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1.
Support Care Cancer ; 29(1): 289-300, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32358776

RESUMEN

PURPOSE: To investigate lifestyle in a population-based sample of long-term (≥ 5 years since diagnosis) young adult cancer survivors (YACSs), and explore factors associated with not meeting the lifestyle guidelines for physical activity (PA), body mass index (BMI), and smoking. METHODS: YACSs (n = 3558) diagnosed with breast cancer (BC), colorectal cancer (CRC), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or localized malignant melanoma (MM) between the ages of 19 and 39 years and treated between 1985 and 2009 were invited to complete a mailed questionnaire. Survivors of localized MM treated with limited skin surgery served as a reference group for treatment burden. RESULTS: In total, 1488 YACSs responded (42%), and 1056 YACSs were evaluable and included in the present study (74% females, average age at survey 49 years, average 15 years since diagnosis). Forty-four percent did not meet PA guidelines, 50% reported BMI ≥ 25 and 20% smoked, with no statistically significant differences across diagnostic groups. Male gender, education ≤ 13 years, comorbidity, lymphedema, pain, chronic fatigue, and depressive symptoms were associated with not meeting single and/or an increasing number of lifestyle guidelines. CONCLUSION: A large proportion of long-term YACSs do not meet the lifestyle guidelines for PA, BMI, and/or smoking. Non-adherence to guidelines is associated with several late effects and/or comorbidities that should be considered when designing lifestyle interventions for YACSs.


Asunto(s)
Supervivientes de Cáncer/estadística & datos numéricos , Ejercicio Físico/psicología , Estilo de Vida Saludable , Cooperación del Paciente/estadística & datos numéricos , Sobrevivientes/estadística & datos numéricos , Adulto , Índice de Masa Corporal , Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Neoplasias Colorrectales/terapia , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Melanoma/terapia , Persona de Mediana Edad , Dolor/complicaciones , Neoplasias Cutáneas/terapia , Fumar/epidemiología , Encuestas y Cuestionarios , Sobrevivientes/psicología , Adulto Joven
2.
Med Clin North Am ; 105(1): 149-174, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33246516

RESUMEN

Obesity is a chronic disease caused by dysregulated energy homeostasis pathways that encourage the accumulation of adiposity, which in turn results in the development or exacerbation of weight-related comorbidities. Treatment of obesity relies on a foundation of lifestyle modification; weight loss pharmacotherapy, bariatric surgery and devices are additional tools to help patients achieve their health goals. Appropriate management of patients with obesity provides multiple metabolic benefits beyond weight loss.


Asunto(s)
Obesidad/terapia , Sobrepeso/terapia , Fármacos Antiobesidad/uso terapéutico , Cirugía Bariátrica , Terapia Conductista , Dieta Reductora , Medicina Basada en la Evidencia , Terapia por Ejercicio , Ayuno , Estilo de Vida Saludable , Humanos , Obesidad/etiología , Obesidad/fisiopatología , Sobrepeso/etiología , Sobrepeso/fisiopatología , Examen Físico
3.
MEDICC Rev ; 22(4): 83-84, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33295325

RESUMEN

COVID-19 has dominated the conversation this year. Following the fi rst outbreaks in December 2019, it became clear that older adults were predisposed to greater disease severity and death. What occurred in nursing homes across Europe and the Americas was brutal-as much for the older adults themselves as for their families. Many didn't even get to say goodbye.


Asunto(s)
Anciano/psicología , /psicología , Estilo de Vida Saludable , Factores de Edad , Cuba/epidemiología , Humanos , Casas de Salud , Pandemias
4.
PLoS One ; 15(12): e0243524, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315880

RESUMEN

BACKGROUND: In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern. METHOD: An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was conducted to collect data from people attending or working at higher institutions from March 1, 2020 to April 24, 2020. A total of 1723 completed responses (917 males, 37.4 ±13.4 years old and 806 females 32.2 ± 11.5 years old) were collected. RESULTS: The female participants had significantly lower mental health scores than males (53.9% vs. 46.1%). The mental wellbeing scores were higher among participants with medium and high physical activity (PA) levels (p < 0.00). Additionally, the mental wellbeing scores were significantly improved by dietary quality and it's sleeping score (p < 0.001). However, PA was by far the major determinant of the mental health scores. CONCLUSION: Factors such as PA, diet, and sleeping patterns were associated with mental wellbeing during the COVID-19 confinement among Arab participants.


Asunto(s)
/epidemiología , Estilo de Vida Saludable/fisiología , Pandemias , /patogenicidad , Adolescente , Adulto , Anciano , Árabes , /virología , Ejercicio Físico , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Cuarentena , Instituciones Académicas , Encuestas y Cuestionarios , Universidades , Adulto Joven
5.
Texto & contexto enferm ; 29: e20180376, Jan.-Dec. 2020. graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059136

RESUMEN

ABSTRACT Objective: to identify and synthesize evidence that relates the salutogenic theory proposed by Antonovsky with cardiovascular disease in adults. Methods: we conducted a scoping review as proposed by Arksey and O'Malley. Bibliographic databases were searched for original research articles about salutogenesis and cardiovascular health. The search yielded 29 studies that met the previously defined inclusion criteria. The results were evaluated and summarized in the form of a narrative. Results: the findings of the studies pointed to a correlation among a strong sense of coherence, high quality of life and a greater likelihood of adopting healthy behaviors. Furthermore, the articles showed that social support improves perceived health and well-being of adults with cardiovascular disease. Conclusions: as a central concept of the salutogenic theory, a sense of coherence represents a topic of interest for nursing professionals. Through their interventions, nurses can strengthen and improve people's skills in the quest for and maintenance of their own health.


RESUMO Objetivo: identificar e sintetizar as evidências que relacionam a teoria salutogênica proposta pelo Antonosvsky com doenças cardiovasculares em adultos. Métodos: realizou-se uma revisão exploratória da literatura de acordo com a proposta de Arksey e O'Malley e identificou-se artigos de pesquisa originais sobre a salutogênese e a saúde cardiovascular por meio de bases de dados bibliográficas. Desses, 29 cumpriram com os critérios de inclusão previamente definidos. Os resultados foram avaliados e sintetizados em uma narrativa. Resultados: os resultados demonstram uma correlação entre um forte sentido de coerência, melhor qualidade de vida e maior tendência de adotar condutas saudáveis, além de evidenciarem que o apoio social melhora a percepção de saúde e o bem-estar de adultos com doenças cardiovasculares. Conclusões: o sentido de coerência como conceito central da teoria salutogênica representa um tema de interesse para profissionais de enfermagem. Por meio de intervenções, estes podem fortalecer e melhorar as capacidades das pessoas na busca e manutenção de sua própria saúde.


RESUMEN Objetivo: identificar y sintetizar la evidencia que relaciona la teoría salutogénica propuesta por Antonovsky con enfermedad cardiovascular en personas adultas. Métodos: se llevó a cabo un scoping review según lo propuesto por Arksey y O'Malley, se identificaron artículos de investigación originales sobre salutogénesis y salud cardiovascular a través de bases de datos bibliográficas, de los cuales 29 cumplieron con los criterios de inclusión definidos previamente. Los resultados fueron evaluados y sintetizados en una narrativa. Resultados: los hallazgos demuestran relación entre un fuerte sentido de coherencia, con una alta calidad de vida y mayor tendencia a adoptar conductas saludables, además evidencian que el apoyo social mejora la percepción de la salud y el bienestar de las personas adultas con enfermedad cardiovascular. Conclusiones: el sentido de coherencia como concepto central de la teoría salutogénica representa un tema de interés para los profesionales de enfermería quienes, a través de intervenciones, podrán fortalecer y mejorar las capacidades de las personas para la búsqueda y mantenimiento de su propia salud.


Asunto(s)
Enfermedades Cardiovasculares , Sentido de Coherencia , Calidad de Vida , Salud , Revisión , Adulto , Estilo de Vida Saludable
6.
PLoS One ; 15(11): e0242487, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33253259

RESUMEN

OBJECTIVE: Eating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA). METHODS: Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention. RESULTS: There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months' follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups. CONCLUSION: Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing. CLINICAL TRIAL: This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Estilo de Vida Saludable , Sobrepeso/complicaciones , Sobrepeso/terapia , Adulto , Anciano , Dietoterapia , Ejercicio Físico , Conducta Alimentaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Autoeficacia , Pérdida de Peso
7.
PLoS One ; 15(11): e0241193, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175849

RESUMEN

BACKGROUND: Programmes using motivational interviewing show potential in facilitating lifestyle change, however this has not been well established and explored in individuals at risk of, yet without symptomatic pre-existent cardiovascular disease. The objective of this systematic review and meta-analysis was to determine the effectiveness of motivational interviewing in supporting modifiable risk factor change in individuals at an increased risk of cardiovascular disease. METHODS: Systematic review and meta-analysis with results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-related databases were searched for randomised controlled trials from 1980 to March 2020. Criteria for inclusion included; preventive programmes, motivational interviewing principles, modification of cardiovascular risk factors in adults of both genders, different ethnicities and employment status, and having at least 1 or more modifiable cardiovascular risk factor/s. Two reviewers independently extracted data and conducted a quality appraisal of eligible studies using an adapted Cochrane framework. The Cochrane framework supports to systematically identify, appraise and synthesize all the empirical evidence that meets the pre-specified eligibility criteria to answer a specific question. FINDINGS: A total of 12 studies met the inclusion criteria. While completeness of intervention reporting was found to be adequate, the application of motivational interviewing was found to be insufficiently reported across all studies (mean overall reporting rate; 68%, 26% respectively). No statistical difference between groups in smoking status and physical activity was reported. A random effects analysis from 4 studies was conducted, this determined a synthesized estimate for standardised mean difference in weight of -2.00kg (95% CI -3.31 to -0.69 kg; p = 0.003), with high statistical heterogeneity. Pooled results from 4 studies determined a mean difference in LDL-c of -0.14mmol/l (5.414mg/dl), which was non-significant. The characteristics of interventions more likely to be effective were identified as: use of a blended approach delivered by a nurse expert in motivational interviewing from an outpatient-clinic. The application of affirmation, compassion and evocation, use of open questions, summarising, listening, supporting and raising ambivalence, combining education and barrier change identification with goal setting are also important intervention characteristics. CONCLUSIONS: While motivational interviewing may support individuals to modify their cardiovascular risk through lifestyle change, the effectiveness of this approach remains uncertain. The strengths and limitations of motivational interviewing need to be further explored through robust studies.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Ejercicio Físico/psicología , Estilo de Vida Saludable/fisiología , Entrevista Motivacional , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Colesterol/sangre , Ejercicio Físico/fisiología , Humanos , Lipoproteínas LDL/sangre , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Resultado del Tratamiento , Triglicéridos/sangre
8.
Medicine (Baltimore) ; 99(45): e22958, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33157937

RESUMEN

INTRODUCTION: Treatment-resistant depression (TRD) has a high prevalence and can be exacerbated by poor physical health and economic hardships, which have become common stressors during the current COVID-19 pandemic. The therapeutic approaches used to treat these patients are not always available, may be not be accepted by some patients, and often require face-to-face interactions. OBJECTIVE: The main aim of this study will be to evaluate the effectiveness of an Internet-based adjuvant lifestyle-based intervention for patients with TRD. METHODS: This will be a parallel, randomized, and controlled clinical trial. A total of 180 patients with TRD will be randomly allocated (1:1:1) to 1 of 3 groups: treatment prescribed by the mental health team and written suggestions for lifestyle changes (placebo control group); treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week mindfulness-based cognitive therapy program (active control group); or treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week lifestyle change promotion program (intervention group). We will perform this study during the COVID-19 pandemic, and will administer interventions by teletherapy, and contact participants by telephone calls, text messages, and/or teleconferences. We will collect patient data using questionnaires administered at baseline, immediately after the intervention, and after 6 and 12 months. The primary outcome will be score on the Beck Depression Inventory-II. The secondary outcomes will be score on the Clinical Global Impressions Scale (used to quantify and track patient progress and treatment response over time) and health-related quality of life measured using the European Quality of Life-5 Dimensions Questionnaire. DISCUSSION: Patients with TRD are especially vulnerable when face-to-face psychotherapy is unavailable. The main strength of the proposed study is the novelty of the intervention to be used as an adjuvant therapy. Our results may provide guidance for treatment of patients with TRD in future situations that require lockdown measures. CLINICALTRIALS REGISTRATION NUMBER: NCT04428099.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Trastorno Depresivo Resistente al Tratamiento/terapia , Estilo de Vida Saludable , Neumonía Viral/epidemiología , Telemedicina , Terapia Cognitivo-Conductual , Promoción de la Salud , Humanos , Atención Plena , Pandemias , Ensayos Clínicos Pragmáticos como Asunto , Calidad de Vida , Encuestas y Cuestionarios
9.
Artículo en Ruso | MEDLINE | ID: mdl-33161665

RESUMEN

In actual conditions health care priority is in increasing population size and its life expectancy including duration of healthy life, reducing morbidity, mortality and disability of population, observance of rights of citizens related to health protection that can effectively be achieved by adherence of healthy lifestyle. In order to determine possibility of improving motivation of population to lead healthy lifestyle, through formation of leadership qualities in medical specialists, the study applied such methods as expert evaluation, questionnaire survey, interview, monographic and statistical techniques. The sampling consisted of 46 employees of the I. M. Sechenov First Moscow State Medical University as experts, 107 students of this educational organization were involved in questionnaire survey and interviewing, and 68 of them were included in the group with pronounced leadership qualities, and 39 respondents consisted the control group. Involving population into healthy lifestyle is priority task of all medical specialists that is regulated by work functions of their professional standards. The effective direction of this work is to influence internal motivation of citizens. The presence of leadership qualities in future medical specialists increases their ability to motivate the population to lead healthy lifestyle at the level of theoretical training by 33.3% and practical training by 65.5% as compared to control group. The main directions of improving motivational work to involve population into healthy lifestyle by future medical specialists is refusal by students' bad habits, teaching them specialized topics in all related disciplines, formation of students' leadership potential. To develop student's leadership skills, training program can be applied in the laboratory of excellence "Factory of health leaders", implemented at the N. A. Semashko Department of public health and health care.


Asunto(s)
Motivación , Especialización , Estilo de Vida Saludable , Humanos , Liderazgo , Moscú
11.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47917

RESUMEN

Infográficos sobre alimentos e hábitos saudáveis também serão divulgados pelo Instituto durante semana comemorativa do Dia Mundial da Alimentação


Asunto(s)
Neoplasias/prevención & control , Estilo de Vida Saludable , Actividad Motora
12.
Maturitas ; 141: 39-45, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33036701

RESUMEN

OBJECTIVES: To investigate the effect of omega-3 (ω-3) polyunsaturated fatty acid supplementation and a multidomain intervention (MI) (physical activity counselling, cognitive training and nutritional advice) among community-dwelling older adults on levels of intrinsic capacity (IC), a construct recently proposed by the World Health Organization. STUDY DESIGN: Secondary analysis from the factorial-design 3-year Multidomain Alzheimer Preventive Trial (MAPT) with 1445 subjects (64.2 % female, mean age 75.3 years, SD = 4.4) randomized to one group of MI plus ω-3 (800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid/day); MI plus placebo; ω-3 supplementation alone; or placebo alone. Data collection was held between 2008 and 2014. MAIN OUTCOME MEASURES: IC domains were examined with the Geriatric Depression Scale (psychological); Short Physical Performance Battery (mobility); Z-score combining four tests (cognitive function); and handgrip strength (vitality). All domains were combined into a composite IC Z-score. RESULTS: After 3 years, IC Z-score decreased among all groups when time was considered continuous (MI plus ω-3: -0.16, 95 %CI: -0.22 to -0.10; MI alone: -0.13, 95 %CI: -0.19 to -0.07; ω-3 alone: -0.19, 95 %CI: -0.25 to -0.10; placebo: -0.20, 95 %CI: -0.26 to -0.14; all p < 0.0001). There were no significant differences between groups. In a sensitivity analysis with categorical time, significant within-group declines were first identified at 24 months for all groups. CONCLUSIONS: This trial designed to improve cognitive function was unable to find effects of the intervention on the composite IC Z-score. Further investigations are needed, especially trials providing stronger interventions (such as exercise training and a controlled diet) and also embracing the sensorial domain of IC.


Asunto(s)
Enfermedad de Alzheimer/prevención & control , Cognición/efectos de los fármacos , Ácidos Grasos Omega-3/uso terapéutico , Anciano , Anciano de 80 o más Años , Suplementos Dietéticos , Ácidos Docosahexaenoicos , Ácido Eicosapentaenoico/análogos & derivados , Ejercicio Físico , Ácidos Grasos Omega-3/farmacología , Femenino , Evaluación Geriátrica , Fuerza de la Mano , Estilo de Vida Saludable , Humanos , Vida Independiente , Estilo de Vida , Estudios Longitudinales , Masculino , Rango del Movimiento Articular/efectos de los fármacos
13.
Medicine (Baltimore) ; 99(43): e22855, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120822

RESUMEN

BACKGROUND: Abdominal obesity occurs when excessive visceral and subcutaneous fat is built up around the abdomen and stomach, which negatively impacts human health. Moxibustion, arose from Traditional Chinese Medicine (TCM), has been widely applied in the treatment of abdominal obesity. Several studies have shown the positive effects of moxibustion in prevention and treatment of endocrine issues and excess body weight. In this context, our study aims to examine the safety and efficacy of the combination of moxibustion and characteristic lifestyle intervention of TCM in the treatment of abdominal obesity. METHODS/DESIGN: This study will be a multicenter, randomized, controlled trial conducted from September 2020 to January 2022 that includes 150 participants who have abdominal obesity and meet the eligibility criteria. The participants will be randomly divided into 3 groups in a 2:2:1 allocation ratio. The intervention group will receive moxibustion combined with characteristic lifestyle intervention of TCM; the other group will receive moxibustion combined with lifestyle intervention; the control group will receive lifestyle intervention only. Eight-week moxibustion sessions will be provided to participants assigned to the 2 intervention groups. The characteristic lifestyle intervention of TCM will also last 8 weeks, whereas the lifestyle intervention will last 12 weeks including 8-week treatment period, 4-week follow-up period. The primary outcome is the waist circumference measured by a tape measure. The secondary outcomes include obesity-related indicators, serum biochemical indexs, blood pressure, conversion score of physical symptoms, and measurement of the scale. Adverse events will be recorded during the treatment and follow-up period. DISCUSSION: The results are expected to provide clinical evidence for the application of the combination of moxibustion and characteristic lifestyle intervention of TCM in patients with abdominal obesity. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04501198, Registered on 9 June 2020.


Asunto(s)
Moxibustión/métodos , Obesidad Abdominal/terapia , Femenino , Estilo de Vida Saludable , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto
14.
East Mediterr Health J ; 26(10): 1155-1164, 2020 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-33103742

RESUMEN

Background: Variable models of care have been adopted in different countries in response to the COVID-19 pandemic. Egypt has assigned certain hospitals specifically for the quarantine of COVID-19 patients, where operational medical teams work continuously for 14 days, after which they are released for self-isolation at home for a similar period. Aims: The study aimed to evaluate and compare perceived adverse psychological symptoms (stress, anxiety, depression), and insomnia by health-care professionals working in quarantine and non-quarantine hospitals during the COVID-19 pandemic in Egypt, and to explore associated factors with adverse psychological symptoms and insomnia. Methods: An online cross-sectional survey was performed in April 2020, using a snowball sampling method. Sociodemographic information perceived general health, healthy lifestyle, insomnia (using Insomnia Severity Index), adverse psychological symptoms (using the Depression, Anxiety and Stress Scale-21), worries and concerns about COVID-19, future perspective about COVID-19, and coping strategies were collected. Results: Five hundred and forty health-care professionals participated; 10.2% (n=55) worked in quarantine hospitals. Younger age (ORa=0.96, 95% CI:0.93-0.99, ORa=0.95; 95% CI:0.92-0.97; ORa=0.96 CI:0.93-0.99), being not ready/sure of readiness to work in quarantine hospital (ORa=1.91, 95% CI:1.22-3.00; ORa=2.01, 95% CI:1.28-3.15; ORa=1.91, 95% CI:1.22-2.98), and insomnia (ORa=5.22, 95% CI:3.38-8.05; ORa=7.58, 95% CI:4.91-11.68; ORa=6.38 95% CI:4.19-9.73) significantly predicted stress, depression and anxiety, respectively. Being female (ORa=1.59, 95% CI:1.04-2.42; ORa=2.09, 95% CI:1.38-3.16) could also significantly predict stress and anxiety. Conclusion: Female and younger age health care professionals were more prone to report adverse psychological symptoms. More and earlier screening for health-care professionals dealing with COVID-19, in addition to providing psychological support, is highly encouraged.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Salud Mental/estadística & datos numéricos , Personal de Hospital/psicología , Neumonía Viral/epidemiología , Cuarentena/psicología , Adaptación Psicológica , Adulto , Factores de Edad , Anciano , Ansiedad/epidemiología , Betacoronavirus , Estudios Transversales , Depresión/epidemiología , Egipto/epidemiología , Femenino , Estado de Salud , Estilo de Vida Saludable , Humanos , Masculino , Persona de Mediana Edad , Estrés Laboral/epidemiología , Pandemias , Factores de Riesgo , Factores Sexuales , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Adulto Joven
15.
Arq. bras. cardiol ; 115(3): 468-477, out. 2020. tab, graf
Artículo en Portugués | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1131324

RESUMEN

Resumo Fundamento Os dados mais utilizados como referência de aptidão cardiorrespiratória (ACR) são os de Cooper, que utiliza valores calculados de captação máxima de oxigênio (VO2máx). Objetivo Desenvolver valores de ACR a partir do teste cardiopulmonar de exercício (TCPE) em uma população brasileira com alto nível socioeconômico e livre de cardiopatia estrutural. Os resultados dos testes de VO2max foram comparados aos dados de Cooper e do FRIEND Registry. Métodos Foram utilizados neste estudo dados de TCPE de indivíduos consecutivos entre 1º de janeiro de 2000 e 31 de maio de 2016. Os critérios de inclusão foram: VO2máx pré-definido. Foi construído um gráfico de ACR de acordo com os percentuais do VO2máx: muito ruim (≤20%), ruim (20-40%), regular (40-60%), boa (60-80%), excelente (80-90%), e superior (≥90%). A correlação Kappa foi usada para analisar nossos dados em comparação aos dados dos outros dois bancos de dados. Os testes estatísticos com p<0,005 foram considerados significativos. Resultados A coorte final incluiu 18.186 testes: 12.552 homens, 5.634 mulheres (7 a 84 anos). A resposta mais recorrente foi "boa" (20,2%). Houve diferença média de peso, altura, índice de massa corporal (IMC) e idade no gráfico da ACR. Houve correlação inversa entre VO2máx e idade, peso e IMC. Usando uma regressão linear e essas variáveis, uma equação preditiva foi desenvolvida para o VO2máx. Nossas descobertas diferiram das dos outros bancos de dados. Conclusão Desenvolvemos uma classificação para a ACR e encontramos valores mais altos em todas as faixas de classificação de capacidade funcional, em contraste com os dados de Cooper e do FRIEND Registry. Nossos achados oferecem uma interpretação mais precisa da ACR nessa grande amostra populacional brasileira, quando comparados aos padrões anteriores, com base no VO2máx estimado. (Arq Bras Cardiol. 2020; 115(3):468-477)


Abstract Background The most widely used data for cardiorespiratory fitness (CRF) referrals are from the Cooper Clinic, which uses calculated maximal oxygen uptake (VO2max) values. Objective To develop CRF values from cardiopulmonary exercise testing (CPX) in a Brazilian population with high socioeconomic level and free of structural heart disease. VO2max testing results were compared with the Cooper Clinic and FRIEND Registry data. Methods CPX data from consecutive individuals between January 1,2000, and May 31,2016 were used in this study. Inclusion criteria were: VO2max by a pre-specified definition. We built a CRF chart according to VO2max percentiles: very poor (≤20%), poor (20-40%), fair (40-60%), good (60-80%), excellent (80-90%), and superior (≥90%). Kappa correlation was used to analyze our data in comparison with that of the other two databases. Statistical tests with p<0.005 were considered significant. Results Final cohort included 18,186 tests: 12,552 men, 5,634 women (7-84 years). The most recurrent response was "good" (20.2%). There was a mean difference in weight, height, body mass index (BMI), and age in the CRF chart. An inverse correlation existed between VO2max and age, weight, and BMI. Using a linear regression and these variables, a predictive equation was developed for VO2max. Our findings differed from that of the other databases. Conclusion We developed a classification for CRF and found higher values in all classification ranges of functional capacity in contrast to the Cooper Clinic and FRIEND Registry. Our findings offer a more accurate interpretation of ACR in this large Brazilian population sample when compared to previous standards based on the estimated VO2max. (Arq Bras Cardiol. 2020; 115(3):468-477)


Asunto(s)
Ejercicio Físico , Aptitud Física , Resistencia Física , Estilo de Vida Saludable , Entrenamiento Aeróbico , Actividad Motora
17.
BMC Geriatr ; 20(1): 380, 2020 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-33008403

RESUMEN

BACKGROUND: In the context of worldwide public health, it is very important to promote physical activity among the older people. This study explored the roles and attitudes of senior leaders in promoting group-based exercise in their local communities, specifically to determine the level and extent to which to elderly participation was encouraged. METHODS: This study conducted semi-structured face-to-face in-depth interviews and employed a subsequent thematic analysis. Participants included 10 club leaders and five sub-leaders who were working at senior clubs in Fujisawa-city, Kanagawa, Japan, from July to September 2018. RESULTS: Four themes emerged from the interview responses, including "unwavering attitude/conviction in relation to the vision," "leaders must set an example," "a search for balance in delegating responsibilities to members," and "creating and fostering culture and environment of mutual help." Further, each participant outlined several aims, including "achieving healthy longevity for the entire local community," "having older people promote healthy activities among the older people," and "creating a pro-health town." CONCLUSIONS: Findings indicate that policymakers, public health workers, and healthcare providers should recognize the pivotal roles that senior group leaders play in promoting healthy activities for the older people. These efforts should be strongly considered when developing policies and strategies designed to promote overall healthy longevity from a general community perspective.


Asunto(s)
Participación de la Comunidad/métodos , Ejercicio Físico , Promoción de la Salud/métodos , Liderazgo , Participación Social , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Envejecimiento/psicología , Actitud , Ejercicio Físico/fisiología , Ejercicio Físico/psicología , Femenino , Estilo de Vida Saludable , Humanos , Entrevistas como Asunto , Japón , Masculino , Investigación Cualitativa , Características de la Residencia , Rol
19.
Lancet Oncol ; 21(10): 1378-1386, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33002439

RESUMEN

BACKGROUND: Genetic variants and lifestyle factors have been associated with gastric cancer risk, but the extent to which an increased genetic risk can be offset by a healthy lifestyle remains unknown. We aimed to establish a genetic risk model for gastric cancer and assess the benefits of adhering to a healthy lifestyle in individuals with a high genetic risk. METHODS: In this meta-analysis and prospective cohort study, we first did a fixed-effects meta-analysis of the association between genetic variants and gastric cancer in six independent genome-wide association studies (GWAS) with a case-control study design. These GWAS comprised 21 168 Han Chinese individuals, of whom 10 254 had gastric cancer and 10 914 geographically matched controls did not. Using summary statistics from the meta-analysis, we constructed five polygenic risk scores in a range of thresholds (p=5 × 10-4 p=5 × 10-5 p=5 × 10-6 p=5 × 10-7, and p=5 × 10-8) for gastric cancer. We then applied these scores to an independent, prospective, nationwide cohort of 100 220 individuals from the China Kadoorie Biobank (CKB), with more than 10 years of follow-up. The relative and absolute risk of incident gastric cancer associated with healthy lifestyle factors (defined as not smoking, never consuming alcohol, the low consumption of preserved foods, and the frequent intake of fresh fruits and vegetables), was assessed and stratified by genetic risk (low [quintile 1 of the polygenic risk score], intermediate [quintile 2-4 of the polygenic risk score], and high [quintile 5 of the polygenic risk score]). Individuals with a favourable lifestyle were considered as those who adopted all four healthy lifestyle factors, those with an intermediate lifestyle adopted two or three factors, and those with an unfavourable lifestyle adopted none or one factor. FINDINGS: The polygenic risk score derived from 112 single-nucleotide polymorphisms (p<5 × 10-5) showed the strongest association with gastric cancer risk (p=7·56 × 10-10). When this polygenic risk score was applied to the CKB cohort, we found that there was a significant increase in the relative risk of incident gastric cancer across the quintiles of the polygenic risk score (ptrend<0·0001). Compared with individuals who had a low genetic risk, those with an intermediate genetic risk (hazard ratio [HR] 1·54 [95% CI 1·22-1·94], p=2·67 × 10-4) and a high genetic risk (2·08 [1·61-2·69], p<0·0001) had a greater risk of gastric cancer. A similar increase in the relative risk of incident gastric cancer was observed across the lifestyle categories (ptrend<0·0001), with a higher risk of gastric cancer in those with an unfavourable lifestyle than those with a favourable lifestyle (2·03 [1·46-2·83], p<0·0001). Participants with a high genetic risk and a favourable lifestyle had a lower risk of gastric cancer than those with a high genetic risk and an unfavourable lifestyle (0·53 [0·29-0·99], p=0·048), with an absolute risk reduction of 1·12% (95% CI 0·62-1·56). INTERPRETATION: Chinese individuals at an increased risk of incident gastric cancer could be identified by use of our newly developed polygenic risk score. Compared with individuals at a high genetic risk who adopt an unhealthy lifestyle, those who adopt a healthy lifestyle could substantially reduce their risk of incident gastric cancer. FUNDING: National Key R&D Program of China, National Natural Science Foundation of China, 333 High-Level Talents Cultivation Project of Jiangsu Province, and China Postdoctoral Science Foundation.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Estilo de Vida Saludable , Neoplasias Gástricas/genética , Adulto , Anciano , Grupo de Ascendencia Continental Asiática , China/epidemiología , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad/epidemiología , Predisposición Genética a la Enfermedad/psicología , Estudio de Asociación del Genoma Completo/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Herencia Multifactorial , Polimorfismo de Nucleótido Simple , Estudios Prospectivos , Factores de Riesgo , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/psicología
20.
Arch Cardiovasc Dis ; 113(10): 590-598, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33011157

RESUMEN

BACKGROUND: Cardiovascular diseases are a leading cause of mortality, but a substantial proportion are preventable. AIMS: The Mutuelle générale de l'éducation nationale (MGEN), a provider of private health insurance in France, has developed the VIVOPTIM programme, a novel digital approach to healthcare based on individualized, multiprofessional, ranked management of cardiovascular risk factors. METHODS: Between November 2015 and June 2016, eligible individuals (age 30-70 years) from two regions of France were invited to participate. Volunteers completed a questionnaire based on the Framingham Heart Study Risk Score and were assigned to one of three cardiovascular risk levels. VIVOPTIM comprises four components: cardiovascular risk assessment, instruction on cardiovascular diseases and associated risk factors, personalized coaching (telephone sessions with a specially trained healthcare professional to provide information on risk factors and disease management, set individual health targets, monitor progress and motivate participants), and e-Health monitoring. RESULTS: Data from 2240 participants were analysed. Significant benefits were observed on mean systolic blood pressure (-3.4mmHg), weight (-1.5kg), smoking (-2.2 cigarettes/day) and daily steps (+1726 steps/day (all P<0.0001)), though not on weekly duration of exercise (-0.2hours/week, P=0.619). CONCLUSION: As a result of the positive mid-to-long-term results of the pilot programme on weight, smoking, blood pressure, and uptake of physical activity, the VIVOPTIM programme was extend to the whole of France in 2018 and has the potential to have a genuine impact on patient care and organization of the healthcare system in France.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Estilo de Vida Saludable , Educación del Paciente como Asunto , Prevención Primaria , Telemedicina , Adulto , Anciano , Presión Sanguínea , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/etiología , Dieta Saludable , Ejercicio Físico , Femenino , Francia , Conocimientos, Actitudes y Práctica en Salud , Estado de Salud , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Medición de Riesgo , Factores de Riesgo , Cese del Hábito de Fumar , Pérdida de Peso
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