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2.
Medicine (Baltimore) ; 99(28): e20884, 2020 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-32664080

RESUMEN

The objective of this work is to verify the relationship between the self-perception of health and the self-concept of physical appearance in adolescents, in order to check their influence on the physical activity they perform with the aim of preventing chronic illnesses. To this end, an observational, cross-sectional descriptive study with analytical components was carried out. Opportunistic activity, in which young people, between the ages of 16 and 22, were recruited from 5 secondary schools of the municipality of San Cristóbal de La Laguna, on the island of Tenerife (Spain). Data were collected through the General Health Questionnaire, the Rosemberg Self-esteem Scale, and the physical exercise habits test physical activity questionnaire for adolescents-A, revealing the first 2 that most percentage of responses were grouped on the positive side. The physical exercise habits test physical activity questionnaire for adolescents-A described that the most commonly performed physical activity was walking (75%).


Asunto(s)
Enfermedad Crónica/prevención & control , Ejercicio Físico/psicología , Apariencia Física/fisiología , Adolescente , Actitud Frente a la Salud , Enfermedad Crónica/epidemiología , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Instituciones Académicas/estadística & datos numéricos , Autoimagen , España/epidemiología , Encuestas y Cuestionarios , Caminata/fisiología , Caminata/estadística & datos numéricos , Adulto Joven
3.
BMC Fam Pract ; 21(1): 147, 2020 07 22.
Artículo en Inglés | MEDLINE | ID: mdl-32698768

RESUMEN

BACKGROUND: Epidemic chronic diseases pose significant challenges to the improvement of healthcare in China and worldwide. Despite increasing international calls for the inclusion of evidence-based decision-making (EBDM) processes in chronic disease prevention and control programming as well as policymaking, there is relatively little research that assesses the current capacity of physicians and the factors that influence that capacity in China. METHOD: This cross-sectional study was conducted in community health centres (CHCs) in Shanghai, China, using multistage cluster sampling. An evidence-based chronic disease prevention (EBCDP) evaluation tool was employed to assess physician EBCDP awareness, adoption, implementation and maintenance based on the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework and using a 7-point Likert scale. Linear regression analysis was used to assess associations between each EBCDP aspect and overall EBCDP status with participant characteristics or organizational factors. RESULT: A total of 892 physicians from CHCs in Shanghai, China, were assessed. The physicians perceived their awareness (mean = 4.90, SD = 1.02) and maintenance (mean = 4.71, SD = 1.07) of EBCDP to be relatively low. Physicians with relatively lower job titles and monthly incomes (> 9000 RMB) tended to have relatively higher scores for the awareness, adoption, and implementation of EBCDP (P < 0.05). Those who had participated in one program for chronic disease prevention and control were less likely to adopt (b = - 0.284, P = 0.007), implement (b = - 0.292, P = 0.004), and maintain (b = - 0.225, P = 0.025) EBCDP than those who had participated in more programs. Physicians in general practice (Western medicine) had a lower level of awareness of EBCDP than those in other departments (P < 0.0001). Physician from CHCs located in suburban areas had lower scores for awareness (b = - 0.150, P = 0.047), implementation (b = - 0.171, P = 0.029), and maintenance (b = - 0.237, P = 0.002) that those from urban CHCs. Physicians in CHCs affiliated with universities had higher scores on all four EBCDP aspects that those in CHCs not affiliated with a university. CONCLUSIONS: This study provides quantitative evidence illustrating EBCDP practices among physicians in CHCs with various personal and organizational characteristics, respectively. More methods should be provided to increase the awareness of such physicians regarding EBCDP to stimulate the use of EBCDP for their patients and in connection with other public health priorities.


Asunto(s)
Actitud del Personal de Salud , Enfermedad Crónica/prevención & control , Toma de Decisiones Clínicas , Práctica Clínica Basada en la Evidencia/estadística & datos numéricos , Médicos Generales/estadística & datos numéricos , Adulto , China , Centros Comunitarios de Salud , Estudios Transversales , Femenino , Humanos , Ciencia de la Implementación , Renta , Modelos Lineales , Masculino , Persona de Mediana Edad , Percepción
5.
Prev Chronic Dis ; 17: E49, 2020 06 25.
Artículo en Inglés | MEDLINE | ID: mdl-32584753

RESUMEN

Publicly available data on racial and ethnic disparities related to coronavirus disease 2019 (COVID-19) are now surfacing, and these data suggest that the novel virus has disproportionately sickened Hispanic communities in the United States. We discuss why Hispanic communities are highly vulnerable to COVID-19 and how adaptations were made to existing infrastructure for Penn State Project ECHO (Extension for Community Healthcare Outcomes) and Better Together REACH (a community-academic coalition using grant funds from Racial and Ethnic Approaches to Community Health) to address these needs. We also describe programming to support COVID-19 efforts for Hispanic communities by using chronic disease prevention programs and opportunities for replication across the country.


Asunto(s)
Betacoronavirus , Enfermedad Crónica/epidemiología , Enfermedad Crónica/prevención & control , Servicios de Salud Comunitaria , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/prevención & control , Hispanoamericanos , Pandemias/prevención & control , Neumonía Viral/etnología , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Humanos , Neumonía Viral/epidemiología , Estados Unidos/epidemiología
6.
PLoS One ; 15(6): e0233565, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32484817

RESUMEN

OBJECTIVE: Lifestyle is considered as a key factor that affects one's health and quality of life, and it has become the focus of increasing research interest worldwide. Research has shown that lifestyle is an important health determinant in preventive health care. However, lifestyle is a multifaceted construct and there is limited evidence regarding lifestyle assessment, which evaluates individuals' multi-domain lifestyle factors. This study developed evaluation items for measuring the multifaceted lifestyle profile of community-dwelling older adult to prevent chronic disease and improve their health and quality of life. METHODS: Opinions from 21 experts with experience in older adults and lifestyle research were collected from December 2019 to January 2020. Three Delphi surveys were carried out, based on previous research. The first survey gathered opinions using a mix of open- and closed-ended questions regarding items of the older adults' multifaceted lifestyle profile. The second was conducted after adding and modifying several items based on the first Delphi survey. In the third survey, after the results of the second one were presented to the expert panels, final opinions from the experts were converged. RESULTS: In total, 59 items were selected as the first Delphi results; 62 items were selected as the second results after adding and modifying the values below a content validity ratio of .42; and 62 items were selected as the third Delphi results. The average content validity ratio of the final Delphi survey was .92, the stability was .18, and the consensus was .80, which were all high. CONCLUSIONS: This study verified the content validity of the evaluation items for community-dwelling older adults' multifaceted lifestyle profile. In the future, it is expected that after verifying the validity and reliability, this will be used as a standardized assessment tool in clinical environments.


Asunto(s)
Enfermedad Crónica/prevención & control , Evaluación Geriátrica/métodos , Estilo de Vida , Calidad de Vida , Anciano , Consenso , Técnica Delfos , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Vida Independiente , Estudios Interdisciplinarios , Masculino , Reproducibilidad de los Resultados , Encuestas y Cuestionarios/estadística & datos numéricos
7.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-47536

RESUMEN

A diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, disse nesta terça-feira (26) que a resposta à pandemia de COVID-19 na Região das Américas deve incluir atenção às doenças não transmissíveis, uma vez que uma em cada quatro pessoas correm maior risco de desenvolver a forma grave da COVID-19 por ter problemas crônicos de saúde.


Asunto(s)
Infecciones por Coronavirus , Enfermedad Crónica/prevención & control , Estrategias de eSalud , Américas/epidemiología
8.
PLoS One ; 15(4): e0231709, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32294142

RESUMEN

INTRODUCTION: Post-stroke fatigue (PSF) is a common symptom affecting 23-75% of stroke survivors. It is associated with increased risk of institutionalization and death, and it is of many patients considered among the worst symptoms to cope with after stroke. Longitudinal studies focusing on trajectories of fatigue may contribute to understanding patients' experience of fatigue over time and its associated factors, yet only a few have been conducted to date. OBJECTIVES: To explore whether subgroups of stroke survivors with distinct trajectories of fatigue in the first 18 months post stroke could be identified and whether these subgroups differ regarding sociodemographic, medical and/or symptom-related characteristics. MATERIALS AND METHODS: 115 patients with first-ever stroke admitted to Oslo University Hospital or Buskerud Hospital were recruited and data was collected prospectively during the acute phase and at 6, 12 and 18 months post stroke. Data on fatigue (both pre- and post-stroke), sociodemographic, medical and symptom-related characteristics were collected through structured interviews, standardized questionnaires and from the patients' medical records. Growth mixture modeling (GMM) was used to identify latent classes, i.e., subgroups of patients, based on their Fatigue Severity Scales (FSS) scores at the four time points. Differences in sociodemographic, medical, and symptom-related characteristics between the latent classes were evaluated using univariate and multivariable ordinal regression analyses. RESULTS AND THEIR SIGNIFICANCE: Using GMM, three latent classes of fatigue trajectories over 18 months were identified, characterized by differing levels of fatigue: low, moderate and high. The mean FSS score for each class remained relatively stable across all four time points. In the univariate analyses, age <75, pre-stroke fatigue, multiple comorbidities, current depression, disturbed sleep and some ADL impairment were associated with higher fatigue trajectories. In the multivariable analyses, pre-stroke fatigue (OR 4.92, 95% CI 1.84-13.2), multiple comorbidities (OR 4,52,95% CI 1.85-11.1) and not working (OR 4.61, 95% CI 1.36-15,7) were the strongest predictor of higher fatigue trajectories The findings of this study may be helpful for clinicians in identifying patients at risk of developing chronic fatigue after stroke.


Asunto(s)
Depresión/epidemiología , Fatiga/diagnóstico , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/complicaciones , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/prevención & control , Comorbilidad , Fatiga/epidemiología , Fatiga/etiología , Femenino , Humanos , Análisis de Clases Latentes , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Noruega/epidemiología , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Factores de Tiempo
9.
Scand J Med Sci Sports ; 30(5): 816-827, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32020713

RESUMEN

BACKGROUND: Globally, populations are ageing. Typically, physical activity levels decline and health worsens as we age; however, estimates of the impact of physical inactivity for population health often fail to specifically focus on older adults. METHODS: Multiple databases were searched for systematic reviews and/or meta-analyses of longitudinal observational studies, investigating the relationship between physical activity and any physical or mental health outcome in adults aged ≥60 years. Quality of included reviews was assessed using AMSTAR. RESULTS: Twenty-four systematic reviews and meta-analyses were included. The majority of reviews were of moderate or high methodological quality. Physically active older adults (≥60 years) are at a reduced risk of all-cause and cardiovascular mortality, breast and prostate cancer, fractures, recurrent falls, ADL disability and functional limitation and cognitive decline, dementia, Alzheimer's disease, and depression. They also experience healthier ageing trajectories, better quality of life and improved cognitive functioning. CONCLUSION: This review of reviews provides a comprehensive and systematic overview of epidemiological evidence from previously conducted research to assess the associations of physical activity with physical and mental health outcomes in older adults.


Asunto(s)
Enfermedad Crónica/prevención & control , Ejercicio Físico , Salud Mental , Conducta Sedentaria , Anciano , Humanos , Metaanálisis como Asunto , Persona de Mediana Edad , Mortalidad , Calidad de Vida , Literatura de Revisión como Asunto
10.
Ann Epidemiol ; 43: 44-50, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32061471

RESUMEN

PURPOSE: Five health practices are recognized to be essential for the prevention of chronic disease, viz. avoiding smoking, drinking in moderation, healthy diet, regular physical activity, and adequate sleep. However, how much of these behaviors contribute to socioeconomic disparities in health continues to be debated-some claim "hardly any," while others say "nearly all." METHODS: The data were from the NHANES 2015-16. Selected outcomes were self-rated health, hypertension, cardiovascular disease, and diabetes. Socioeconomic status was measured by education and household income. We implemented Oaxaca-Blinder decomposition to examine the extent to which socioeconomic inequalities in health could be explained by socioeconomic differences in adherence to health practices. RESULTS: 55%-90% of education-based inequalities in hypertension (89%), cardiovascular diseases (56%), and diabetes (75%) could be explained by health practices-especially current smoking and overweight. By contrast, most income-related inequalities in health outcomes could not be explained by health practices. CONCLUSIONS: How much heath practices can account for socioeconomic inequalities in health depends on the indicator of socioeconomic status. Educational disparities in health is explained by the higher prevalence of smoking and overweight in educationally disadvantaged groups. However, income-related gaps in health may require further consideration besides lifestyle modification.


Asunto(s)
Enfermedad Crónica/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Disparidades en el Estado de Salud , Renta , Servicios Preventivos de Salud , Adulto , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/prevención & control , Escolaridad , Femenino , Humanos , Hipertensión/prevención & control , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Factores Sexuales , Clase Social , Factores Socioeconómicos
11.
Artículo en Inglés | MEDLINE | ID: mdl-32033038

RESUMEN

In the frame of joint action in chronic diseases (JA CHRODIS), an extensive process at the European Union level was carried out to identify a core set of quality criteria and to formulate recommendations that improved prevention, early detection, and quality of care for people with chronic diseases. Diabetes was used as a model disease. The core set of quality criteria may be applied to develop and improve practices, programs, strategies, and policies in various domains (e.g., prevention, care, health promotion, education, and training). The quality criteria are general enough to be applied in countries with different political, administrative, social, and health care organizations. Moreover, they can be applied to a number of other chronic diseases. JA CHRODIS recommendations and quality criteria are being tested in a series of pilot actions within the JA CHRODIS PLUS. A total of 15 partners representing nine European countries worked together to implement pilot actions and generate practical lessons that could contribute to the further uptake and use of JA CHRODIS recommendations. Special emphasis is given to meaningful patient involvement in co-designing the pilot actions and to the sustainability and scalability of the pilot actions. These insights were found to be at the core of the learning from pilot actions to foster high quality care for people with chronic diseases.


Asunto(s)
Enfermedad Crónica/prevención & control , Guías de Práctica Clínica como Asunto , Calidad de la Atención de Salud , Prestación de Atención de Salud , Diagnóstico Precoz , Europa (Continente) , Unión Europea , Promoción de la Salud , Humanos , Organizaciones
12.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 26-40, ene.-feb. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-191482

RESUMEN

El eccema de manos es una patología frecuente con un fuerte impacto en la calidad de vida de los pacientes y un alto coste social y laboral. Su manejo por los médicos de atención primaria y de medicina del trabajo es complejo debido a la variedad de etiologías, la evolución difícilmente predecible de la enfermedad y la respuesta al tratamiento. El diagnóstico precoz y las medidas protectoras adecuadas son esenciales para evitar la cronificación, que es mucho más difícil de tratar. Una correcta derivación a un especialista y la valoración de una baja laboral en el momento adecuado resultan cruciales para un buen manejo de estos pacientes. En esta guía sobre el eccema crónico de manos analizamos el proceso diagnóstico, las medidas preventivas y los tratamientos, con especial énfasis en el papel del médico de atención primaria y de medicina del trabajo en los estados iniciales de su manejo


Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease


Asunto(s)
Humanos , Eccema/diagnóstico , Eccema/terapia , Atención Primaria de Salud/normas , Medicina del Trabajo/normas , Eccema/prevención & control , Diagnóstico Precoz , Enfermedad Crónica/prevención & control , Sociedades Médicas/normas , Calidad de Vida , Factores de Riesgo , Prevención Primaria , Prevención Secundaria , Fototerapia
13.
Nutr. hosp ; 37(1): 46-55, ene.-feb. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-187573

RESUMEN

Introducción: las enfermedades crónicas no transmisibles (ECNT) son la principal causa de muerte en todo el mundo. Los metabolitos secundarios provenientes de fuentes vegetales como Cnidoscolus aconitifolius pueden usarse como coadyuvante en la prevención de las enfermedades relacionadas con el estrés oxidativo y la inflamación, tales como las ECNT. Objetivo: se evaluó la actividad antioxidante y antiinflamatoria in vitro de los compuestos biológicamente activos de extractos de C. aconitifolius. Métodos: se determinó el contenido de fenoles, flavonoides, flavanonas e hidroflavonoles. El potencial antioxidante se determinó con los ensayos de 1,1-difenil-2-picrilhidrazilo (DPPH), ácido 2,2'-azinobis (3-etilbenzotiazolina-6-sulfónico) (ABTS) y la actividad inhibitoria de la enzima convertidora de la angiotensina (ACE). Para la actividad antiinflamatoria se utilizaron la reacción en cadena de la polimerasa (PCR) cuantitativa en tiempo real y el ensayo por inmunoabsorción ligado a enzimas (ELISA) en macrófagos diferenciados de monocitos THP-1 y estimulados con lipopolisacárido (LPS). Resultados: el extracto acuoso registró el mayor contenido de fenoles (70,61  0,07 g/100 g de extracto) y el extracto etanólico registró el mayor contenido de flavonoides (47,76  4,84 g/100 g de extracto), flavanonas y dihidroflavonoles (70,10  7,29 g/100 g de extracto). El extracto acetónico registró la mayor inhibición del radical DPPH (49,85 ± 5,30 %) mientras que el etanólico presentó la mayor inhibición del radical ABTS (41,01 ± 3,81 %). Los extractos etanólico y acuoso inhibieron la ECA. El extracto etanólico tuvo la mayor actividad antiinflamatoria al reducir la expresión génica de TNF- en un 39,78 % y la de IL-6 en un 97,81 %, y su producción en un 46 % y un 48,38 %, respectivamente. Conclusiones: los extractos mostraron in vitro su potencial antioxidante y antiinflamatorio por su contenido en compuestos bioactivos


Introduction: noncommunicable diseases (NCDs) are the main cause of death worldwide. Secondary metabolites from plant sources such as Cnidoscolus aconitifolius may be used as adjuvants in the prevention of diseases related to oxidative stress and inflammation such as NCDs. Objective: the in vitro antioxidant and anti-inflammatory activities associated with biologically active compounds in C. aconitifolius extracts were evaluated. Methods: the contents of phenols, flavonoids, flavonones and hydroflavonoles were determined. The potential antioxidant activity was determined with 1,1-Diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays, and angiotensin-converting enzyme (ACE) activity. For anti-inflammatory activity quantitative PCR and enzyme-linked immunosorbent assay (ELISA) tests were used in macrophages derived from THP-1 monocytes and stimulated with LPS. Results: the aqueous extract recorded the highest phenolic content (70.61  0.07 g/100 g of extract), and the ethanolic extract registered the highest content in flavonoids (47.76  4.84 g/100 g of extract), flavonones and dihydroflavonoles (70.10  7.29 g/100 g of extract). The acetone extract obtained the highest DPPH inhibition (49.85 ± 5.30 %), while the ethanolic extract showed the highest ABTS inhibition (41.01 ± 3.81 %). The etanolic and aqueous extracts had the highest ACE inhibition. The ethanolic extract had the highest anti-inflammatory activity, decreasing gene expression for TNF- by 39.78 % and for IL-6 by 97.81 %, and their production by 46 % and 48.38 %, respectively, in macrophages stimulated with LPS. Conclusions: these extracts demonstrated in vitro their antioxidant and anti-inflammatory potential due to their content of bioactive compounds


Asunto(s)
Técnicas In Vitro , Antioxidantes/aislamiento & purificación , Jatropha/metabolismo , Inflamación/tratamiento farmacológico , Extractos Vegetales/farmacología , Antioxidantes/farmacología , Estrés Oxidativo/efectos de los fármacos , Inflamación/metabolismo , Enfermedad Crónica/prevención & control , Fenoles , Flavonoides , Flavanonas , Ensayo de Inmunoadsorción Enzimática
14.
Artículo en Ruso | MEDLINE | ID: mdl-32105274

RESUMEN

AIM: To study the compliance of neurologists and headache specialists to chronic headache and chronic migraine (CM) diagnosis and treatment guidelines. MATERIAL AND METHODS: The survey included 634 neurologists from all regions of the Russian Federation. Mean age of respondents was 40.7±8.5 years, mean years of experience 14.2±7.8 years. RESULTS: Most doctors work in outpatient or hospital settings (49% and 24%, respectively), 7% were headache specialists. Tension-type headache (TTH) was diagnosed in 30% and CM in 17% of patients while 44% of patients were presumed to have a mixed headache disorder (TTH+CM). Only 10% of physicians do not use instrumental diagnostic methods in chronic headache. This study has shown sufficient attention to comorbid conditions and frequent prescription of headache preventative treatment. Botox prescription data is equivocal: 35% of physicians recommend such treatment, 27% do not, while other doctors prescribe it for off-label indications. CONCLUSION: To overcome clinical inertia, further education in chronic headaches and their optimal treatment is warranted.


Asunto(s)
Cefalea/diagnóstico , Cefalea/terapia , Encuestas de Atención de la Salud , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/terapia , Neurólogos/educación , Adulto , Enfermedad Crónica/prevención & control , Enfermedad Crónica/terapia , Cefalea/complicaciones , Cefalea/prevención & control , Humanos , Trastornos Migrañosos/complicaciones , Trastornos Migrañosos/prevención & control , Federación de Rusia , Cefalea de Tipo Tensional/complicaciones , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/prevención & control , Cefalea de Tipo Tensional/terapia
16.
J Am Coll Cardiol ; 75(5): 539-555, 2020 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-32029137

RESUMEN

In the second part of this JACC State-of-the-Art Review, an early and sustainable preventive care plan is described for cardiometabolic-based chronic disease. This plan can improve cardiometabolic health by targeting early mechanistic events to decrease the risk for certain cardiovascular diseases (e.g., coronary heart disease, heart failure, and atrial fibrillation). Included are various prevention modalities, intensive lifestyle interventions, pharmacotherapy and cardiovascular outcome trial evidence, and bariatric/metabolic procedures. A tactical approach of implementing published clinical practice guidelines/algorithms for early behavioral, adiposity, and dysglycemia targeting is emphasized, as well as relevant educational and research implications.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Servicios Preventivos de Salud , Animales , Enfermedad Crónica/prevención & control , Humanos
17.
Scand J Med Sci Sports ; 30(5): 939-946, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31986220

RESUMEN

OBJECTIVES: This study examined the association of leisure-time physical activity (LTPA) with the risk of long-term sickness absence (LTSA). METHODS: A total of 10 427 subjects from the general working population in Denmark answered questions about physical activity habits, health and work environment in the 2010 Danish Work Environment Cohort Study (DWECS). Data on LTSA (≥6 consecutive weeks during 2-year follow-up) were obtained from the Danish Register for Evaluation of Marginalization (DREAM). Cox regression analysis censored for competing events and adjusted for potential confounders (age, sex, BMI, smoking habits, depression, cancer, back diseases, previous LTSA, occupational social class, and psychosocial work environment) estimated the association between the predictor (LTPA) and the outcome variable (LTSA). During the 2-year follow-up period, 9.2% of the studied population experienced LTSA. RESULTS: In the general working population, moderate LTPA was not associated with LTSA (HR = 0.89, 95% CI: 0.72-1.09), while high LTPA showed a tendency (HR = 0.77, 95% CI: 0.59-1.01). In subgroup analyses, women below the age of 45 years with high LTPA showed a significantly lower risk of LTSA when compared with their low LTPA counterparts (HR = 0.44, 95% CI: 0.25-0.78). CONCLUSION: The results suggest that high levels of physical activity during leisure are associated with a lowered risk of LTSA, especially among younger women.


Asunto(s)
Enfermedad Crónica/prevención & control , Ejercicio Físico , Actividades Recreativas , Ausencia por Enfermedad/estadística & datos numéricos , Adulto , Dinamarca/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Recursos Humanos
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 6-7, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914561

RESUMEN

This article illustrates that health management, as one of the tools of health service, plays an important role in the control and treatment of chronic diseases as well as the history of health management development in China. It was pointed out that currently the concept of health management is not well established in China and the practice of health management in the Chinese market is quite in a mess. Therefore, there is an urgent need for the standardization of health management practice. The China Health Management Association released an organizational standard entitled "Standard for Chronic Disease Health Management" in November, 2019. It is comprehensive, science-based, easy to use and fit into the Chinese situation and it is expected that it will facilitate the development of health management in China.


Asunto(s)
Prestación de Atención de Salud/organización & administración , China , Enfermedad Crónica/prevención & control , Prestación de Atención de Salud/normas , Humanos , Estándares de Referencia
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 39-41, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914567

RESUMEN

This standard specifies the terms and definitions, processes, components, information systems and information summary, analysis and utilization of health management of major chronic and non-communicable diseases (chronic diseases). It is suitable for medical and health service institutions, health examination institutions and health management-related enterprises to carry out health management services for individuals with major chronic diseases such as cardiovascular diseases, diabetes, cancer, chronic respiratory diseases and so on.


Asunto(s)
Enfermedad Crónica/prevención & control , Prestación de Atención de Salud/organización & administración , Humanos
20.
BMC Public Health ; 20(1): 9, 2020 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-31906907

RESUMEN

BACKGROUND: The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. METHODS: Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007-10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). RESULTS: A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. CONCLUSION: Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.


Asunto(s)
Enfermedad Crónica/epidemiología , Enfermedad Crónica/prevención & control , Adolescente , Adulto , Anciano , China/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , India/epidemiología , Masculino , México/epidemiología , Persona de Mediana Edad , Federación de Rusia/epidemiología , Sudáfrica/epidemiología , Adulto Joven
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