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1.
Meat Sci ; 183: 108616, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34481232

RESUMO

This cross-country study investigates the potential to improve pig welfare by exploiting consumer demand, domestically and in export markets, for welfare pork produced in indoor production systems. The analysis is based on questionnaire data collected in 2019 focusing on demand for Danish welfare pork both in Denmark and in two nearby export markets, Sweden and Germany. To reduce hypothetical bias, a willingness-to-pay indicator is combined with an indicator of positive interest in buying a fictive Danish welfare labelled pork. We find that the market potential is relatively weak. Our findings indicate that there is some, albeit limited, potential in Denmark and Germany while demand is practically non-existing in Sweden, probably because the pig welfare guaranteed by Swedish legislation is similar to what is provided by the fictive welfare label employed in the study. Hence, consumer demand alone cannot secure enhanced pig welfare. Moreover, we found national differences in the characteristics of consumers who are interested in Danish welfare pork.


Assuntos
Bem-Estar do Animal , Comportamento do Consumidor/estatística & dados numéricos , Carne de Porco/normas , Adulto , Animais , Comportamento do Consumidor/economia , Estudos Transversais , Dinamarca , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Carne de Porco/economia , Inquéritos e Questionários , Suécia , Suínos
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.
World J Gastroenterol ; 27(39): 6647-6658, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34754158

RESUMO

BACKGROUND: Stigmatization is the separation of an individual from a group due to aspects that make them different. Resilience may in turn influence the perception of stigma. Patients with inflammatory bowel disease (IBD) are susceptible to stigma, although data are very limited. AIM: To validate an Italian translation of the IBD perceived stigma scale (PSS) in relation to patients' resilience. METHODS: Consecutive IBD outpatients were prospectively enrolled (December 2018-September 2019) in an Italian, tertiary referral, IBD center. Clinical and demographic data were collected. Stigma and resilience were evaluated through the IBD-PSS and the 25-item Connor-Davidson Resilience Scale, respectively. The International Quality of Life Assessment Project approach was followed to translate the IBD-PSS into Italian and to establish data quality. Higher scores represent greater perceived stigma and resilience. Multivariable analysis for factors associated with greater stigma was computed. RESULTS: Overall, 126 IBD patients (mean age 46.1 ± 16.9) were enrolled. The International Quality of Life Assessment criteria for acceptable psychometric properties of the scale were satisfied, with optimal data completeness. There was no ceiling effect, whilst floor effect was present (7.1%). The discriminant validity and the internal consistency reliability were good (Cronbach alpha = 0.87). The overall internal consistency was 95%, and the test-retest reliability was excellent 0.996. The median PSS score was 0.45 (0.20-0.85). Resilience negatively correlated with perceived stigma (Spearman's correlation = -0.18, 95% confidence intervals: -0.42-0.08, P = 0.03). CONCLUSION: We herein validated the Italian translation of the PSS scale, also demonstrating that resilience negatively impacts perceived stigma.


Assuntos
Doenças Inflamatórias Intestinais , Qualidade de Vida , Adulto , Humanos , Itália , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
J Orthop Traumatol ; 22(1): 45, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34757530

RESUMO

PURPOSE: The aim of this retrospective study was to investigate the clinical follow-up of patients with external snapping hip syndrome (ESHS) treated with endoscopic gluteus maximus tendon release and to compare the residual muscular strength and thigh circumference as an indirect outcome measure. METHODS: Patients of all ages with external snapping hip syndrome were treated with endoscopic gluteus maximus tendon release. Outcome measures evaluated included: visual analog scale (VAS), modified Harris Hip Score (mHHS), and Non-Arthritic Hip Score (NAHS). The gluteus maximus strength and the circumference of the thigh were also evaluated. RESULTS: Among 25 patients, 23 fulfilled the inclusion criteria and one patient was lost to follow-up. The series included 22 patients, 6 males and 16 females with a mean age of 27.9 ± 13.4 years (range 16-76 years). All patients had resolution of the snapping symptoms after the procedure. The mean follow-up was 18 ± 9.3 months. All outcomes improved in a statistically significant manner: VAS value decreased from 6.8 (range 6-8) to 0.6 (range 0-4) (p < 0.001), mHHS increased from 48.6 (range 17.6-67) to 88.2 (range 67-94.6) (p < 0.001), NAHS increased from 49.0 (range 21.5-66) to 90.8 (range 66-98.75) (p < 0.001). A statistically significant reduction of operated limb thigh circumference compared to the contralateral side (3.7%) was also found, while there were no statistical differences regarding the strength of gluteus maximus muscles. CONCLUSIONS: Endoscopic gluteus maximus tendon release is an excellent surgical option to treat snapping hip syndrome. The evaluated muscle strength revealed no functional impairment. The significance of the limb circumference reduction has yet to be determined. LEVEL OF EVIDENCE: IV: retrospective comparative trial.


Assuntos
Articulação do Quadril , Tenotomia , Adolescente , Adulto , Idoso , Feminino , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético , Estudos Retrospectivos , Tendões , Resultado do Tratamento , Adulto Jovem
5.
Zhonghua Yi Xue Za Zhi ; 101(42): 3495-3500, 2021 Nov 16.
Artigo em Chinês | MEDLINE | ID: mdl-34775708

RESUMO

Objective: To explore risk factors for hyperkalemia in hemodialysis (HD) patients, and establish and verify a risk assessment model of hyperkalemia in HD patients. Methods: The clinical data of HD patients who were admitted to the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University between April 2020 and January 2021 were retrospectively collected and divided into training dataset and validation dataset by using the conversion-random number generator. In the training dataset, multivariate logistic regression analysis was used to screen the risk factors for hyperkalemia in HD patients and the factors were scored to establish the risk assessment model. The validation dataset was substituted into the model and the receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to verify the effectiveness of the risk prediction model in predicting hyperkalemia. Results: A total of 502 HD patients were enrolled and further divided into training dataset (n=372) and validation dataset (n=130). There were 268 males and 234 females, with a mean age of (54±13) years. Multivariate logistic regression analysis showed that metabolic acidosis, high potassium diet, history of hyperkalemia, the change of electrocardiogram (ECG), disfunction of vascular access and time interval from last dialysis were risk factors for causing hyperkalemia in patients undergoing HD. Risk assessment model was established based on these risk factors. The AUC of the ROC curve was 0.799. Using 5 as the cut-off value, the sensitivity and specificity for predicting hyperkalemia events was 61.4% and 86.3%, respectively. Conclusion: The current study preliminarily established a risk assessment model for hyperkalemia in HD patients, which can help clinicians manage the potassium level of HD patients.


Assuntos
Hiperpotassemia , Adulto , Idoso , Feminino , Humanos , Hiperpotassemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Diálise Renal , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
6.
BMJ ; 375: e066542, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34759002

RESUMO

OBJECTIVE: To evaluate whether a structured exercise programme improved functional and health related quality of life outcomes compared with usual care for women at high risk of upper limb disability after breast cancer surgery. DESIGN: Multicentre, pragmatic, superiority, randomised controlled trial with economic evaluation. SETTING: 17 UK National Health Service cancer centres. PARTICIPANTS: 392 women undergoing breast cancer surgery, at risk of postoperative upper limb morbidity, randomised (1:1) to usual care with structured exercise (n=196) or usual care alone (n=196). INTERVENTIONS: Usual care (information leaflets) only or usual care plus a physiotherapy led exercise programme, incorporating stretching, strengthening, physical activity, and behavioural change techniques to support adherence to exercise, introduced at 7-10 days postoperatively, with two further appointments at one and three months. MAIN OUTCOME MEASURES: Disability of Arm, Hand and Shoulder (DASH) questionnaire at 12 months, analysed by intention to treat. Secondary outcomes included DASH subscales, pain, complications, health related quality of life, and resource use, from a health and personal social services perspective. RESULTS: Between 26 January 2016 and 31 July 2017, 951 patients were screened and 392 (mean age 58.1 years) were randomly allocated, with 382 (97%) eligible for intention to treat analysis. 181 (95%) of 191 participants allocated to exercise attended at least one appointment. Upper limb function improved after exercise compared with usual care (mean DASH 16.3 (SD 17.6) for exercise (n=132); 23.7 (22.9) usual care (n=138); adjusted mean difference 7.81, 95% confidence interval 3.17 to 12.44; P=0.001). Secondary outcomes favoured exercise over usual care, with lower pain intensity at 12 months (adjusted mean difference on numerical rating scale -0.68, -1.23 to -0.12; P=0.02) and fewer arm disability symptoms at 12 months (adjusted mean difference on Functional Assessment of Cancer Therapy-Breast+4 (FACT-B+4) -2.02, -3.11 to -0.93; P=0.001). No increase in complications, lymphoedema, or adverse events was noted in participants allocated to exercise. Exercise accrued lower costs per patient (on average -£387 (€457; $533) (95% confidence interval -£2491 to £1718; 2015 pricing) and was cost effective compared with usual care. CONCLUSIONS: The PROSPER exercise programme was clinically effective and cost effective and reduced upper limb disability one year after breast cancer treatment in patients at risk of treatment related postoperative complications. TRIAL REGISTRATION: ISRCTN Registry ISRCTN35358984.


Assuntos
Terapia Comportamental/métodos , Neoplasias da Mama/reabilitação , Terapia por Exercício/métodos , Mastectomia/reabilitação , Modalidades de Fisioterapia/economia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Comportamental/economia , Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Análise Custo-Benefício , Avaliação da Deficiência , Terapia por Exercício/economia , Feminino , Humanos , Mastectomia/economia , Pessoa de Meia-Idade , Qualidade de Vida , Medicina Estatal , Resultado do Tratamento , Reino Unido
7.
BMC Geriatr ; 21(1): 641, 2021 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772361

RESUMO

BACKGROUND: Identifying practical and distinguished indicators and influencing factors of male aging may be useful in predicting subsequent aging trends, designing personalized prevention, and improving lifestyle and health. METHODS: A cross-sectional, population-based study was performed in Jiashan County, China in 2016. A total of 690 local male residents, aged 40 to 80 years, were eligible for recruitment. Demographic and lifestyle information was collected through structured interviews. A self-designed head scale, the Medical Outcomes Study 36-item Short Form (SF-36), International Index of Erectile Function (IIEF5), Aging Males' Symptoms (AMS), and International Prostate Symptom Score (IPSS) were used. Analysis of variance, local polynomial regression smoothing curves, multiple linear regression, and partial correlation analyses were performed. RESULTS: All the scales deteriorated with increasing age (P < 0.01), especially from the age of 60. The most significant changes between adjacent age groups were found in IIEF5 scores (16.7, 43.5 and 39.4%). Income, nutrition, personality and neighborhood relationship had an effect on SF-36 and AMS after adjusting for age (P < 0.01). Furthermore, neighborhood relationship modified the age effect on the head scale score and IIEF5 (P = 0.03); nutrition modified the relationship between age and SF-36 (P < 0.01). CONCLUSIONS: Recession of reproductive health may be a distinct predictor of male aging. The associations of social inequalities or personality and health offer potential interventions for men's health in aging. Self-reported scales may limit the precision and more physical fitness tests could be combined for a more precise assessment.


Assuntos
Envelhecimento , Nível de Saúde , Idoso , China , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
8.
BMC Med Res Methodol ; 21(1): 251, 2021 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-34775952

RESUMO

BACKGROUND: For valid accelerometer-assessed physical activity (PA) data, several methodological aspects should be considered. We aimed to 1) visualize the applicability of absolute accelerometer cut-offs to classify PA intensity, 2) verify recommendations to measure PA over 7 days by examining inter-day variability and reactivity, 3) examine seasonal differences in PA, and 4) recommend during which 10 h day period accelerometers should be worn to capture the most PA in patients with heart failure (HEART) and healthy individuals (HEALTH). METHODS: Fifty-six HEART (23% female; mean age 66 ± 13 years) and 299 HEALTH (51% female; mean age 54 ± 19 years) of the COmPLETE study wore accelerometers for 14 days. Aim 1 was analyzed descriptively. Key analyses were performed using linear mixed models. RESULTS: The results yielded poor applicability of absolute cut-offs. The day of the week significantly affected PA in both groups. PA-reactivity was not present in either group. A seasonal influence on PA was only found in HEALTH. Large inter-individual variability in PA timing was present. CONCLUSIONS: Our data indicated that absolute cut-offs foster inaccuracies in both populations. In HEART, Sunday and four other days included in the analyses seem sufficient to estimate PA and the consideration of seasonal differences and reactivity seems not necessary. For healthy individuals, both weekend days plus four other days should be integrated into the analyses and seasonal differences should be considered. Due to substantial inter-individual variability in PA timing, accelerometers should be worn throughout waking time. These findings may improve future PA assessment. TRIAL REGISTRATION: The COmPLETE study was registered at clinicaltrials.gov ( NCT03986892 ).


Assuntos
Acelerometria , Insuficiência Cardíaca , Adulto , Idoso , Exercício Físico , Feminino , Nível de Saúde , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade
9.
Vestn Oftalmol ; 137(5): 40-46, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34726856

RESUMO

Surgical treatment of keratectasia, in addition to its cessation, is aimed at increasing the acuity and quality of vision. This can also significantly affect patient's quality of life. The criteria for assessing the quality of life does not always consider the balance between quantitative indicators and subjective perception, which can depend on the psychological aspect of self-esteem.Purpose - to perform comparative assessment of the quality of life of patients with keratoconus (KK) before and after intrastromal keratoplasty by a newly developed method using an original questionnaire. MATERIAL AND METHODS: The study included 20 patients (14 men and 6 women, with mean age of 33 years, from 21 to 45 years old; 20 eyes) diagnosed with degree II-IV KK, with non-corrected visual acuity of 0.3 or lower. The original questionnaire with three blocks of questions about subjective assessment of the severity of discomfort associated with the disease, expectations of treatment results and its effectiveness was used to study the quality of life of KK patients who underwent surgery. The evaluation method used a five-point grading scale. RESULTS: Despite the inability to objectively assess the result of treatment, patients can generally note the trend for improvement. Especially significant are the increase of visual acuity, improvement of general health, feeling of comfort and more optimistic view of one's future. Comparison of the expectations and treatment results has shown that some therapeutic effects are overestimated by the patients, while some others are underestimated. A priori, they overvalue the effects of treatment (actions associated with visual tasks - reading, writing), but at the same time undervalue the characteristics of overall personal and emotional state (except for spatial safety and comfort), i.e. the characteristics that determine the quality of life. CONCLUSION: The aims of writing a valid and reliable questionnaire have been achieved partially, and its further development requires comparison of the obtained results with psychodiagnostic data, which would reveal the nature of psychological factors that form the quality of life perception in patients with various vision disorders.


Assuntos
Transplante de Córnea , Ceratocone , Adulto , Córnea/cirurgia , Feminino , Humanos , Ceratocone/diagnóstico , Ceratocone/cirurgia , Ceratoplastia Penetrante , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
10.
Pan Afr Med J ; 40: 26, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733394

RESUMO

Introduction: the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria. Methods: a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test. Results: findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care. Conclusion: the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers.


Assuntos
COVID-19/psicologia , Atenção à Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Adulto , Ansiedade , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Medo , Feminino , Pessoal de Saúde , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , SARS-CoV-2 , Inquéritos e Questionários
11.
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
12.
BMC Health Serv Res ; 21(1): 1221, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763679

RESUMO

BACKGROUND: Immunopreventable diseases are a public health reality in Brazil and worldwide, a reality that is not exclusive to children, but affects the adult population. OBJECTIVES: Discriminating the total costs of hospitalizations from immunopreventable diseases in the population aged 20 to 59 years. METHODS: A population, observational, descriptive, retrospective study was conducted with secondary information from DATASUS to discriminate the hospitalizations associated with immunopreventable diseases in Brazil and their care costs, within the Scope of the SUS, between 2008 and 2018, in the economically active population (20 to 59 years). RESULTS: It was analyzed 127,746 hospitalizations for immunopreventable diseases, (27.92% of all hospitalizations) were observed in the adult population, totaled R$115,682,097.54 (29.72% of the total costs). Of this population studied, 51.48% were registered as male; 66.74% were associated with influenza disease; 16.05% to chickenpox/herpes zoster infection and 7.55% to acute hepatitis B infections. The trend analysis of the time series of hospitalizations in this population showed a stationary trend. CONCLUSIONS: The 127,746 hospitalizations could be avoided with immunization, and 127,746 workers who could be working and not hospitalized. There were also R$115,682,097.54 that could be invested in other public health needs, which became necessary for the treatment of preventable diseases.


Assuntos
Herpes Zoster , Custos Hospitalares , Adulto , Brasil/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-34769563

RESUMO

The purpose of this pilot study was to assess Chronic Myeloid Leukemia (CML) patients' adherence to, beliefs about, and barriers to oral anticancer agents (OAC) using brief self-report measures in community-based cancer clinics. Patients completed a structured interview including a health literacy assessment, a Brief Medication Questionnaire, two single-item self-report adherence questions, and the Medications Adherence Reasons Scale. Of the 86 participants, 88.4% were white; 55.8% male; mean age, 58.7 years; and 22.1% had limited health literacy. Nonadherence (missing at least one dose in the last week) was reported by 18.6% of participants and associated (p < 0.003) with less-than-excellent perceived ability to take CML medications (16.3%). Black participants reported more difficulty taking CML medications than white participants (28.6% vs. 8.3%, p = 0.053). Among all participants, 43.0% reported their CML medicine was ineffective and 24.4% that taking CML pills was somewhat to very hard. The most common reasons for missing a dose were simply missed it (24.4%) and side effects (18.6%). Most patients perceived their ability to take CML medication was good to excellent, yet nearly one in five reported missing at least one dose in the last week. Brief, no-cost self-report assessments to screen CML patients' OAC adherence, barriers, and beliefs could facilitate counseling in busy community cancer clinics.


Assuntos
Antineoplásicos , Leucemia Mielogênica Crônica BCR-ABL Positiva , Administração Oral , Antineoplásicos/uso terapêutico , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Projetos Piloto
14.
J Occup Health ; 63(1): e12287, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34734459

RESUMO

OBJECTIVES: Declining physical capacity caused by aging increases the risk of occupational falls on the same level and to lower levels. In emerging countries in Asia, the development of a program for older farmers to assess their risk of occupational falls is valuable. The current study aimed to evaluate the relationship between physical capacity and experience of occupational falls among middle-aged and older Thai farmers. METHODS: We conducted a cross-sectional survey of 419 Thai farmers aged 40 years and over during March and April, 2021. For the assessment of physical capacity, we used the Self-Check Risk Assessment of Falls and Other Accidents in the Workplace tool developed in Japan, consisting of five physical test components. Multiple logistic regression and receiver operating characteristic curves were used to analyze the data. RESULTS: The results revealed that 25.5% of participants had experienced occupational falls in the past 12 months. For each of the five physical test components, there was no significant association between physical capacity and experience of occupational falls. The area under the receiver operating characteristic curve was less than 0.60 for each of the five physical test components. A similar trend was observed when the analysis was limited to participants aged 50 years and over. CONCLUSIONS: The current study did not reveal any associations between physical capacity in each test and experience of occupational falls among middle-aged and older Thai farmers. Because the mechanisms underlying occupational falls are complex, multiple intervention approaches may be important for preventing accidents.


Assuntos
Acidentes por Quedas , Fazendeiros , Desempenho Físico Funcional , Autoavaliação (Psicologia) , Prevenção de Acidentes , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tailândia
15.
PLoS One ; 16(11): e0251683, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34731175

RESUMO

Previous research has shown that the COVID-19 outbreak, social distancing, and lockdown can affect people's psychological well-being. The aims of this study were (1) to estimate the extent to which perceptions and expectations regarding the social, economic, and domestic effects of the COVID-19 outbreak are associated with psychological distress and (2) to identify some demographic, psychosocial, and economic factors associated with increased vulnerability to psychological distress during the COVID-19 outbreak in Chile. 1078 people participated in a telephone survey between May 30 and June 10, 2020. The sample is representative of the Chilean adult population. Psychological distress was assessed through a questionnaire of anxious and depressive symptoms (Patient Health Questionnaire-4). We analyzed the data set using ordinary least-squares regression models, first estimating models for the entire sample, and then stratifying the sample into different groups to explore differences by gender and age. 19.2% of participants displayed significant psychological distress (PHQ-4 ≥ 6), with moderate to severe anxiety-depression symptoms being more prevalent in women than in men (23.9% vs 14.1%, χ2 16.78, p<0.001). The results of this study suggest that being a woman, feeling lonely and isolated, living in the areas hit hardest by the pandemic and lockdown, expecting a lack of income due to having to stop working as a consequence of the pandemic, and having a history of diagnosed mental disorders are significantly associated with psychological distress (p<0.05). The results of this study highlight the need to implement psychosocial programs to guard people's psychological well-being and social policies to address economic uncertainty during the current COVID-19 outbreak in Chile.


Assuntos
COVID-19/psicologia , Efeitos Psicossociais da Doença , Angústia Psicológica , Adolescente , Adulto , COVID-19/economia , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Pandemias , Adulto Jovem
16.
Anticancer Res ; 41(11): 5577-5584, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732428

RESUMO

BACKGROUND/AIM: An update on the incidence, risk factors, clinical sequalae, and management of postoperative pancreatic fistula (POPF) following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). PATIENTS AND METHODS: Retrospective analysis of prospectively collected data from the St George CRS/HIPEC database. RESULTS: Sixty-five (5.7%) out of 1,141 patients developed a POPF. Patients with POPFs were older, had a higher peritoneal cancer index, longer operation time, and required more units of blood intraoperatively. Splenectomy and distal pancreatectomy were significant risk factors for developing POPFs. While there was no effect on overall long-term survival in POPF patients, they did suffer higher rates of Clavien-Dindo grade 3/4 complications, in-hospital deaths, and longer hospital length of stay. Of the 65 POPF patients, 23 were taken back to theatre, 48 required radiological drains and 7 underwent endoscopic retrograde cholangiopancreatography. CONCLUSION: There are multiple risk factors for developing POPFs that are non-modifiable. While POPFs are associated with increased postoperative morbidity, long-term survival does not appear to be affected.


Assuntos
Procedimentos Cirúrgicos de Citorredução/efeitos adversos , Quimioterapia Intraperitoneal Hipertérmica/efeitos adversos , Fístula Pancreática/epidemiologia , Neoplasias Peritoneais/terapia , Quimioterapia Adjuvante , Procedimentos Cirúrgicos de Citorredução/mortalidade , Bases de Dados Factuais , Feminino , Humanos , Quimioterapia Intraperitoneal Hipertérmica/mortalidade , Incidência , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Fístula Pancreática/diagnóstico , Fístula Pancreática/mortalidade , Fístula Pancreática/terapia , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/patologia , Intervalo Livre de Progressão , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
17.
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
18.
Salud Colect ; 17: e3583, 2021 Sep 27.
Artigo em Espanhol | MEDLINE | ID: mdl-34752020

RESUMO

Benzodiazepines and "Z-drugs" (BZD/Z) are overprescribed in many countries. This study evaluates their consumption in a social security sector health insurance provider with national coverage in Argentina. With a descriptive and observational approach, outpatient dispensations of BZD/Zs were analyzed for people over 18 years old from April 2020 to March 2021, disaggregated by sex, age, active ingredient, and half-life. An annual prevalence of use of 11.6% was found among the 431,445 adult affiliates, with higher rates in women and in those over age 60. Overall consumption of BZD/Zs was 77.6 defined daily doses (DDD) per 1000 enrollee-days. The average user received 5.1 annual dispensations and the equivalent of 1.4 DDD for each day of the year. BZD/Zs with long half-life were the most used. We found high levels of BZD/Z consumption and for longer periods than recommended. It is necessary to improve the quality of consumption and reduce the negative impact of inappropriate use of these drugs among treated individuals.


Assuntos
Benzodiazepinas , Preparações Farmacêuticas , Adolescente , Adulto , Argentina , Benzodiazepinas/efeitos adversos , Feminino , Humanos , Renda , Pessoa de Meia-Idade , Previdência Social
19.
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
20.
Medicine (Baltimore) ; 100(41): e27418, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731116

RESUMO

ABSTRACT: The occurrence of COVID-19 pandemic had a significant negative effect on health care systems over the last year. Health care providers were forced to focus mainly on COVID-19 patients, neglecting in many cases equally important diseases, both acute and chronic. Therefore, also screening and diagnostic strategies for HIV could have been significantly impaired.This retrospective, multicenter, observational study aimed at assessing the number and characteristics of new HIV/AIDS diagnoses during COVID-19 pandemic in Italy and compared characteristics of people living with HIV at diagnosis between pre- and post-COVID-19 era (2019 vs 2020).Our results showed a significant reduction of HIV diagnoses during pandemic. By contrast, people living with HIV during pandemic were older and were diagnosed in earlier stage of disease (considering CD4+ T cell count) compared to those who were diagnosed the year before. Moreover, there was a significant decrease of new HIV diagnoses among men who have sex with men, probably for the impact of social distancing and restriction applied by the Italian Government. Late presentation incidence, if numbers in 2020 were lower than those in 2019, is still an issue.Routinely performing HIV testing in patients with suspected SARS-CoV-2 infection is identifying and linking to care underdiagnosed people living with HIV earlier. Thus, combined tests (HIV and SARS-CoV-2) should be implemented in patients with SARS-CoV-2 symptoms overlapping HIV's ones. Lastly, our results lastly showed how urgent implementation of a national policy for HIV screening is necessary.


Assuntos
Atenção à Saúde/organização & administração , Infecções por HIV/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Adulto , Contagem de Linfócito CD4/estatística & dados numéricos , COVID-19/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Humanos , Itália/epidemiologia , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
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