age = 54.9 ± 12.3 years), and local group (n = 30, 13 male, 17 female; 50.3 ± 12.3). Tranexamic acid was used systemically by IV application (15mg/kg) in IV group, locally in the surgical field (2g) in local group as well as combined systemic and local together in combined group. The amount of blood loss, number of erythrocyte suspension transfusion, and changes in hemoglobin and hematocrit levels were documented accordingly. The estimated mean tranexamic acid and erythrocyte suspensions cost, extra nurse care, monitoring and laboratory costs associated with blood transfusion, and total hospital costs were compared among groups. RESULTS: No differences existed in hemoglobin and hematocrit levels after surgery among the groups. The combined group required fewer blood transfusion compared to the local and IV groups, and the total amount of ES was statistically significantly lower (P = 0.039) in the combined group. Although the medication cost was higher in the combined group than in the other groups (P < 0.001), combined group was more cost-effective (P < 0.001) when the total costs related to blood loss were evaluated. No occurrence of deep vein thrombosis or pulmonary embolism was found in the study. CONCLUSION: Combined administration of IV and local tranexamic acid seems to be more effective in reducing the requirement and amount of blood transfusion without increasing the risk of thromboembolic complications in primary THA compared to IV or local administrations. Despite increasing the prophylaxis costs, combined administration of TXA can result in lower total hospitalization costs by decreasing blood loss and consequent treatment costs in primary THA. LEVEL OF EVIDENCE: Level I, Randomized Controlled Trial.


Assuntos
Antifibrinolíticos , Artroplastia de Quadril , Ácido Tranexâmico , Administração Intravenosa , Adulto , Idoso , Artroplastia de Quadril/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Adv Health Care Manag ; 202021 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-34779185

RESUMO

Leading health care institutions have recommended greater alignment among health care and social services organizations as a strategy to improve population health. Deepening our understanding of how interorganizational relationships among health care and social service organizations influence care for people with complex needs could improve the design of interventions aimed at aligning these organizations to achieve health goals. Accordingly, we used qualitative methods to (1) elucidate the functions performed by health care and social service organizations caring for older adults and (2) investigate corresponding relationship forms. In-depth interviews with 175 representatives of health care and social service organizations in 10 communities were analyzed. Three distinct interorganizational relationships functions emerged: First, interorganizational relationships gave organizations a deeper and more accurate understanding of how their work was interdependent with the work of other organizations in the community. This function was achieved through coalitions that loosely tied large numbers of organizations and allowed information to flow among them. Second, interorganizational relationships allowed organizations to take joint action toward a shared goal, a function achieved in the form of pairs or small groups of organizations working closely together. Third, interorganizational relationships fostered accountability, with one organization advocating for the needs of clients or patients with another organization. Our results suggest that initiatives to promote regional alignment among health care and social services organizations may benefit from flexible models that anticipate a narrowing of partners to achieve tangible outcomes. Initiatives also need to accommodate low-level conflict that routinely exists among organizations in these sectors.


Assuntos
Saúde da População , Serviço Social , Idoso , Atenção à Saúde , Instalações de Saúde , Humanos , Organizações
7.
Sensors (Basel) ; 21(21)2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34770281

RESUMO

Foot strike detection is important when evaluating a person's gait characteristics. Accelerometer and gyroscope signals from smartphones have been used to train artificial intelligence (AI) models for automated foot strike detection in able-bodied and elderly populations. However, there is limited research on foot strike detection in lower limb amputees, who have a more variable and asymmetric gait. A novel method for automated foot strike detection in lower limb amputees was developed using raw accelerometer and gyroscope signals collected from a smartphone positioned at the posterior pelvis. Raw signals were used to train a decision tree model and long short-term memory (LSTM) model for automated foot strike detection. These models were developed using retrospective data (n = 72) collected with the TOHRC Walk Test app during a 6-min walk test (6MWT). An Android smartphone was placed on a posterior belt for each participant during the 6MWT to collect accelerometer and gyroscope signals at 50 Hz. The best model for foot strike identification was the LSTM with 100 hidden nodes in the LSTM layer, 50 hidden nodes in the dense layer, and a batch size of 64 (99.0% accuracy, 86.4% sensitivity, 99.4% specificity, and 83.7% precision). This research created a novel method for automated foot strike identification in lower extremity amputee populations that is equivalent to manual labelling and accessible for clinical use. Automated foot strike detection is required for stride analysis and to enable other AI applications, such as fall detection.


Assuntos
Amputados , Idoso , Inteligência Artificial , Árvores de Decisões , Humanos , Extremidade Inferior , Memória de Curto Prazo , Estudos Retrospectivos
8.
Int J Public Health ; 66: 1604073, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744596

RESUMO

Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate. Methods: In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012-2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50-69/70-75) on testing rate over time. Results: Among insurees (2012:355'683; 2018:348'526), yearly CRC testing rate increased from 2012 to 2018 (overall: 8.1-9.9%; colonoscopy: 5.0-7.6%; FOBT: 3.1-2.3%). Odds ratio (OR) were higher for 70-75-year-olds (2012: 1.16, 95%CI 1.13-1.20; 2018: 1.05, 95%CI 1.02-1.08). Deductible interacted with changes in testing rate over time (p < 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years. Conclusions: CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.


Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Idoso , Colonoscopia/economia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/economia , Detecção Precoce de Câncer/estatística & dados numéricos , Humanos , Formulário de Reclamação de Seguro/estatística & dados numéricos , Seguro Saúde/economia , Pessoa de Meia-Idade , Sangue Oculto , Mecanismo de Reembolso , Suíça
9.
JBJS Rev ; 9(11)2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34757981

RESUMO

BACKGROUND: The utilization of outpatient shoulder arthroplasty has been increasing. With increasing pressure to reduce costs, further underscored by the coronavirus (COVID-19) pandemic, many health-care organizations will move toward outpatient interventions to conserve inpatient resources. Although abundant literature has shown the advantages of outpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA), there is a relative paucity describing outpatient shoulder arthroplasty. Thus, the purpose of this study was to summarize the peer-reviewed literature of outpatient shoulder arthroplasty with particular attention to patient selection, patient outcomes, and cost benefits. METHODS: The PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase databases were queried according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All articles on outpatient shoulder arthroplasty were included. Data on patient selection, patient outcomes, and cost analyses were recorded. Patient outcomes, including complications, reoperations, and readmissions, were analyzed by weighted average. RESULTS: Twenty-three articles were included for analysis. There were 3 review articles and 20 studies with Level-III or IV evidence as assessed per The Journal of Bone & Joint Surgery Level of Evidence criteria. Patient selection was most often predicated on age <70 years, body mass index (BMI) <35 kg/m2, absence of active cardiopulmonary comorbidities, and presence of home support. Complications and readmissions were not common and either improved or were equivalent to those of inpatient shoulder arthroplasty. Patient satisfaction was high in studies of short-term and intermediate-term follow-up. The proposed cost benefit ranged from $747 to $53,202 with outpatient shoulder arthroplasty. CONCLUSIONS: The published literature to date supports outpatient shoulder arthroplasty as an effective, safe, and cost-reducing intervention with proper patient selection. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Artroplastia do Ombro , COVID-19 , Idoso , Humanos , Pacientes Ambulatoriais , Avaliação de Resultados da Assistência ao Paciente , Seleção de Pacientes , SARS-CoV-2
10.
Geospat Health ; 16(2)2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763415

RESUMO

Longevity is a near-universal human aspiration that can affect moral progress and economic development at the social level. In rapidly developing China, questions about the geographical distribution and environmental factors of longevity phenomenon need to be answered more clearly. This study calculated the longevity index (LI), longevity index for females (LIF) and longevity index for males (LIM) based on the percentage of the long-lived population among the total number of elderly people to investigate regional and gender characteristics at the county level in China. A new multi-scale geographically weighted regression (MGWR) model and four possible geographical environmental factors were applied to explore environmental effects. The results indicate that the LIs of 2838 counties ranged from 1.3% to 16.3%, and the distribution showed obvious regional and gender differences. In general, the LI was high in the East and low in the West, and the LIF was higher than the LIM in 2614 counties (92.1%). The MGWR model performed well explaining that geographical environmental factors, including topographic features, vegetation conditions, human social activity and air pollution factors have a variable influence on longevity at different spatial scales and in different regions. These findings enrich our understanding of the spatial distribution, gender differences and geographical environmental effects on longevity in China, which provides an important reference for people interested in the variations in the associations between different geographical factors.


Assuntos
Poluição do Ar , Regressão Espacial , Idoso , Poluição do Ar/análise , China/epidemiologia , Feminino , Geografia , Humanos , Longevidade , Masculino
11.
Kardiologiia ; 61(10): 53-60, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34763639

RESUMO

Objective    The purpose of this study was to investigate the association between global longitudinal strain (GLS) and plasma NT-proBNP for predicting left ventricular (LV) performance in asymptomatic patients after acute myocardial infarction (AMI).Material and methods    We prospectively included patients with diagnosis of AMI without clinical signs and symptoms of heart failure (HF) and followed these patients for 6 mos. Baseline echocardiography was performed at admission, and follow-up echocardiography was performed after 6 mos. A normal GLS was defined as having an absolute value of ≥16 %. According to the baseline GLS, participants were divided into two groups and compared. In all participants, blood samples of plasma NT-proBNP were obtained at admission, before discharge, and 6 mo after discharge.Results    The study population was consisted of 98 participants, of which 80 (81.6 %) were males, and the mean age was 56.0±9.3 years. Baseline echocardiography showed that most of the participants (60, 61.2 %) had abnormal GLS<16 %, whereas 38 (38.8 %) participants had normal or borderline GLS ≥16 %. Compared with the normal GLS group, participants with abnormal GLS had higher GRACE score, higher troponin I concentration, lower systolic blood pressure, lower mean LV ejection fraction, and decreased LV diastolic function. At 6­mo follow-up, only LV systolic function remained significantly different between the two groups. Compared to baseline, there was a significant improvement of GLS in the abnormal GLS group at 6­mo follow-up (p=0.04). Prevalence of complications after AMI was significantly higher in this group. There were significant differences between baseline and discharge NT-proBNP concentrations between the two groups (p<0.05). In the abnormal GLS group, there were significant correlations between baseline and discharge NT-proBNP concentrations with baseline LV systolic function. Discharge NT-proBNP concentration also correlated significantly with 6­mo follow-up GLS. For determining the effect of baseline GLS abnormality, the areas under the ROC curve for baseline and discharge NT-proBNP concentrations were 0.73 (95 % CI 0.60-0.85, p=0.001) and 0.77 (95 % CI 0.66-0.87, p<0.001), respectively. Regarding early prediction of follow-up GLS abnormality, the area under the ROC curve for discharge NT-proBNP concentration was significantly higher 0.70 (95 % CI 0.55-0.84, p=0.016). The optimum cut-off value of discharge NT-pro-BNP was 688.5 pg / ml, with 72.4 % sensitivity and 65.4 % specificity to predict 6­mon GLS abnormality following acute myocardial infarction.Conclusion    The main finding of this study is that impaired LV GLS is associated with elevated plasma concentrations of NT-proBNP in post-AMI patients. Pre-discharge NT-proBNP concentration combined with impaired initial GLS could predict worsening LV systolic function over time in asymptomatic post-AMI patients.


Assuntos
Disfunção Ventricular Esquerda , Idoso , Biomarcadores , Ecocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico , Peptídeos Natriuréticos , Fragmentos de Peptídeos , Volume Sistólico , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia , Função Ventricular Esquerda
12.
Rev Lat Am Enfermagem ; 29: e3488, 2021.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-34730764

RESUMO

OBJECTIVE: to map the indicators of Good Nursing Practices in Primary Health Care, from the perspective of Collective Health, reported to the vulnerable social groups. METHOD: this is a scoping review according to the PRISMA Extension for Scoping Reviews. The searches were carried out in2020 in six databases and in a virtual library. Independent reviewers performed the reading of the full texts, as well as treatment, analysis and synthesis of the content. RESULTS: a total of 13 articles were found, the first from 2007 and the last from 2020. The data were classified according to the following empirical categories: assessment and control of health conditions(3 indicators); assessment of knowledge about health(3 indicators); use of sociodemographic characteristics to estimate risks or vulnerabilities(3 indicators); assessment and monitoring of health needs(5 indicators); promotion of safety and trust in health services(6 indicators); and assessment of the care process(4 indicators). CONCLUSION: the articles showed a variety of indicators that assess the interventions carried out in the context of Nursing in Primary Care with vulnerable social groups. These indicators are related to health conditions, especially those of the biopsychological body, reported to vulnerable populations, especially women, children, adolescents and older adults.


Assuntos
Atenção Primária à Saúde , Populações Vulneráveis , Adolescente , Idoso , Criança , Serviços de Saúde , Humanos
13.
Arch Osteoporos ; 16(1): 165, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34735660

RESUMO

Our purpose was to assess the prevalence of morphometric vertebral fractures (VFs) in osteoporotic patients in our country. We found that 25.4% of patients had sustained a VF, and the majority of them (76.6%) were undiagnosed prior to inclusion in this study. INTRODUCTION: We assessed the prevalence of morphometric vertebral fractures (VFs) in osteoporotic patients in our country. METHODS: Patients were recruited via announcements by the national media, their attending physicians or the National patients' Society. Inclusion criteria were (1) age > 50 years, (2) postmenopausal status > 2 years (women), (3) > 1-year use of medication for osteoporosis and (4) lack of radiological vertebral assessment for > 1 year. Exclusion criteria were (1) bone metabolic diseases other than osteoporosis, (2) patients with secondary osteoporosis, (3) patients with inability to stand/walk, (4) previous high-energy VFs. All patients performed lateral X-rays of the thoracic and lumbar spine that were evaluated separately both by certified radiologists on site as well as 3 consultant orthopaedic surgeons remotely through a specifically designed web database system. The Genant semi-quantitative method was used for the classification and grading of VFs and statistical analysis of the results was performed. RESULTS: One thousand six hundred fifty-two patients (1516 female, 70.02 ± 8.28 years; 136 male, 74.78 ± 8.25 years) were included in the final analysis. The prevalence of VFs was 25.4%, 76.6% of fractured patients were previously undiagnosed, and of these 39.9% had > 1 VFs. The most common fracture was T12, most fractures were found to be mild (grade 1) across all age groups, and patients 70-79 years and > 80 years were found to have a statistically significantly higher number of fractures than younger patients (p < 0.001). CONCLUSIONS: Our results of the high prevalence of morphometric VFs emphasise the need for baseline assessment of vertebral fragility in patients receiving treatment for osteoporosis, as well as follow-up radiographs at specified time periods while on therapy.


Assuntos
Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Absorciometria de Fóton , Idoso , Densidade Óssea , Feminino , Grécia/epidemiologia , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/epidemiologia , Prevalência , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia
14.
Front Public Health ; 9: 657199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733812

RESUMO

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.


Assuntos
Infecções Urinárias , Idoso , Estudos Transversais , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Resultado do Tratamento , Infecções Urinárias/diagnóstico
15.
Accid Anal Prev ; 163: 106460, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34735887

RESUMO

To maintain road safety for older drivers as well as other road users, it is important to provide interventions that improve self-awareness and behaviors in older drivers. We developed an intervention that provides feedback on accuracy of self-awareness of driving performance using a workbook, and examined its effectiveness using a prospective design with a follow-up after two months. Japanese drivers aged between 69 and 87 (Mean = 73.96) years were assigned to either the intervention group (n = 26) or the wait-list control group (n = 27). All participants were asked to assess their own driving performance by completing a questionnaire. They also completed an on-road driving assessment that involved driving on a public road while wearing an electronic device that measured their actual driving behaviors, accompanied by a driving instructor who sat in the passenger seat and assessed the participant's driving performance (expert assessment). Thereafter, only the intervention group received the immediate intervention (first wave). One month later, the intervention group completed the booster intervention by post. Two months after the first wave, both groups completed the questionnaire and on-road driving assessment again (second wave). Result revealed that discrepancy between self-assessment and expert assessment reduced in only the intervention group between the two waves. This finding suggests that the intervention was able to improve the accuracy of self-assessment. Furthermore, the expert assessment improved in the intervention group between the two waves, but this change was not observed in the control group. Similar trend was evident for vehicle speed at intersections with a stop sign but the result was not statistically significant. Changes in head rotation at intersections requiring turn in the intervention group did not differ from those in the control group. Improved accuracy of self-assessment as a result of the intervention could have led to improved general driving performance, but did not influence head rotation.


Assuntos
Condução de Veículo , Autoavaliação (Psicologia) , Acidentes de Trânsito , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Japão , Estudos Prospectivos , Inquéritos e Questionários
17.
Artigo em Inglês | MEDLINE | ID: mdl-34769791

RESUMO

BACKGROUND: The quality of life in osteoporosis is studied for men rather than for women. Aim of the study was to determine how bone mass density (BMD) relates to life quality components and the severity of pain felt by men affected by osteoporosis. METHODS: Presented research is a cross-sectional study. The cohort of 62 men aged 65 to 85 years was divided into a group with osteoporosis (N = 27) and a group without osteoporosis (N = 35). The participants' quality of life was measured with the Qualeffo41 Questionnaire, BMD was quantified by densitometry, and pain intensity was assessed on the Visual Analogue Scale. RESULTS: We found that lower BMD was strongly correlated to participants' quality of life (r = -0.72), especially the quality of leisure and social activities (r = -0.66), general health perception (r = -0.59), and mobility (r = -0.57). Pain significantly affected general health perception in older men with osteoporosis. General health assessment and pain were highly correlated with each other (r = 0.888). CONCLUSION: BMD and the overall quality of life of the study participants were related to each other. The strongest relationship occurred between reduced BMD and leisure and social activities component. The pain significantly affected participants' general health perception. The results may be employed to create new prophylactic strategies to improve life quality in men with osteoporosis.


Assuntos
Osteoporose , Qualidade de Vida , Absorciometria de Fóton , Idoso , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Masculino , Osteoporose/epidemiologia , Dor/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-34769804

RESUMO

This study explores the impact of farmland transfer on the multidimensional relative poverty of the elderly in rural areas to provide a reference for the study of rural land transfer in China and improve the welfare system for the elderly. Based on the China Family Panel Studies (CFPS) rural sample data in 2018, this paper uses the AF multidimensional index measurement method to assess multidimensional relative poverty in rural areas. Logit regression estimation examines the single index poverty of rural older adults transferred from rural land and the impact of multidimensional relative poverty, using the propensity score matching method (PSM) to analyze the results' robustness. The transfer of agricultural land has different impacts on the poverty of different rural elderly poverty indicators and negatively affects the comprehensive effect of rural elderly poverty. The transfer of agricultural land significantly alleviates rural elderly poverty. Reasonable and effective transfer of agricultural land, together with improved rural social security and a caring service system for the elderly, will promote the continuous operation of large-scale agricultural operations and alleviate rural elderly poverty.


Assuntos
Pobreza , População Rural , Idoso , Agricultura , China , Fazendas , Humanos
19.
BMC Geriatr ; 21(1): 615, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34719380

RESUMO

BACKGROUND: Healthy ageing is a complex construct which involves multiple dimensions. Previous studies of healthy ageing have focused only on measuring the intrinsic capacity of the older person. The objectives of this study were to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador. METHODS: A cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more. A multidimensional model was designed based on the World Health Organization's concept of healthy ageing. For the analysis, two groups were created: a healthy ageing and a less healthy ageing group. Bivariate and multivariate logistic regressions were performed to analyze the probability of belonging to the healthy group according to sex, age, area of ​​residence, level of education, perceived health status, perceived life satisfaction, and poverty by income level. RESULTS: The 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults were less likely to be in the healthy ageing group (OR 0.58; 95% CI 0.464-0.737; OR 0.44; 95% CI 0.343-0.564). Older adults with secondary education or higher, who considered their health as excellent and who were satisfied with their life, had a greater probability of being in healthy ageing group (OR 2.61; 95% CI 1.586-4.309; OR 28.49; 95% CI 3.623-224.02; OR 0.23; 95% CI 0.165-0.341). CONCLUSIONS: This study contributes with a multidimensional approach to healthy ageing. It proposes to evaluate the intrinsic capacity of the individual, the social and political environment and the interaction with it, through indicators that discriminate who are ageing in a healthy way and who are not. By using this model, it was identified that gender and economic situation seem to play an important role on heathy ageing of the Ecuadorian population. Public policies are necessary to promote healthy ageing, especially focused on improving socioeconomic conditions and gender equity.


Assuntos
Envelhecimento Saudável , Idoso , Envelhecimento , Estudos Transversais , Equador/epidemiologia , Feminino , Nível de Saúde , Humanos
20.
BMC Geriatr ; 21(1): 618, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34724895

RESUMO

BACKGROUND: The discharge of older hospitalised patients is critical in terms of patient safety. Inadequate transfer of information about medications to the next healthcare provider is a known problem, but there is a lack of understanding of this problem in settings where shared electronic health records are used. The aims of this study were to evaluate the prevalence of patients for whom hospitals sent adequate requests for medication-related follow-up at discharge, the proportion of patients with unplanned hospital revisits because of inadequate follow-up requests, and the association between medication reviews performed during hospitalisation and adequate or inadequate follow-up requests. METHODS: We conducted a retrospective chart review. The study population was randomly selected from a cluster-randomised crossover trial which included patients 65 years or older who had been admitted to three hospitals in Sweden with shared electronic health records between hospital and primary care. Each patient was assessed with respect to the adequacy of the request for follow-up. For patients where the hospitals sent inadequate requests, data about any unplanned hospital revisits were collected, and we assessed whether the inadequate requests had contributed to the revisits. The association between medication reviews and adequate or inadequate requests was analysed with a Chi-square test. RESULTS: A total of 699 patients were included. The patients' mean age was 80 years; an average of 10 medications each were prescribed on hospital admission. The hospitals sent an adequate request for 418 (60%) patients. Thirty-eight patients (14%) had a hospital revisit within six months of discharge which was related to an inadequate request. The proportion of adequate or inadequate requests did not differ between patients who had received a medication review during hospitalisation and those who had not (p = 0.83). CONCLUSIONS: The prevalence of patients for whom the hospitals sent adequate follow-up requests on discharge was low. More than one in every ten who had an inadequate request revisited hospital within six months of discharge for reasons related to the request. Medication reviews conducted during hospitalisation did not affect the proportion of adequate or inadequate requests sent. A communication gap still exists despite the usage of a shared electronic health record between primary and secondary care levels.


Assuntos
Hospitais , Alta do Paciente , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Hospitalização , Humanos , Estudos Retrospectivos
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