Effectiveness of Pilates-based exercises on the diastasis recti abdominis in climacteric women: a randomized controlled trial

Introduction: Recent studies have related the climacteric period with changes in connective tissue elasticity that may be related to diastasis recti abdominis. Mat Pilates is a method of exercise without impact that currently has more practitioners, due to its satisfactory results. However, there are no studies that evaluate the effectiveness of mat Pilates for women with diastasis recti abdominis. Objective: To evaluate the effectiveness of the mat Pilates program in climacteric women with diastasis recti abdominis. Methods: This randomized single-blinded clinical trial evaluated climacteric women with diastasis recti abdominis. The participants were randomized into the experimental group, which participated in 3 weekly sessions of mat Pilates for 12 weeks for a total of 36 sessions, and the control group (without exercises). The inter-rectus distance was measured with a digital caliper. The G*Power Version 3.1.9.2. software was used for the sample calculation, and the SPSS 20.0 program was used for statistical analysis. Results: The study comprised 21 women, including 10 in the control group and 11 in the experimental group, with mean ages of 54.3 ± 7.1 and 55.3 ± 6.0 years and body mass index values of 28.8 ± 5.5 kg/m2 and 29.9 ± 4.48 kg/m2, respectively. In the experimental group, reductions were observed in all the measures related to diastasis recti abdominis (p<0.05) in the supraumbilical, umbilical, and infra-umbilical regions. Conclusion: The mat Pilates method is effective for reducing diastasis recti abdominis in the climacteric period.

Income-Related Inequality Changes in Osteoarthritis First-Line Interventions: A Cohort Study.

OBJECTIVE: To examine income-related inequality changes in the outcomes of an osteoarthritis (OA) first-line intervention. DESIGN: Retrospective cohort study. SETTING: Swedish health care system. PARTICIPANTS: We included 115,403 people (age: 66.2±9.7 years; females 67.8%; N=115,403) with knee (67.8%) or hip OA (32.4%) recorded in the "Swedish Osteoarthritis Registry" (SOAR). INTERVENTIONS: Exercise and education. MAIN OUTCOME MEASURES: Erreygers' concentration index (E) measured income-related inequalities in "Pain intensity," "Self-efficacy," "Use of NSAIDs," and "Desire for surgery" at baseline, 3-month, and 12-month follow-ups and their differences over time. E-values range from -1 to +1 if the health variables are more concentrated among people with lower or higher income. Zero represents perfect equality. We used entropy balancing to address demographic and outcome imbalances and bootstrap replications to estimate confidence intervals for E differences over time. RESULTS: Comparing baseline to 3 months, "pain" concentrated more among individuals with lower income initially (E=-0.027), intensifying at 3 months (difference with baseline: E=-0.011 [95% CI: -0.014; -0.008]). Similarly, the "Desire for surgery" concentrated more among individuals with lower income initially (E=-0.009), intensifying at 3 months (difference with baseline: E=-0.012 [-0.018; -0.005]). Conversely, "Self-efficacy" concentrated more among individuals with higher income initially (E=0.058), intensifying at 3 months (difference with baseline: E=0.008 [0.004; 0.012]). Lastly, the "Use of NSAIDs" concentrated more among individuals with higher income initially (E=0.068) but narrowed at 3 months (difference with baseline: E=-0.029 [-0.038; -0.021]). Comparing baseline with 12 months, "pain" concentrated more among individuals with lower income initially (E=-0.024), intensifying at 12 months (difference with baseline: E=-0.017 [-0.022; -0.012]). Similarly, the "Desire for surgery" concentrated more among individuals with lower income initially (E=-0.016), intensifying at 12 months (difference with baseline: E=-0.012 [-0.022; -0.002]). Conversely, "Self-efficacy" concentrated more among individuals with higher income initially (E=0.059), intensifying at 12 months (difference with baseline: E=0.016 [0.011; 0.021]). The variable 'Use of NSAIDs' was not recorded in the SOAR at 12-month follow-up. CONCLUSION: Our results highlight the increase of income-related inequalities in the SOAR over time.

Creencias actitudinales sobre el comportamiento suicida en profesionales de salud del área de emergencias en un hospital público de Lima, Perú

Introducción: Cada año se producen unas 800 000 muertes por suicidio, superando el número de personas que mueren por homicidio y guerras en todo el mundo. En 2016, el suicidio fue la segunda causa de muerte entre las personas de 15 a 29 años en todo el mundo. Objetivo: Describir las creencias actitudinales sobre el comportamiento suicida en los profesionales de salud del área de emergencias de un hospital público. Metodología: Investigación con enfoque cuantitativo, de tipo descriptivo y de corte transversal. La población estuvo conformada por profesionales que laboraban en el área de emergencias de un hospital público en Lima. Se empleó una muestra no probabilística por conveniencia que estuvo conformada por 93 participantes. Se utilizó el Cuestionario de creencias actitudinales sobre el comportamiento suicida, compuesto por cuatro factores con una confiabilidad de 0,87. Resultados: Participaron 93 profesionales de salud. La edad promedio fue de 35,6 años. El Factor 1: Legitimación del suicidio y el Factor 4: El propio suicidio, son los que presentaron actitudes de rechazo al comportamiento suicida; mientras que el Factor 2: Suicidio en enfermos terminales y el Factor 3: Moral del suicidio, evidenciaron actitudes a favor. Las puntuaciones en los cuatro factores y en el puntaje total del cuestionario, para el grupo de médicos y otros profesionales, no mostraron diferencias significativas. El 51,6% (n=48) pertenecen al percentil 50, que tiene actitudes y creencias indiferentes para el suicidio y el 34,7% (n=23) al percentil 75, que tiene actitudes y creencias a favor de este. Discusión: La mayoría de los participantes mostraron actitudes y creencias neutrales para el suicidio. Solo se evidenciaron actitudes a favor del suicidio en los factores de moral y enfermos terminales. Las creencias actitudinales para los médicos y otros profesionales de la salud no mostraron diferencias significativas.

Introduction: Each year there are some 800,000 deaths by suicide, exceeding the number of people who die by homicide and wars throughout the world. In 2016, suicide was the second leading cause of death among people aged 15-29 worldwide. Objective: To describe attitudinal beliefs about suicidal behavior in health professionals in the emergency area of a public hospital. Methods: Quantitative, descriptive, and cross-sectional research. The population consisted of professionals who worked in the emergency department of a public hospital in Lima. A non-probabilistic convenience sample of 93 participants was used. The Attitudinal Beliefs Questionnaire on suicidal behavior, composed of four factors with a reliability of 0.87, was used. Results: 93 health professionals participated. The average age was 35.6 years. Factor 1: Legitimization of suicide and Factor 4: Suicide itself, showed attitudes of rejection of suicidal behavior, while Factor 2: Suicide in terminally ill patients and Factor 3: Morality of suicide, showed attitudes in favor. The scores in the four factors and in the total score of the questionnaire for the group of physicians and other professionals did not show significant differences. The 51.6% (n=48) belong to the 50th percentile, who have indifferent attitudes and beliefs for suicide and 34.7% (n=23) to the 75th percentile, who have attitudes and beliefs in favor of it. Discussion: Most of the participants showed neutral attitudes and beliefs for suicide. Attitudes in favor of suicide were only evident in the morale and terminally ill factors. Attitudinal beliefs for physicians and other health professionals showed no significant differences.

Precision Health Care Elements, Definitions, and Strategies for Patients with Diabetes: A Literature Review.

Diabetes is a prevalent disease with a high risk of complications. The number of people with diabetes worldwide was reported to increase every year. However, new integrated individualized health care related to diabetes is insufficiently developed. PURPOSE: The objective of this study was to conduct a literature review and discover precision health care elements, definitions, and strategies. METHODS: This study involved a 2-stage process. The first stage comprised a systematic literature search, evidence evaluation, and article extraction. The second stage involved discovering precision health care elements and defining and developing strategies for the management of patients with diabetes. RESULTS: Of 1337 articles, we selected 35 relevant articles for identifying elements and definitions of precision health care for diabetes, including personalized genetic or lifestyle factors, biodata- or evidence-based practice, glycemic target, patient preferences, glycemic control, interdisciplinary collaboration practice, self-management, and patient priority direct care. Moreover, strategies were developed to apply precision health care for diabetes treatment based on eight elements. CONCLUSIONS: We discovered precision health care elements and defined and developed strategies of precision health care for patients with diabetes. precision health care is based on team foundation, personalized glycemic target, and control as well as patient preferences and priority, thus providing references for future research and clinical practice.

Personality Variables as Predictors of Health Services Consumption.

Expenditure on healthcare and services can be a serious problem for public health. Personality variables should be included as indicators to be considered when studying the consumption of health resources and their planning. This study aims to identify the psychological and psychosocial variables that identify people who can be considered high consumers of health resources versus those who barely consume such resources. The sample was made up of a total of 1124 subjects; one half were men, and one half were women, all of legal age and residents in Spain. A battery of tests was created that included a questionnaire of sociodemographic variables and of healthcare consumption, as well as several psychological variables (Zimbardo Time Paradox Inventory, Multidimensional Locus of Control Scale, Psychological Reactance Scale, Coping Responses Inventory, self-efficacy scale applied to health, and the Symptom Checklist-90-R). The following variables of the model were significant predictors (p ≤ 0.05): a negative past, a fatalistic present, psychological cognitive reactance, behavioral coping, health self-efficacy, and the level of somatization. Data from the statistical analyses show how to create a psychological profile of people who are high consumers of healthcare resources that will allow for the creation of intervention programs in this regard.

Fetal growth prediction: Establishing fetal growth prediction curves in the second trimester.

BACKGROUND: Monitoring fetal weight during pregnancy has a guiding role in prenatal care. OBJECTIVE: To establish a personalized fetal growth curve for effectively monitoring fetal growth during pregnancy. METHODS: (1) This study retrospectively analyzed the birth weight database of 2,474 singleton newborns delivered normally at term. The personalized fetal growth curve model was formed by combining the estimating birth weight of newborns with the proportional weight formula. (2) Multiple linear stepwise regression method was used to estimate the birth weight of newborns. RESULTS: (1) Delivery gestational age, weight at first visit, maternal height, pre-pregnancy body mass index, fetal sex, parity had significant effects on birth weight. Based on these parameters, the formula for calculating term optimal weight was obtained (R2= 22.8%, P< 0.001). (2) The personalized fetal growth curve was obtained according to the epidemiological factors input model of each pregnant woman. CONCLUSIONS: A model of personalized fetal growth curve can be established, and be used to evaluate fetal growth and development through estimated fetal weight monitoring.

Personal and familial factors associated with toilet training

ABSTRACT Purpose: Toilet training (TT) is an important marker in a child's physical and psychosocial development. The present study aimed to evaluate aspects associated to delayed TT. Material and Methods: We interviewed 372 parents of children who had completed TT up to 48 months before the interview. The questionnaires were applied at school exits when parents went to pick their children up and at public parks. Questions included demographics, aspects related to TT, dysfunction voiding symptom score and evaluation of constipation. Results: The interviews were performed at a mean of 15.3±10.4 (0 to 47) months after the end of TT. Girls accounted for 53% of the sample. The mean age at finishing TT was 31.6±9.3 months and similar in both genders (p=0.77). TT occurred before school entry in 45.7% of the children and medical advice for TT was sought only by 4.8% of the parents. No association was observed of age at completing TT and presence of lower urinary tract symptoms (LUTS) (p=0.57) and/or constipation (p=0.98). In the univariate analysis, prematurity (OR=2.7 [95% CI 2.3-3.1], p <0.0001) and mothers who work outside their household (OR=1.8 [95% CI 1.4-2.3], p <0.0001) were associated to delayed TT. Conclusion: Children completed TT at a mean of 2 years and 7 months of age. The age of completing TT was not related to LUTS and/or constipation. Premature children and those whose mothers work outside the home finish TT later.

Personal and familial factors associated with toilet training.

PURPOSE: Toilet training (TT) is an important marker in a child's physical and psychosocial development. The present study aimed to evaluate aspects associated to delayed TT. MATERIAL AND METHODS: We interviewed 372 parents of children who had completed TT up to 48 months before the interview. The questionnaires were applied at school exits when parents went to pick their children up and at public parks. Questions included demographics, aspects related to TT, dysfunction voiding symptom score and evaluation of constipation. RESULTS: The interviews were performed at a mean of 15.3±10.4 (0 to 47) months after the end of TT. Girls accounted for 53% of the sample. The mean age at finishing TT was 31.6±9.3 months and similar in both genders (p=0.77). TT occurred before school entry in 45.7% of the children and medical advice for TT was sought only by 4.8% of the parents. No association was observed of age at completing TT and presence of lower urinary tract symptoms (LUTS) (p=0.57) and/or constipation (p=0.98). In the univariate analysis, prematurity (OR=2.7 [95% CI 2.3-3.1], p <0.0001) and mothers who work outside their household (OR=1.8 [95% CI 1.4-2.3], p <0.0001) were associated to delayed TT. CONCLUSION: Children completed TT at a mean of 2 years and 7 months of age. The age of completing TT was not related to LUTS and/or constipation. Premature children and those whose mothers work outside the home finish TT later.

Management of patients diagnosed or suspected with Covid-19 in cardiorespiratory arrest: a scoping review / Manejo de pacientes diagnósticos o sospechosos de Covid-19 en la parada cardiorrespiratoria: revisión de alcance / Manejo de pacientes diagnosticados ou com suspeita de Covid-19 em parada cardiorrespiratória: scoping review

ABSTRACT Objective: to map the production of knowledge about the recommendations that can be applied in managing patients diagnosed or suspected with COVID-19 in cardiorespiratory arrest. Method: a scoping review, according to the Joanna Briggs Institute (2020) guidelines. Search was performed in ten data sources, and two electronic search engines were used; from 2001 to 2020. Results: of the 547 studies found, 14 met the inclusion and exclusion criteria. Most studies were published in 2020 (35.7%), and most studies were conducted in Canada (21.4%). It is observed the use of a systematized care to identify the possible means of care that should be provided to patients who suffer a cardiorespiratory arrest in hospitals, such as the monitoring of suspected cases by assessing the victim's breathing and pulse and identifying arrhythmias and shockable rhythms quickly. Personal protective equipment must be used to protect against droplets and aerosols and respiratory etiquette. Conclusion: managing patients in cardiorespiratory arrest suspected or diagnosis with COVID-19 requiring cardiopulmonary resuscitation should be performed in isolation areas and with the use of adequate protective equipment. There are gaps in scientific productions so that they address more clearly and instructively management when performing cardiopulmonary resuscitation in patients suspected or diagnosed with COVID-19.

RESUMEN Objetivo: mapear la producción de conocimiento sobre las recomendaciones que se pueden aplicar en el manejo de un paciente diagnosticado o sospechoso de tener COVID-19 en paro cardíaco. Método: se trata de una revisión de alcance, de acuerdo con las directrices del Instituto Joanna Briggs (2020). La búsqueda se realizó en diez fuentes de datos y se utilizaron dos buscadores electrónicos; período de tiempo de 2001 a 2020. Resultados: de las 547 publicaciones encontradas, 14 cumplieron los criterios de inclusión y exclusión. La mayoría de los estudios se publicaron en el año 2020 (35,7%) y la mayoría de los estudios se realizaron en Canadá (21,4%). Se observa el uso de una atención sistemática para identificar las posibles vías de asistencia que se deben brindar a los pacientes que sufren una parada cardiorrespiratoria en el ámbito hospitalario, como monitorear los casos sospechosos de la enfermedad mediante la evaluación de la respiración y el pulso de la víctima e identificar rápidamente arritmias y ritmos desfibrilables. Cabe mencionar el uso de equipo de protección personal para protegerse de gotitas y aerosoles y conductas respiratorias específicas para estos casos. Conclusión: el manejo de pacientes en parada cardiorrespiratoria con COVID-19 sospechado o diagnosticado que requieran reanimación cardiopulmonar debe realizarse en áreas de aislamiento y con el uso de equipo de protección adecuado. Se observó que existen lagunas en las producciones científicas, por lo que se abordan de forma más clara e instructiva sobre el manejo al realizar reanimación cardiopulmonar en pacientes con sospecha o diagnóstico de COVID-19.

RESUMO Objetivo: mapear a produção de conhecimento sobre as recomendações que podem ser aplicadas no manejo de paciente diagnosticado ou com suspeita de COVID-19 em Parada Cardiorrespiratória. Método: trata-se de uma revisão de escopo, de acordo com as orientações do Instituto Joanna Briggs (2020). Realizada busca em dez fontes de dados, e utilizados dois buscadores eletrônicos; recorte temporal de 2001 a 2020. Resultados: das 547 publicações encontradas, 14 atenderam aos critérios de inclusão e exclusão. A maior parte dos estudos foi publicada no ano de 2020 (35,7%), e a maioria dos estudos foi realizada no Canadá (21,4%). Observa-se o uso de um cuidado sistematizado para identificação das possíveis vias de assistência que deverão ser prestadas a pacientes que sofrem uma parada cardiorrespiratória no ambiente hospitalar, como o monitoramento de casos suspeitos da doença através da avaliação da respiração e pulso da vítima e identificação das arritmias e de ritmos chocáveis de forma rápida. Vale salientar o uso de equipamentos de proteção individual para proteção contra gotículas e aerossóis e condutas respiratórias específicas para estes casos. Conclusão: o manejo do paciente em parada cardiorrespiratória com suspeita ou diagnóstico de COVID-19 que necessita de reanimação cardiopulmonar deve ser realizado em áreas de isolamento e com a utilização de equipamentos de proteção adequados. Foi visto que existem lacunas nas produções científicas, para que abordem de maneira mais clara e instrutiva sobre o manejo ao realizar ressuscitação cardiopulmonar em pacientes com suspeita ou diagnóstico de COVID-19.

Effects of a Mobile-App-Based Self-Management Support Program For Elderly Hemodialysis Patients.

OBJECTIVES: To identify the effects of a mobile-app-based self-management program for elderly hemodialysis patients on their sick-role behavior, basic psychological needs, and self-efficacy. METHODS: A nonequivalent control group with a non-synchronized design was utilized, and 60 participants (30 in each of the experimental and control groups) were recruited from Chungnam National University Hospital from March to August 2018. The program consisted of continuous training on how to use the mobile-app, self-checking via the app, message transfer through Electronic Medical Records, and feedback. The control group received the usual care. Data were analyzed using the χ2-test, the t-test, the repeated-measures ANOVA, and the McNemar test. A formalized messaging program was developed, and the app was developed with consideration of the specific physical and cognitive limitations of the elderly. RESULTS: Comparisons were conducted between the experimental (n = 28) and control (n = 28) groups. Statistically significant increases in sick-role behavior, basic psychological needs, and self-efficacy were found in the experimental group (p < 0.001). Physiological parameters were maintained within the normal ranges in the experimental group, and the number of non-adherent patients decreased, although the change was not statistically significant. CONCLUSIONS: The mobile-app-based self-management program developed in this study increased the sick-role behavior, basic psychological needs, and self-efficacy of elderly hemodialysis patients, while physiological parameters were maintained within the normal range. Future studies are needed to develop management systems for high-risk hemodialysis patients and family-sharing apps to manage non-adherent patients.

Percepción del usuario sobre la relación médico-paciente en un servicio público / Perception of user on the medical-patient relationship in a public service

Introducción: Se presenta un análisis sobre la relación que establece el médico con su paciente, en el servicio de salud pública más importante de la provincia de Chimborazo. Es posible evidenciar claramente el trato inadecuado del profesional al paciente, determinar si repercute de manera negativa sobre la salud de estos, y el efecto sobre la cobertura del profesional y por ende de la unidad de salud a la que se pertenece, son las interrogantes de investigación. Metodología: Es un estudio de campo, descriptivo, de corte transversal, con una muestra de 1200 personas que acuden al servicio de consulta externa en el Hospital General Docente de Riobamba. Esta presentación se deriva de un estudio con más de 2600 individuos involucrados en tres servicios de salud privados y públicos. Se trabaja sobre variables específicas como respeto, sensibilidad, capacidad profesional, explicación del procedimiento, consejería del médico, y conformidad de la atención por parte del paciente. Además, se recolectan datos generales del paciente y del médico como sexo, edad y número de consultas que determinan el tipo de relación entre el profesional y la población. Resultados: De manera general existe un alto grado de satisfacción de pacientes atendidos. No obstante, existe evidencia sobre la falta de comprensión del paciente, poca sensibilidad del profesional y la inadecuada explicación sobre procedimientos, lo cual lleva a una atención insuficiente. Conclusión: La relación médico paciente es un conjunto de actividades que van, desde contacto visual, empatía, respeto y conocimiento adecuado hasta la manera de agendar una nueva cita.

Introduction: An analysis is presented on the relationship established by the doctor with his patient, in the most important public health service in the province of Chimborazo. It is possible to clearly demonstrate the inadequate treatment of the professional to the patient, determine if it negatively affects their health, and the effect on the coverage of the professional and therefore of the health unit to which it belongs, are the questions of investigation. Methodology: This is a cross-sectional, descriptive field study with a sample of 1200 people who attend the outpatient service in the General Teaching Hospital of Riobamba. This presentation is derived from a study with more than 2,600 individuals involved in three private and public health services. We work on specific variables such as respect, sensitivity, professional capacity, explanation of the procedure, doctor's advice, and compliance of the patient's care. In addition, general data of the patient and the doctor are collected as sex, age and number of consultations that determine the type of relationship between the professional and the population. Results: In general there is a high degree of satisfaction of patients attended. However, there is evidence of lack of understanding of the patient, poor sensitivity of the professional and inadequate explanation of procedures, which leads to insufficient attention. Conclusion: The patient doctor relationship is a set of activities ranging from eye contact, empathy, respect and adequate knowledge to the way of scheduling a new appointment.

Rheumatoid arthritis: profile of patients and burden of caregivers / Artrite reumatoide: perfil de pacientes e sobrecarga de cuidadores

Abstract Objective: to describe the profile of patients with Rheumatoid Arthritis (RA) and their caregivers receiving care at the Rheumatology Outpatient Clinic of a teaching hospital, and evaluate the burden of the caregivers. Method: a cross-sectional study was performed with 41 patients with RA and their caregivers using a questionnaire to identify sociodemographic variables; the Burden Interview Scale and the Stanford Health Assessment Questionnaire. Descriptive analyzes and comparison between clinical-demographic variables and the functional status of patients were performed and the correlation between sociodemographic variables and levels of burden of caregivers was tested. Results: there was a prevalence of female patients (87.8%); a mean age of 64.4 years (±12.9); a mean time for the diagnosis of RA of 13.5 years (±8.5), a prevalence of moderate disability (39.0%); lower disability in the Hygiene domain (1.6; ±0.5) and greater disability in the Other Activities of Daily Life (2.1; ±0.6), Reach (2.0; ±0.7) and Grip (2.0; ±0.7) domains. The caregivers were women (73.2%); aged between 17 and 81 years (mean: 46.8; ±15.1); with a high school education (41.4%). The degree of kinship was 56.2% offspring and 36.6% spouses. Eighteen (44.0%) caregivers suffered burden, nine (22.0%) of whom had mild burden and nine (22.0%) of whom suffered intense burden. There was a higher incidence of intense burden among spouses (12.2%) and mild burden among children (12.2%). Conclusion: the low occurrence of burden among caregivers may be related to the profile of the patients, who presented good levels of independence for self-care. The profile of caregivers and the prevalence of overburdened spouses and offspring shows the need and importance of the implementation of caregiver training by health service professionals to improve care for RA patients. AU

Resumo Objetivo: Descrever o perfil de pacientes com Artrite Reumatoide (AR) e seus cuidadores, atendidos no Ambulatório de Reumatologia de um hospital de ensino, e avaliar sobrecarga dos cuidadores. Método: Estudo transversal com 41 pacientes e seus cuidadores, utilizando-se questionário de identificação com variáveis clínico-demográficas; Escala de Sobrecarga do Cuidador de Zarith e Health Assessment Questionnaire. Realizaram-se análises descritivas, comparação entre variáveis clínico-demográficas e estado funcional dos pacientes, correlação entre variáveis sociodemográficas e níveis de sobrecarga dos cuidadores. Resultados: Prevalência de pacientes do sexo feminino (87,8%); média de idade de 64,4 anos (±12,9); tempo médio de diagnóstico da AR de 13,5 anos (±8,5); predomínio de deficiência moderada (39,0%); menor deficiência no domínio Higiene (1,6;±0,5) e maior deficiência nos domínios Outras atividades do dia a dia (2,1;±0,6), Alcance (2,0;±0,7) e Pegada (2,0;±0,7). Os cuidadores eram mulheres (73,2%); faixa etária entre 17 e 81 anos (média: 46,8; ±15,1); ensino médio completo (41,4%); grau de parentesco: 56,2% filhos e 36,6% cônjuges. Dezoito (44,0%) cuidadores apresentaram sobrecarga, sendo 9 (22,0%) com sobrecarga ligeira e 9 (22,0%) com sobrecarga intensa. Maior incidência de sobrecarga intensa entre cônjuges (12,2%) e sobrecarga ligeira entre filhos (12,2%). Conclusão: A baixa ocorrência de sobrecarga entre cuidadores pode estar relacionada ao perfil dos doentes, que apresentaram bons níveis de independência para o autocuidado. O perfil dos cuidadores e prevalência de cônjuges e filhos com sobrecarga evidencia a necessidade e a importância de os profissionais do serviço implementarem ações de capacitação dos cuidadores, para melhorar a assistência aos pacientes com AR. AU

Risk factors of new-onset diabetes among senior public officials in Chengdu / 中华全科医师杂志

The consecutive data of 822 senior public officials in Chengdu undergoing health checkup from 2011 to 2016 were retrospectively reviewed.Among them,56 new cases of diabetes was diagnosed with a cumulative incidence of 6.81％.Fifty six age-and sex-matched healthy subjects served as controls,the risk factors of new-onset diabetes were analyzed with multivariate logistic regression.The results showed that BMI (OR =1.82,95％ CI:1.27-2.59,P =0.00) and fasting plasma glucose (OR =13.63,95％ CI:2.71-68.43,P =0.00) were independent risk factors of new-onset diabetes in senior public officials.

Projeto Terapêutico Singular: reflexões para a enfermagem em saúde coletiva / Personalized Therapy Plan: reflections for nursing in public health / Proyecto Terapéutico Singular: reflexiones para la enfermería en salud colectiva

Objetivo: compreender o Projeto Terapêutico Singular (PTS) a partir dos conceitos de sujeito da assistência à saúde, prática profissional, profissional de saúde e processo saúde-doença e discutí-los conforme os achados da literatura científica nacional. Método: pesquisa documental, descritiva, qualitativa, realizada em 2015. Foi direcionada por documentos norteadores do Ministério da Saúde, como base reflexiva para a discussão de bibliografias brasileiras. Desenvolveu-se análise de conteúdo orientada pela perspectiva de sistematização temático-categorial. Resultados: foram identificados dois agrupamentos temáticos, destacando que a compreensão do PTS, pela discussão dos seus elementos constituintes, corrobora a articulação com a enfermagem e sua aplicabilidade no cotidiano da atenção à saúde. Conclusão: o PTS representa uma importante contribuição para a reflexão das práticas de cuidado, pois favorece a articulação entre os diversos saberes existentes e a construção de possíveis espaços de diálogo com as necessidades de saúde dos indivíduos e seus projetos de emancipação.

Objective: to understand the Personalized Therapy Plan (Projeto Terapêutico Singular, PTS) by applying the concepts subject of health care, professional practice, health personnel and health-disease process, and discuss them in view of the findings of Brazilian scientific literature. Method: conducted in 2015, this descriptive, qualitative documentary study was informed by Ministry of Health guideline documents as a basis for reflective discussion of Brazilian bibliographies. Content analysis was applied on the principle of thematic category systemization. Results: two thematic groupings were identified, which underscored that discussing the constituents of PTS leads to an understanding that corroborates its interrelation with nursing and its applicability to healthcare routines. Conclusion: PTS makes an important contribution to thinking about care practices, because it favors coordination among the various existing bodies of expertise, and construction of potential spaces for dialogue with individuals' health needs and plans for empowerment.

Objetivo: comprender el Proyecto Singular Terapéutico Singular (PTS) a partir de los conceptos de sujeto de la asistencia a la salud, la práctica profesional, el profesional de salud y el proceso salud-enfermedad y discutirlos según los hallazgos de la literatura científica nacional. Método: investigación documental, descriptiva, cualitativa, realizada en 2015. Fue guiada siguiéndose los documentos del Ministerio de Salud, como base de reflexión para la discusión de la bibliografía brasileña. Se ha desarrollado el análisis de contenido guiado por la perspectiva de la sistematización temático-regional. Resultados: se han identificado dos agrupaciones temáticas, destacando que la comprensión del PTS, por la discusión de sus elementos constituyentes, corrobora la articulación de la enfermería y su aplicabilidad en la rutina de atención a la salud. Conclusión: PTS representa una importante contribución a la reflexión de las prácticas de cuidado ya que favorece la articulación entre los diversos conocimientos y la construcción de posibles espacios de diálogo con las necesidades de salud de los individuos y sus proyectos de emancipación.

Health vulnerabilities: the diagnosis of freshmen from a Portuguese University / Vulnerabilidades en salud: el diagnóstico de estudiantes de primer año de una Universidad Portuguesa / Vulnerabilidades em saúde: o diagnóstico dos caloiros de uma Universidade Portuguesa

The start of university is presented as a crucial stage in the life of the student. If, on the one hand, it is a period of increased autonomy and freedom, on the other, it is a period that also increases the sense of responsibility and self discipline. In this study, based on a quantitative approach, we identified the main risk situations experienced by freshmen at the University of Evora, by applying a questionnaire developed for this purpose and the Beck inventory. Key findings are highlighted, such as the consumption of harmful substances (tobacco, alcohol and illicit drugs), whose values exceed the average population. The consumption of alcoholic beverages begins early and is continuous and excessive. Also, the presence of symptoms compatible with dysphoria and depression is noted in about 9% of students. Self-medication practices were found in 58.7% of the freshmen. Our findings reveal the need for preventive intervention by health professionals, due to these young people's great exposure to health risks.

La concurrencia de transición se presenta como una etapa crucial en la vida del estudiante que entra en la universidad. Si, por un lado, se trata de un período de mayor autonomía y libertad, por el otro, es un período que también aumenta el sentido de responsabilidad y autodisciplina. En este estudio, basado en un enfoque cuantitativo, se identificaron las situaciones de riesgo principales experimentados por estudiantes de primer año en la Universidad de Évora, mediante la aplicación de un cuestionario elaborado para tal efecto y el inventario de Beck. De relieve los principales hallazgos como el consumo de sustancias nocivas (tabaco, alcohol y drogas ilícitas), cuyos valores superan la media de la población. El consumo de bebidas alcohólicas comienza temprano y es un consumo continuo y excesivo. Tenga en cuenta también la presencia de síntomas compatibles con disforia y depresión en alrededor del 9% de los estudiantes. También los valores obtenidos con la práctica de la automedicación muestra que si existe una situación por encima de los valores encontrados en otros estudios. Nuestros resultados revelan la necesidad de intervención preventiva de los profesionales de la salud.

O ingresso na universidade apresenta-se como uma fase crucial na vida do estudante, fase em que há aumento da autonomia e liberdade, do sentido de responsabilidade e a da autodisciplina, mas propicia mais acesso aos riscos à saúde. Como o objetivo de identificar as situações de risco experenciadas pelos caloiros de Universidade de Évora, desenvolveu-se um estudo quantitativo cujos dados foram coletados mediante a aplicação de um questionário e do inventário de Beck. Destaca-se o consumo de substâncias nocivas (tabaco, álcool e drogas ilícitas), cujos valores superam a média da população portuguesa e a presença de sintomatologia compatível com disforia e depressão em cerca de 9% dos estudantes. Verificou-se a prática da auto-medicação em 58,7% dos ingressantes. Os achados deste estudo revelam a necessidade de uma intervenção preventiva por parte dos profissionais de saúde devido a alta exposição aos riscos de saúde destes jovens.

Study of the individualized health management of senile mental disorders / 中华老年医学杂志

Objective To evaluate the effect of the individualized health management on senile mental disorders.Methods 421 patients with senile mental disorders were randomized into two groups:the intervention group (n =213) received routine antipsychotic drugs treatment,health education and individual health management,and the control group(n=208) received only population health education and routine drug antipsychiatric treatment.Results The Brief Psychiatric Rating Scale (BPRS) scores in two group were significantly higher after treatment than before treatment (all P＜0.01).The BPRS score in each period after treatment were significantly higher in intervention group than in control group (all P＜0.01).The mini mental state examination (MMSE) score in two treatment groups were significantly higher after treatment than before treatment (all P＜0.01).The MMSE score in each period after treatment were significantly higher in intervention group than in control group (all P＜0.05).Conclusions The individualized health management in senile mental disorders is not only feasible,but also effective.

Telecare system for cardiac surgery patients: implementation and effectiveness.

OBJECTIVES: To manage a patient's blood pressure and recovery, and to reduce unnecessary hospital visits after heart surgery, we developed and established a telecare service. METHODS: We established and test-operated the system that enabled biometric data to be measured and monitored at home, and directed connections to the video consultation with monitoring personnel and medical staff when abnormal symptoms were detected. RESULTS: As a result of using the telecare service with patients discharged from the hospital after undergoing heart surgery, the patients were mostly satisfied with the service and use of the equipment, and some patients wanted to actually receive the service continuously along with a device which could be more easily used. CONCLUSIONS: Telecare services are greatly needed for patients discharged after heart surgery for a certain period of time. A model should be developed which provides devices necessary for each disease in package form and customizes the content and services in one package.

Telecare System for Cardiac Surgery Patients: Implementation and Effectiveness / 대한의료정보학회지

OBJECTIVES: To manage a patient's blood pressure and recovery, and to reduce unnecessary hospital visits after heart surgery, we developed and established a telecare service. METHODS: We established and test-operated the system that enabled biometric data to be measured and monitored at home, and directed connections to the video consultation with monitoring personnel and medical staff when abnormal symptoms were detected. RESULTS: As a result of using the telecare service with patients discharged from the hospital after undergoing heart surgery, the patients were mostly satisfied with the service and use of the equipment, and some patients wanted to actually receive the service continuously along with a device which could be more easily used. CONCLUSIONS: Telecare services are greatly needed for patients discharged after heart surgery for a certain period of time. A model should be developed which provides devices necessary for each disease in package form and customizes the content and services in one package.