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2.
BMJ ; 368: l6669, 2020 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-31915124

RESUMEN

OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366). MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer. RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50. CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Estilo de Vida Saludable/fisiología , Esperanza de Vida , Neoplasias , Conducta de Reducción del Riesgo , Adulto , Consumo de Bebidas Alcohólicas , Índice de Masa Corporal , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/psicología , Diabetes Mellitus Tipo 2/prevención & control , Diabetes Mellitus Tipo 2/psicología , Ejercicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/prevención & control , Neoplasias/psicología , Investigación en Enfermería , Estudios Prospectivos , Fumar
3.
Sports Health ; 12(1): 51-57, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31660785

RESUMEN

BACKGROUND: Athletic training rooms have a high prevalence of bacteria, including multidrug-resistant organisms, increasing the risk for both local and systematic infections in athletes. There are limited data outlining formal protocols or standardized programs to reduce bacterial and viral burden in training rooms as a means of decreasing infection rate at the collegiate and high school levels. HYPOTHESIS: Adaptation of a hygiene protocol would lead to a reduction in bacterial and viral pathogen counts in athletic training rooms. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Two high school and 2 collegiate athletic training rooms were studied over the course of the 2017-2018 academic year. A 3-phase protocol, including introduction of disinfectant products followed by student-athlete and athletic trainer education, was implemented at the 4 schools. Multiple surfaces in the athletic training rooms were swabbed at 4 time points throughout the investigation. Bacterial and viral burden from swabs were analyzed for overall bacterial aerobic plate count (APC), bacterial adenosine triphosphate activity, influenza viral load, and multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). RESULTS: Overall bacterial load, as measured by APC, was reduced by 94.7% (95% CI, 72.6-99.0; P = 0.003) over the course of the investigation after protocol implementation. MRSA and VRE were found on 24% of surfaces prior to intervention and were reduced to 0% by the end of the study. Influenza was initially detected on 25% of surfaces, with no detection after intervention. No cases of athletic training room-acquired infections were reported during the study period. CONCLUSION: A uniform infection control protocol was effective in reducing bacterial and viral burden, including multidrug-resistant organisms, when implemented in the athletic training rooms of 2 high schools and 2 colleges. CLINICAL RELEVANCE: A standardized infection control protocol can be utilized in athletic training rooms to reduce bacterial and viral burden.


Asunto(s)
Infecciones Comunitarias Adquiridas/prevención & control , Reservorios de Enfermedades/microbiología , Control de Infecciones/métodos , Instituciones Académicas , Infecciones Comunitarias Adquiridas/transmisión , Desinfectantes/administración & dosificación , Infecciones por Bacterias Grampositivas/prevención & control , Infecciones por Bacterias Grampositivas/transmisión , Desinfección de las Manos , Educación en Salud , Humanos , Gripe Humana/prevención & control , Gripe Humana/transmisión , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Orthomyxoviridae/aislamiento & purificación , Conducta de Reducción del Riesgo , Infecciones Estafilocócicas/prevención & control , Infecciones Estafilocócicas/transmisión , Enterococos Resistentes a la Vancomicina/aislamiento & purificación
4.
Br J Anaesth ; 124(1): 63-72, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31607388

RESUMEN

BACKGROUND: The prospective observational European multicentre cohort study (POPULAR) of postoperative pulmonary complications (NCT01865513) did not demonstrate that adherence to the recommended train-of-four ratio (TOFR) of 0.9 before extubation was associated with better pulmonary outcomes from the first postoperative day up to hospital discharge. We re-analysed the POPULAR data as to whether there existed a better threshold for TOFR recovery before extubation to reduce postoperative pulmonary complications in patients who had quantitative neuromuscular monitoring (87% acceleromyography). METHODS: To identify the optimal TOFR, the complete case cohort of patients with quantitative neuromuscular monitoring (n=3150) was split into several pairs of sub-cohorts related to TOFR values from 0.86 to 0.96; values of 0.97 and higher could not be used as the sub-cohorts were too small. The optimal TOFR was considered to have the lowest P-value from multivariate logistic regression calculated for each of the TOFR values. Data are presented as adjusted absolute risk reduction or median difference with 95% confidence interval. RESULTS: Extubating patients with TOFR >0.95 rather than >0.9 reduced the adjusted risk of postoperative pulmonary complications by 3.5% (0.7-6.0%) from that reported in POPULAR (11.3%). Increasing the recommended TOFR from 0.9 to 0.95 reduced the adjusted risk by 4.9% (1.2-8.5%). Sub-cohorts resulting from 1:1 propensity score matching revealed that sugammadex had been given in higher doses by 0.30 (0.13-0.48) mg kg-1 in the sub-cohort with TOFR > 0.95. CONCLUSIONS: A post hoc analysis of patients receiving quantitative monitoring of neuromuscular function suggests that postoperative pulmonary complications are reduced for TOFR > 0.95 before tracheal extubation compared with TOFR > 0.9. TRIAL REGISTRATION NUMBER: NCT01865513.


Asunto(s)
Extubación Traqueal/métodos , Monitorización Neurofisiológica Intraoperatoria/métodos , Monitoreo Neuromuscular/métodos , Complicaciones Posoperatorias/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Anestesia , Estudios de Cohortes , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Neuromuscular/métodos , Bloqueantes Neuromusculares , Complicaciones Posoperatorias/epidemiología , Puntaje de Propensión , Estudios Prospectivos , Conducta de Reducción del Riesgo , Sugammadex , Adulto Joven
5.
Angiology ; 71(2): 112-121, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31185723

RESUMEN

Atherosclerosis is a multistep process that progresses over a long period of time and displays a broad range of severity. In its final form, it manifests as a lesion of the intimal layer of the arterial wall. There is strong evidence supporting that oxidative stress contributes to coronary heart disease morbidity and mortality and antioxidant high-density lipoprotein (HDL) could have a beneficial role in the prevention and prognosis of the disease. Indeed, certain subspecies of HDL may act as natural antioxidants preventing oxidation of lipids on low-density lipoprotein (LDL) and biological membranes. The antioxidant function may be attributed to inhibition of synthesis or neutralization of free radicals and reactive oxygen species by HDL lipids and associated enzymes or transfer of oxidation prone lipids from LDL and biological membranes to HDL for catabolism. A limited number of clinical trials suggest that the increased antioxidant potential of HDL correlates with decreased risk for atherosclerosis. Some nutritional interventions to increase HDL antioxidant activity have been proposed with limited success so far. The limitations in measuring and understanding HDL antioxidant function in vivo are also discussed.


Asunto(s)
Antioxidantes/fisiología , Aterosclerosis/metabolismo , Lipoproteínas HDL/fisiología , Aterosclerosis/prevención & control , Humanos , Conducta de Reducción del Riesgo
6.
Rev Saude Publica ; 53: 101, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31800912

RESUMEN

OBJECTIVE: To evaluate the effectiveness of interventions aimed at the prevention of risk factors and incidence of type 2 diabetes in the workers population. METHODS: Systematic review of interventions aimed at adult workers at risk of type 2 diabetes published in Medline, Embase, Web of Science, Central Cochrane Registry of Controlled Trials, and Lilacs. Randomized trials, quasi-experimental research and cohort studies were selected; in English, Spanish and Portuguese; published from 2000 to 2017. Intervention effectiveness was evaluated concerning the incidence of type 2 diabetes and a significant reduction in body weight, or another anthropometric or metabolic parameter. RESULTS: 3,024 articles were generated, of which 2,825 that did not answer the research question were eliminated, as well as 130 that did not evaluate original interventions, 57 carried out outside the workplace and two reviews; so that 10 selected items remained. Interventions based on structured programs previously evaluated and integrated into the workplace had a favorable impact on the reduction of body weight and other risk factors. CONCLUSIONS: The effectiveness of lifestyle interventions for the prevention of type 2 diabetes should be based on structured programs with proven effectiveness and adapted to the workplace, with employer participation in the provision of schedules and work environments.


Asunto(s)
Diabetes Mellitus Tipo 2/etiología , Diabetes Mellitus Tipo 2/prevención & control , Salud Laboral , Conducta de Reducción del Riesgo , Lugar de Trabajo , Peso Corporal , Femenino , Humanos , Masculino , Factores de Riesgo , Conducta Sedentaria
7.
Vasc Health Risk Manag ; 15: 551-558, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31853180

RESUMEN

Introduction: As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective: The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results: A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion: In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Conocimientos, Actitudes y Práctica en Salud , Estilo de Vida Saludable , Hospitales Universitarios , Hipertensión/terapia , Servicio Ambulatorio en Hospital , Conducta de Reducción del Riesgo , Adulto , Anciano , Estudios Transversales , Escolaridad , Etiopía , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Ocupaciones , Factores de Riesgo , Factores Sexuales
9.
Environ Sci Technol ; 53(23): 13657-13665, 2019 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-31684725

RESUMEN

Increasing numbers of novel pesticides have been applied in agriculture. However, traditional evaluation of pesticides does not distinguish between their enantiomers, which may lead to inaccurate results. In this study, systematic research on the chiral insecticide fluxametamide was conducted at the enantiomeric level. The methods for enantioseparation and semipreparative separation of fluxametamide enantiomers were developed. The optical rotation and absolute configuration of two enantiomers were determined, and their stability was verified in solvents and soils. Enantioselective bioactivities against four target pests (Plutella xylostella, Spodoptera exigua, Aphis gossypii, and Tetranychus cinnabarinus) were tested. Acute toxicities of fluxametamide enantiomers toward honeybees were also evaluated. S-(+)-Isomer exhibited 52.1-304.4 times and 2.5-3.7 times higher bioactivity than R-(-)-isomer and rac-fluxametamide, respectively. Meanwhile, rac-fluxametamide was more toxic than S/R-isomer, and S-(+)-isomer showed >30-fold higher acute toxicity than R-(-)-isomer. Molecular docking studies were performed with γ-aminobutyric acid receptor (GABAR) to monitor the mechanism of stereoselective bioactivity. The better Grid score of S-(+)-fluxametamide (-60.12 kcal/mol) than R-(-)-enantiomer (-56.59 kcal/mol) indicated higher bioactivity of S-(+)-isomer than of R-(-)-isomer. The dissipation of fluxametamide in cabbage, Chinese cabbage, and soil was nonenantioselective under field conditions. Development of S-(+)-fluxametamide could maintain the high-efficacy and low-risk properties, which should attract attention of producers, applicators, and managers of pesticides.


Asunto(s)
Insecticidas , Plaguicidas , Animales , Simulación del Acoplamiento Molecular , Conducta de Reducción del Riesgo , Estereoisomerismo
10.
Prog Cardiovasc Dis ; 62(5): 431-435, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31711788

RESUMEN

In the past five decades, cardiorespiratory fitness (CRF) has become fairly established as an important risk factor or marker for cardiovascular disease (CVD), as well as CVD - and all-cause mortality. Substantial evidence supports a strong inverse association between baseline levels of CRF and the risk of developing CVD risk factors, including dyslipidemia. Additionally, accumulating evidence also supports that maintaining or improving a certain level of CRF over time leads to a lower rate of developing CVD risk factors, such as dyslipidemia, and also improves survival. Recent evidence also supports the role of resistance exercise and muscular strength to reduce the development of metabolic syndrome and hypercholesterolemia and potentially reduce development of diabetes as well, in addition to improving survival. Therefore, great efforts are needed to increase both CRF and muscle strength with aerobic exercise and resistance exercise in the primary and secondary prevention of CVD.


Asunto(s)
Capacidad Cardiovascular , Enfermedades Cardiovasculares/prevención & control , Dislipidemias/prevención & control , Estilo de Vida Saludable , Lípidos/sangre , Conducta de Reducción del Riesgo , Biomarcadores/sangre , Enfermedades Cardiovasculares/mortalidad , Dislipidemias/sangre , Dislipidemias/mortalidad , Estado de Salud , Humanos , Fuerza Muscular , Pronóstico , Factores Protectores , Entrenamiento de Resistencia , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
12.
Z Gastroenterol ; 57(11): 1309-1320, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31739377

RESUMEN

INTRODUCTION: Lynch syndrome (LS) is the most common hereditary colorectal cancer syndrome and accounts for ~3 % of all CRCs. This autosomal dominant disorder is caused by germline mutations in DNA mismatch repair genes (MLH1, MSH2, MSH6, PMS2, and EPCAM). One in 300 individuals of the general population are considered to be mutation carriers (300 000 individuals/Germany). Mutation carriers are at a high CRC risk of 15-46 % till the age of 75 years. LS also includes a variety of extracolonic malignancies such as endometrial, small bowel, gastric, urothelial, and other cancers. METHODS: The German Consortium for Familial Intestinal Cancer consists of 14 university centers in Germany. The aim of the consortium is to develop and evaluate surveillance programs and to further translate the results in clinical care. We have revisited and updated the clinical management guidelines for LS patients in Germany. RESULTS: A surveillance colonoscopy should be performed every 12-24 months starting at the age of 25 years. At diagnosis of first colorectal cancer, an oncological resection is advised, an extended resection (colectomy with ileorectal anastomosis) has to be discussed with the patient. The lifetime risk for gastric cancer is 0.2-13 %. Gastric cancers detected during surveillance have a lower tumor stage compared to symptom-driven detection. The lifetime risk for small bowel cancer is 4-8 %. About half of small bowel cancer is located in the duodenum and occurs before the age of 35 years in 10 % of all cases. Accordingly, patients are advised to undergo an esophagogastroduodenoscopy every 12-36 months starting by the age of 25 years. CONCLUSION: LS colonic and extracolonic clinical management, surveillance and therapy are complex and several aspects remain unclear. In the future, surveillance and clinical management need to be more tailored to gene and gender. Future prospective trials are needed.


Asunto(s)
Neoplasias Colorrectales Hereditarias sin Poliposis/patología , Reparación de la Incompatibilidad de ADN , Endoscopía del Sistema Digestivo/métodos , Guías de Práctica Clínica como Asunto , Conducta de Reducción del Riesgo , Neoplasias Colorrectales , Neoplasias Colorrectales Hereditarias sin Poliposis/genética , Alemania , Humanos , Vigilancia de la Población , Factores de Tiempo
13.
Lima; Perú. Ministerio de Salud; 20191100. 56 p. tab, graf.
Monografía en Español | LILACS, LIPECS | ID: biblio-1025557

RESUMEN

El documento contiene un conjunto de previsiones y acciones que el estado adopta permanentemente para garantizar la estabilidad y el normal funcionamiento de la institucionalidad político jurídica.


Asunto(s)
Conductas Relacionadas con la Salud , Factores de Riesgo , Colaboración Intersectorial , Conducta de Reducción del Riesgo , Programación , Violencia
14.
Vasc Health Risk Manag ; 15: 291-299, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31616149

RESUMEN

Background: A significant discovery was recently made in which participation in physical activity and sedentary behavior, two contrasting lifestyles, was found to be related to the frequency of hyperuricemia diagnosis. The purpose of this study was to identify the association between sedentary behavior and physical activity levels in South Korean men and women diagnosed with hyperuricemia. Methods: This study included 161,064 healthy men and women participants who had obtained a complete health examination. Physical activity levels and sitting time were assessed by the validated International Physical Activity Questionnaire Short Form Korean version. The presence of hyperuricemia in the subjects was determined by measuring serum uric acid (SUA) concentration (SUA ≥6 mg/dL [male], SUA ≥7 mg/dL [female]). Logistic regression analysis, adjusting other confounding factors, was conducted to identify the association of sedentary behavior and physical activity levels with hyperuricemia (p<0.05). Results: Subjects who spent ≥10 hr/day in sedentary behavior were more likely to have hyperuricemia than those who spent <5 hour/day in sedentary behavior (OR=1.08, 95% CI=1.03-1.12). The subject group that more frequently participated in health enhanced physical activity (HEPA) had a lower hyperuricemia odds ratio than the subject group with lower physical activity participation rate (OR=0.90, 95% Ci=0.86-0.93). From the analysis of sex (male, female), age (young, middle, older), methods of measuring obesity (body mass index, waist circumference, body fat percentage), the association of sedentary behavior and physical activity levels with hyperuricemia was shown differently in different multivariable models. Conclusion: Participation in regular physical activity and reduced sedentary time is highly recommended in order to reduce the prevalence of hyperuricemia.


Asunto(s)
Ejercicio , Estilo de Vida Saludable , Hiperuricemia/prevención & control , Conducta Sedentaria , Ácido Úrico/sangre , Adolescente , Adulto , Anciano , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Hiperuricemia/sangre , Hiperuricemia/diagnóstico , Hiperuricemia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores Protectores , República de Corea/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Conducta de Reducción del Riesgo , Factores de Tiempo , Regulación hacia Arriba , Adulto Joven
15.
J Athl Train ; 54(10): 1089-1094, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31633413

RESUMEN

CONTEXT: Early sports sampling is associated with superior biomechanics in youth athletes; however, the effect of multisport participation on adult biomechanics is unknown. OBJECTIVE: To compare jump-landing biomechanics between adult recreational athletes who previously participated in 0, 1, or 2 or more select high school varsity sports (VSs; basketball, lacrosse, soccer, volleyball) that feature landing and cutting tasks. DESIGN: Descriptive laboratory study. SETTING: University community setting. PATIENTS OR OTHER PARTICIPANTS: Fifty adult recreational athletes (22 women, 28 men; age = 23.8 ± 2.5 years) with no high school VS experience or with high school VS experience in basketball, lacrosse, soccer, or volleyball. Athletes were grouped into those who participated in 0 (0VS, n = 11), 1 (1VS, n = 21), or 2 or more (2VSs, n = 18) of these sports at the high school level. MAIN OUTCOME MEASURE(S): The average Landing Error Scoring System (LESS) total score from 3 individual jump landings was determined. A 1-way analysis of covariance using sex as the covariate was calculated to compare groups. The Pearson R was used to test for the correlation between the LESS score and number of sports played, and a linear regression analysis was performed using the number of sports played to predict the LESS score. The α level was set a priori at .05. RESULTS: The 0VS athletes produced similar LESS scores as the 1VS athletes (5.89 ± 1.2 versus 5.38 ± 1.93 points, respectively, P = .463), whereas the 2VSs athletes demonstrated lower LESS scores (3.56 ± 1.97 points) than the 0VS (P = .002) and 1VS (P = .004) athletes. The LESS scores were moderately negatively correlated with the number of high school VSs played (R2 = -0.491, P < .001). The linear regression analysis was significant (F1,37 = 9.416, P = .004) with R2 = 0.203. For every additional VS played at the high school level, the LESS score decreased by 1.28 points. CONCLUSIONS: Landing Error Scoring System scores were lower in athletes who had a history of multisport high school varsity participation in basketball, lacrosse, soccer, or volleyball compared with those who had a history of single-sport or no participation in these sports at this level. Multisport high school varsity participation in these sports may result in improved neuromuscular performance and potentially reduced injury risks as adults.


Asunto(s)
Baloncesto/fisiología , Deportes de Raqueta/fisiología , Recreación/fisiología , Fútbol/fisiología , Voleibol/fisiología , Heridas y Traumatismos/prevención & control , Deportes Juveniles/fisiología , Adolescente , Adulto , Rendimiento Atlético , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Conducta de Reducción del Riesgo
17.
Anaesthesia ; 74(12): 1580-1588, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31637700

RESUMEN

Pre-operative intervention to improve general health and readiness for surgery is known as prehabilitation. Modification of risk factors such as physical inactivity, smoking, hazardous alcohol consumption and an unhealthy weight can reduce the risk of peri-operative morbidity and improve patient outcomes. Interventions may need to target multiple risk behaviours. The acceptability to patients is unclear. We explored motivation, confidence and priority for changing health behaviours before surgery for short-term peri-operative health benefits in comparison with long-term general health benefits. A total of 299 participants at three UK hospital Trusts completed a structured questionnaire. We analysed participant baseline characteristics and risk behaviour profiles using independent sample t-tests and odds ratios. Ratings of motivation, confidence and priority were analysed using paired sample t-tests. We identified a substantial prevalence of risk behaviours in this surgical population, and clustering of multiple behaviours in 42.1% of participants. Levels of motivation, confidence and priority for increasing physical activity, weight management and reducing alcohol consumption were higher for peri-operative vs. longer term benefits. There was no difference for smoking cessation, and participants reported lower confidence for achieving this compared with other behaviours. Participants were also more confident than motivated in reducing their alcohol consumption pre-operatively. Overall, confidence ratings were lower than motivation levels in both the short- and long-term. This study identifies both substantial patient desire to modify behaviours for peri-operative benefit and the need for structured pre-operative support. These results provide objective evidence in support of a 'pre-operative teachable moment', and of patients' desire to change behaviours for health benefits in the short term.


Asunto(s)
Actitud , Conductas Relacionadas con la Salud , Periodo Preoperatorio , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas , Terapia Conductista , Ejercicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Conducta de Reducción del Riesgo , Cese del Hábito de Fumar , Encuestas y Cuestionarios , Reino Unido , Pérdida de Peso , Adulto Joven
19.
BMC Public Health ; 19(1): 1314, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31638943

RESUMEN

BACKGROUND: Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. METHODS: Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. RESULTS: There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. CONCLUSION: A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.


Asunto(s)
Infecciones por VIH/epidemiología , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Anciano , China/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Conducta de Reducción del Riesgo , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
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