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1.
Barbarói ; (58): 8-29, jan.-jun. 2021.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1150659

RESUMEN

O presente artigo resulta de uma pesquisa intervenção de cunho qualitativo, realizada com quinze adolescentes de uma instituição localizada litoral norte de Santa Catarina. Para coleta de dados foram realizadas oficinas musicais, nas quais os participantes escolheram letras de músicas para abordar questões a respeito de sua condição de vida, discorrendo sobre o território onde vivem, a percepção que têm de si e do tempo e sobre as suas redes sociais de apoio. Em um corte temático para efeitos deste artigo, as redes sociais de apoio foram eleitas como a temática a ser analisada e discutida por meio da análise temático-categorial. Os resultados apontaram para um espaço escolar com uma função indefinida, pautado na contestação das regras e normas que são impostas, onde ocorrem brincadeiras e intrigas. Quanto à rede de amigos, observou-se que essa relação é baseada nos sentimentos de confiança e de lealdade, se configurando como uma rede essencial nesse ciclo da vida, assim como a família que se apresenta como um fator de proteção, mesmo perpassando situações conflituosas, de violência, mortes e separações.(AU)


The proposal of this paper is a result from a qualitative intervention research conducted with fifteen teenagers from an institution located north coast of Santa Catarina. For data collection, music workshops were made and the participants chose music lyrics that address questions about their life condition, talking about the place where they live, their perception of themselves, their perception of the time and of the social support networks. In a cutting theme for the proposes of this article, the social support networks were chosen as the theme to be analyzed and discussed by thematic-categorical analysis. The results pointed to a school area with an undefined function, based on the contestation of the rules and regulations that are imposed, where the games and intrigues happen. Referring to the friends network, observed that this relation is based on feelings of trust and loyalty, setting up as a essential network in the life cycle, as well as the family that presents itself as a protective factor, even through conflict situations , violence, deaths an separations.(AU)


El presente artículo es el resultado de una investigación de intervención con enfoque cualitativo, realizada con quince adolescentes de una institución localizada en litoral norte de Santa Catarina. Para la coleta de dados fueron realizados talleres musicales, en los cuales los miembros preferirán letras de canciones que enfoquen cuestiones con respecto a su condición de vida, disertando sobre los lugares donde viven, la percepción que tienen de sí propio, del tiempo y sus redes de apoyo social. En un tema de corte para los efectos de este artículo, se eligieron las redes de apoyo social como el tema para ser analizado y debatido por el análisis de temáticas-categóricas. Los resultados apuntaron para un espacio escolar con una función indefinida, pautado en la contestación de las reglas y normas que son impuestas, donde hay juegos y chismes. Cuanto a la rede de amistades, se ha observado que esta relación se basa en los sentimientos de confianza y de lealtad, se perfila como una red esencial en el ciclo de vida, así como la familia es presentada como un factor de protección, incluso impregna situaciones contradictorias, con violencia, muertes y separaciones.(AU)


Asunto(s)
Humanos , Adolescente , Apoyo Social , Adolescente , Red Social , Música , Factores Protectores , Relaciones Interpersonales , Estadios del Ciclo de Vida
2.
Artículo en Inglés | MEDLINE | ID: mdl-33803073

RESUMEN

Recently, studies linking the emotion of dispositional gratitude to cyberbullying have attracted attention. However, this is still a seminal research area that requires further scientific studies. Through longitudinal data, this study aims to analyze the mitigating effect of gratitude on cybervictimization and two indicators of adolescent subjective well-being, namely school and life satisfaction. To this end, 221 adolescents attending private schools in Peru (age: mean (M) = 12.09; standard deviation (SD) = 0.89) were selected to respond to a self-administered questionnaire in two waves that were six months apart. Descriptive data show that 27% of cybervictims also suffer other types of traditional bullying. The overlaps between forms of bullying contribute to higher probabilities of experiencing low school and life satisfaction compared to non-victims after six months. The results of the moderation analysis show that experience high gratitude help students to maintain stable levels of life satisfaction regardless of the prevalence of cyberbullying after six months The results are discussed in terms of the relevance of fostering gratitude from early ages.


Asunto(s)
Acoso Escolar , Víctimas de Crimen , Ciberacoso , Adolescente , Humanos , Lactante , Internet , Satisfacción Personal , Perú , Factores Protectores , Instituciones Académicas , Encuestas y Cuestionarios
3.
Artículo en Inglés | MEDLINE | ID: mdl-33804527

RESUMEN

This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities' suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.


Asunto(s)
Personajes , Suicidio , Humanos , Medios de Comunicación de Masas , Factores Protectores , Televisión
4.
Artículo en Inglés | MEDLINE | ID: mdl-33810020

RESUMEN

The present study aims analyze the risk factors that lead to high levels of burnout among nurses and physicians and the protective factors that prevent them. Thus, it is also intended to explore the possible correlation between physical and verbal violence produced at work and the symptoms derived from burnout. Methods: The search was carried out on the Scopus, PubMed and Web of Science databases between 2000 and 2019 (on which date the bibliographic search ends). Descriptive studies estimating the prevalence of workplace violence and risk and protective factors and burnout were included. An adapted version of the Downs and Black quality checklist was used for article selection. 89.6 percent of the studies analysed were in the health sector. There is a significant correlation between burnout symptoms and physical violence at work. On the one hand, the risk factors that moderate this correlation were of structural/organisational type (social support, quality of the working environment, authoritarian leadership, little autonomy or long working days, etc.) and personal type (age, gender, nationality or academic degree, etc.). On the other hand, protective factors were the quality of the working environment, mutual support networks or coping strategies. The results were analysed in-depth and intervention strategies were proposed.


Asunto(s)
Agotamiento Profesional , Médicos , Violencia Laboral , Agotamiento Profesional/epidemiología , Agotamiento Psicológico , Estudios Transversales , Humanos , Factores Protectores , Factores de Riesgo , Lugar de Trabajo
5.
Artículo en Inglés | MEDLINE | ID: mdl-33808234

RESUMEN

The use of electronic media (EM) by youths has been widely described in the literature, indicating the relevance of understanding the factors that can protect against its risks. We aimed to explore the protective role of participating in extracurricular activities (ECAs) and of parental mediation in the use of EM by young people. A total of 1413 people (729 students, aged between 11 and 17 years old, and one of their parents) participated in this study. Youths who engaged in ECAs spent significantly less time per week on EM and perceived that the use of EM devices had less of a negative impact. When parents and their children presented a congruent notion of how much time youth spent on EM, parents perceived EM to have less of a negative impact on their children compared to dyads with discrepant assessments. The hierarchical regression results indicated that regardless of time spent per week on EM, engaging in ECAs was a significant predictor of perceiving a less negative impact, playing a role as a protective factor regarding the use of EM. The ubiquity of EM reinforces the importance of the focus of this study, and its results contribute to creating specific guidelines for parental education and educational policies.


Asunto(s)
Conducta del Adolescente , Adolescente , Niño , Escolaridad , Electrónica , Humanos , Factores Protectores , Estudiantes
6.
Artículo en Inglés | MEDLINE | ID: mdl-33917493

RESUMEN

BACKGROUND: The COVID-19 pandemic is impacting mental health worldwide, particularly among healthcare workers (HCWs). Risk and protective factors for depression and generalized anxiety in healthcare workers need to be identified to protect their health and ability to work. Social support and optimism are known protective psychosocial resources, but have not been adequately studied in the context of the COVID-19 pandemic among healthcare workers in Germany. METHODS: Within the first wave of the VOICE study (n = 7765), a longitudinal web-based survey study among healthcare workers in Germany, we assessed symptoms of depression (PHQ-2) and generalized anxiety (GAD-2), social support (ENRICHD Social Support Inventory; ESSI), and generalized optimism as well as sociodemographic, occupational, and COVID-19 related variables. Multiple linear regression analyses were conducted to examine associations between the constructs. RESULTS: The analyses revealed that higher levels of social support and optimism were associated with lower levels of depression and generalized anxiety. They showed a higher association with depression and generalized anxiety than demographic or occupational risk factors such as female gender and direct contact with infected individuals. CONCLUSION: Psychosocial resources such as social support and optimism appear to contribute to successful coping with the COVID-19 pandemic and should be considered in future studies.


Asunto(s)
Pandemias , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Alemania/epidemiología , Personal de Salud , Humanos , Salud Mental , Factores Protectores , Apoyo Social
7.
Praxis (Bern 1994) ; 110(5): 252-256, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33849291

RESUMEN

We investigated the effect of age on cardiometabolic risk and protective factors in females living in a countryside area of Switzerland. For this cross-sectional analysis, data from 268 female adults, who live in two neighboring countryside villages in Italian-speaking Switzerland were retained. 89 study participants were premenopausal, 82 climacteric and 97 postmenopausal. Television viewing time, short duration of sleep, overweight, blood pressure, levels of atherogenic lipids and glycated hemoglobin significantly increased with age. Walking time also significantly increased with age. Tobacco smoking was more common among premenopausal women. It is concluded that in these countryside villages climacteric and postmenopausal women generally have an unfavorable cardiometabolic risk profile. On the other side, low physical activity and smoking are, compared to premenopausal and climacteric women, less prevalent in postmenopausal women.


Asunto(s)
Enfermedades Cardiovasculares , Posmenopausia , Adulto , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Humanos , Factores Protectores , Factores de Riesgo , Suiza
8.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 33(3): 368-372, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33834984

RESUMEN

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common respiratory disease in clinic, and with a pathological manifestation of pulmonary edema, decreased pulmonary compliance as well as pulmonary epithelial/endothelial cells injury. At present, it was suggested that systemic inflammatory response syndrome (SIRS) caused by various causes which play an important role in the occurrence and development of ALI/ARDS. Widely activated neutrophils can migrate to lung tissue and release plenty of proteases in the procedure of SIRS, including neutrophil serine proteases (NSPs), lysozyme, myeloperoxidase and collagenase, which can induce severe lung injury. Meanwhile, NSPs, such as neutrophil elastase (NE), cathepsin G (CG), proteinase 3 (PR3) and neutrophil serine proteinase 4 (NSP4), are important in the pathogenesis of ALI/ARDS. Therefore, Serpins may protect lung tissue by inhibiting NSPs. However, the specific mechanism of Serpins is not totally clear. In this article, we will discuss the mechanism of action of NSPs in the inflammatory response of ALI/ARDS, the structural overview of Serpins, the primary role of Serpins in ALI/ARDS, such as the inhibition of NSPs activity, other roles of Serpins in ALI/ARDS, such as the inhibition of inflammatory factor release, regulation of apoptosis and protection of vascular endothelial cells and pulmonary surfactant-associated glycoprotein D (SP-D), and the clinical application of exogenous Serpins in ALI/ARDS to explore the role of Serpins in the pathogenesis of ALI/ARDS. The aim is to provide new ideas and strategies for the clinical treatment of ALI/ARDS.


Asunto(s)
Lesión Pulmonar Aguda , Serpinas , Lesión Pulmonar Aguda/etiología , Células Endoteliales , Humanos , Factores Protectores
9.
J Appl Psychol ; 106(3): 330-344, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33871270

RESUMEN

In response to the Coronavirus disease 2019 (COVID-19) global health pandemic, many employees transitioned to remote work, which included remote meetings. With this sudden shift, workers and the media began discussing videoconference fatigue, a potentially new phenomenon of feeling tired and exhausted attributed to a videoconference. In the present study, we examine the nature of videoconference fatigue, when this phenomenon occurs, and what videoconference characteristics are associated with fatigue using a mixed-methods approach. Thematic analysis of qualitative responses indicates that videoconference fatigue exists, often in near temporal proximity to the videoconference, and is affected by various videoconference characteristics. Quantitative data were collected each hour during five workdays from 55 employees who were working remotely because of the COVID-19 pandemic. Latent growth modeling results suggest that videoconferences at different times of the day are related to deviations in employee fatigue beyond what is expected based on typical fatigue trajectories. Results from multilevel modeling of 279 videoconference meetings indicate that turning off the microphone and having higher feelings of group belongingness are related to lower postvideoconference fatigue. Additional analyses suggest that higher levels of group belongingness are the most consistent protective factor against videoconference fatigue. Such findings have immediate practical implications for workers and organizations as they continue to navigate the still relatively new terrain of remote work. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
/prevención & control , Fatiga/etiología , Identificación Social , Aislamiento Social , Comunicación por Videocoferencia , Adolescente , Adulto , Fatiga/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Factores Protectores , Investigación Cualitativa , Análisis de Regresión , Factores de Riesgo , Adulto Joven
10.
BMC Public Health ; 21(1): 670, 2021 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-33827499

RESUMEN

BACKGROUND: The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. METHODS: We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. RESULTS: The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. CONCLUSIONS: The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.


Asunto(s)
Brotes de Enfermedades , Trastornos Mentales , Síndrome Respiratorio Agudo Grave , /epidemiología , Brotes de Enfermedades/historia , Historia del Siglo XXI , Humanos , Trastornos Mentales/epidemiología , Factores Protectores , Factores de Riesgo , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/historia , Síndrome Respiratorio Agudo Grave/psicología
11.
Vasc Health Risk Manag ; 17: 135-143, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33854322

RESUMEN

Purpose: To determine the incidence and risk factor of postoperative venous thromboembolism (VTE) in Thai populations and to evaluate morbidity, mortality, bleeding complications and the benefit of thromboprophylaxis in real-world practice. Patients and Methods: We performed a retrospective, single-center, cohort study of patients from all age groups who underwent elective open or laparoscopic major abdomino-pelvic surgery between January 2008 and December 2018 at Chulabhorn Hospital, Bangkok, Thailand. We collected general medical information and specific data based on items from the Caprini risk scoring system. Results: A total of 2462 major abdomino-pelvic surgeries were included. The study population consisted of 742 males (30.1%) and 1720 females (69.9%) aged 54.59 ± 13.27 years. The incidence of VTE in Thai patients that underwent major abdominal surgery was 0.48%. The most frequent influencing factor for VTE was a history of pulmonary embolism, which increased the risk of VTE 98.28-fold, whereas a history of deep vein thrombosis increased the risk of VTE by 12.34-fold. Other factors influencing VTE development were obesity, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, tumor-node-metastasis (TNM) stage 4 and American College of Chest Physicians (ACCP) class 4. Protective factors included no history of VTE, laparoscopic surgery, TNM stage 0 and benign disease and BMI<30. VTE significantly increased mortality whereas following ACCP guideline reduced mortality. Conclusion: Post-operative VTE incidence in Thai patients undergoing major abdomino-pelvic surgery was lower compared with Western patients. Factors influencing for VTE were history of VTE, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, TNM stage 4 and ACCP class 4. Following ACCP guideline reduced the incidence of mortality.


Asunto(s)
Abdomen/cirugía , Pelvis/cirugía , Complicaciones Posoperatorias/epidemiología , Tromboembolia/epidemiología , Adulto , Anciano , Anticoagulantes/uso terapéutico , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/prevención & control , Factores Protectores , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Centros de Atención Terciaria , Tailandia/epidemiología , Tromboembolia/diagnóstico , Tromboembolia/mortalidad , Tromboembolia/prevención & control , Adulto Joven
12.
Int. j. clin. health psychol. (Internet) ; 21(1): 202-202, ene.-abr. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-200214

RESUMEN

BACKGROUND/OBJECTIVE: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). METHOD: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. RESULTS: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. CONCLUSIONS: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts


OBJETIVO: Se exploró la asociación entre desplazamientos escolares activos (AST, por sus siglas en inglés) e intentos de suicidio entre adolescentes en países de ingresos bajos y medios. MÉTODO: Se utilizaron datos de la Global School-based Health Survey, que incluyó a 127.097 adolescentes de 13 a 17 años de 34 países de ingresos bajos y medios. Se utilizó una encuesta autoinformada para recopilar datos sobre AST e intentos de suicidio, así como otras variables. Se realizó una regresión logística multivariable para evaluar la asociación entre AST e intentos de suicidio. Se realizó un metanálisis con efectos aleatorios para identificar la diferencia en la asociación entre AST e intentos de suicidio. RESULTADOS: La prevalencia de AST fue del 37% y la prevalencia de intentos de suicidio fue del 11,60%. Los adolescentes que participaron en AST tenían menos probabilidades de tener intentos de suicidio independientemente del sexo. El análisis por países indicó una gran inconsistencia en la asociación entre AST e intento de suicidio. CONCLUSIONES: AST parece ser un factor protector para reducir los intentos de suicidio entre adolescentes. Sin embargo, la asociación entre AST e intentos de suicidio varió mucho entre países. Estudios futuros deberían confirmar la asociación entre AST e intentos de suicidio


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Conductas Relacionadas con la Salud , Ejercicio Físico/psicología , Conducta del Adolescente/psicología , Países en Desarrollo , Instituciones Académicas , Salud Mental , Modelos Logísticos , Factores Sexuales , Conductas de Riesgo para la Salud , Autoinforme , Factores Socioeconómicos , Factores Protectores
14.
Diabetes Metab Syndr ; 15(2): 513-518, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33662839

RESUMEN

BACKGROUND AND AIMS: Metformin has antiviral and anti-inflammatory effects and several cohort studies have shown that metformin lower mortality in the COVID population in a majority white population. There is no data documenting the effect of metformin taken as an outpatient on COVID-19 related hospitalizations. Our aim was to evaluate if metformin decreases hospitalization and severe COVID-19 among minority Medicare patients who acquired the SARS-CoV2 virus. METHODS: We conducted a retrospective cohort study including elderly minority Medicare COVID-19 patients across eight states. We collected data from the inpatient and outpatient electronic health records, demographic data, as well as clinical and echocardiographic data. We classified those using metformin as those patients who had a pharmacy claim for metformin and non-metformin users as those who were diabetics and did not use metformin as well as non-diabetic patients. Our primary outcome was hospitalization. Our secondary outcomes were mortality and acute respiratory distress syndrome (ARDS). RESULTS: We identified 1139 COVID-19 positive patients of whom 392 were metformin users. Metformin users had a higher comorbidity score than non-metformin users (p < 0.01). The adjusted relative hazard (RH) of those hospitalized for metformin users was 0.71; 95% CI 0.52-0.86. The RH of death for metformin users was 0.34; 95% CI 0.19-0.59. The RH of ARDS for metformin users was 0.32; 95% CI 0.22-0.45. Metformin users on 1000 mg daily had lower mortality, but similar hospitalization and ARDS rates when compared to those on 500-850 mg of metformin daily. CONCLUSIONS: Metformin is associated with lower hospitalization, mortality and ARDS among a minority COVID-19 population. Future randomized trials should confirm this finding and evaluate for a causative effect of the drug preventing disease.


Asunto(s)
/fisiopatología , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hospitalización/estadística & datos numéricos , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , /epidemiología , Afroamericanos , Anciano , Anciano de 80 o más Años , Causas de Muerte , Relación Dosis-Respuesta a Droga , Grupos Étnicos , Femenino , Humanos , Masculino , Medicare , Grupos Minoritarios , Modelos de Riesgos Proporcionales , Factores Protectores , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estados Unidos/epidemiología
15.
Artículo en Inglés | MEDLINE | ID: mdl-33669815

RESUMEN

The aim is to analyze protective and modifying factors (e.g., vulnerability, resilience, sense of coherence) in relation to the utilization of dental services by seniors at different levels of the healthcare system. Terminological imprecision in the use and transfer of existing terms (sense of coherence, resilience, salutogenesis) to gerodontology is clarified. Factors influencing a reduced utilization (static/dynamic factors) can occur isolated or in combination and, thus, model the risk of a reduced utilization of dental services (influencing-factor mechanism). Protective factors of utilization include patient-specific factors for self-motivation and factors that promote oral-health-related resilience. Resistance forces that counteract can be identified as oral-health-related resilience factors. Achieving social and individual appreciation and establishing a prevention-oriented approach to utilization will be increasingly challenging, since the population is becoming older and access is not equal in terms of opportunity. Resistance forces need to be strengthened in an ethical context. Studies should increasingly present resilience processes, determinants and modes of action at the various interfaces in the healthcare system, which can ensure sustainable medical care in old age. The concepts conveyed here are generally valid and able to point out inequalities and ageism in access to dental services.


Asunto(s)
Sentido de Coherencia , Prestación de Atención de Salud , Humanos , Motivación , Salud Bucal , Factores Protectores
16.
Curr Diab Rep ; 21(4): 12, 2021 03 14.
Artículo en Inglés | MEDLINE | ID: mdl-33715053

RESUMEN

PURPOSE OF REVIEW: To synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors. RECENT FINDINGS: Emerging evidence suggests that hyperglycemia and time in range may be more important for brain development than episodes of hypoglycemia. Further, diabetic ketoacidosis (DKA) at the time of T1D diagnosis appears to be a particular risk factor for neurocognitive complications, particularly deficits in executive function skills and memory, with differences in cerebral white matter microstructure seen via advanced magnetic resonance imaging methods, and lower scores on measures of attention and memory observed among children who were diagnosed in DKA. Other factors that may influence neurocognitive development include child sleep, caregiver distress, and diabetes device use, presumably due to improved glycemic control. We highlight neurocognitive risk and protective factors for children with T1D and priorities for future research in this high-risk population.


Asunto(s)
Diabetes Mellitus Tipo 1 , Cetoacidosis Diabética , Hipoglucemia , Encéfalo/diagnóstico por imagen , Niño , Diabetes Mellitus Tipo 1/complicaciones , Cetoacidosis Diabética/complicaciones , Cetoacidosis Diabética/epidemiología , Humanos , Hipoglucemia/complicaciones , Factores Protectores , Factores de Riesgo
17.
J Psychosom Res ; 144: 110415, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33743398

RESUMEN

OBJECTIVE: The aim of this cross-sectional web-based study was to examine self-reported mental distress, psychosocial burdens, working conditions and potential risk and protective factors for depressive and anxiety symptoms during the COVID-19 pandemic in health care workers (HCW). METHODS: In the largest survey on mental health of HCW conducted during the first wave of COVID-19 in Europe (N = 8071 HCW), we investigated depressive (Patient Health Questionnaire-2, PHQ-2), and anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), working conditions, and psychosocial burden of 3678 HCW of three health care professions in hospitals: physicians (n = 1061), nurses (n = 1275), and medical technical assistants (MTA, n = 1342). RESULTS: The prevalence of clinically significant levels of depressive and anxiety symptoms was 17.4% and 17.8% for physicians, 21.6% and 19.0% for nurses, and 23.0% and 20.1% for MTA, respectively. All three professions demonstrated significantly elevated PHQ-2 and GAD-2 scores, when compared with general German population before the pandemic, but lower scores in relation to that during the pandemic. Multiple linear regression analyses revealed that higher levels of depressive symptoms were associated with insufficient recovery during leisure time, increased alcohol consumption, and less trust in colleagues in difficult situations at work. In addition, elevated anxiety scores were related to increased fear of becoming infected with COVID-19. CONCLUSION: During the pandemic HCW demonstrated a lower burden of mental distress compared to the general population. Nevertheless, a high percentage of HCW demonstrates psychosocial distress, so that the establishment of regular mental health screening and prevention programmes for HCW is indicated.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Personal de Salud/psicología , Hospitales , Salud Mental , Lugar de Trabajo , Adulto , Anciano , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , Factores Protectores , Factores de Riesgo
18.
J Stroke Cerebrovasc Dis ; 30(5): 105708, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33714073

RESUMEN

BACKGROUND: Recent evidence indicates that treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i) may favorably affect the risk of stroke in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease. OBJECTIVES: This meta-analysis considered data from cardiovascular outcome trials (CVOTs) regarding the effect of SGLT2i treatment on stroke risk in T2DM patients with an emphasis on patients with impaired renal function. SELECTION CRITERIA: Double-blind randomized trials (RCTs) representing CVOTs were included if they compared SGLT2i add-on therapy with placebo, and reported stroke among primary or secondary endpoints. RESULTS: Six eligible multicenter RCTs were included. The pooled analysis of 5 RCTs (n = 40,393) showed a neutral effect on the risk of total stroke from treatment with SGLT2i vs. placebo (hazard ratio, HR 0.90, 95% CI: 0.74-1.09, p = 0.29, I2 = 58%). Subgroup analysis (4 RCTs) involving patients with impaired renal function (n = 17,072) demonstrated a significant benefit in favor of SGLT2i (HR: 0.66, 95% CI: 0.54-0.82, p<0.0001, I2 = 8%). The pooled analysis of 2 RCTs (n = 14,543) showed a significant reduction in the risk of hemorrhagic stroke in T2DM patients (HR: 0.46, 95% CI: 0.25-0.83, p = 0.01; I2 = 0). No differences were noticed regarding the risk of ischemic stroke (HR: 0.97, 95% CI: 0.85-1.12, p = 0.69; I2 = 0), non-fatal stroke (HR: 0.98, 95% CI: 0.83-1.16, p = 0.79, I2 = 28%), and fatal stroke (HR: 0.77, 95% CI: 0.50-1.17, p = 0.22, I2 = 0). CONCLUSIONS: Available data suggest that SGLT2i reduce the risk of total stroke in patients with T2DM and impaired renal function. Based on the findings of two RCTs, these drugs may offer a protection against hemorrhagic stroke.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Nefropatías Diabéticas/fisiopatología , Riñón/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Anciano , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidad , Nefropatías Diabéticas/diagnóstico , Nefropatías Diabéticas/mortalidad , Femenino , /mortalidad , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Factores Protectores , Ensayos Clínicos Controlados Aleatorios como Asunto , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/mortalidad , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
19.
J Stroke Cerebrovasc Dis ; 30(5): 105711, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33714074

RESUMEN

OBJECTIVE: Obesity is a risk factor for ischaemic stroke but provides a survival advantage. The relationship between body mass index (BMI) and long-term function is less clear. The presence of an obesity paradox can inform clinical care and identify vulnerable patients who need additional support post-stroke. MATERIALS AND METHODS: This study used linked health administrative data of a population based cohort of adult patients who experienced an ischaemic stroke between 2012 and 2017 in New Zealand. Patient demographics were obtained from the National Minimum Dataset (NMDS). BMI and Activities of Daily Living scores (ADLs) for the same patients were obtained from the International Resident Assessment Instrument (InterRAI™). RESULTS: Linked data was obtained for 3731 patients. Ninety-five percent of the cohort were aged 65 or older and the average age of stroke was 84.5 years. The majority of patients (55%) identified as New Zealand European. Beta regression indicated BMI and European ethnicity were negatively associated with ADL score. Univariate analysis confirmed patients with underweight stroke had significantly higher ADL scores than other BMI categories (p<0.001), however functional status for patients with overweight and obesity were comparable. Further, Asian and Pacific Peoples had higher ADL scores than Europeans (p<0.05). A higher BMI was advantageous to all ADL subscores. CONCLUSION: An abridged obesity paradox was evident in our cohort of stroke patients where a BMI in the overweight, but not obese range conferred a long-term functional status advantage. Collectively these results suggest underweight and non-European patients may require additional supportive clinical care post-stroke.


Asunto(s)
Índice de Masa Corporal , Sobrepeso/diagnóstico , Delgadez/diagnóstico , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Evaluación Geriátrica , Humanos , /mortalidad , Masculino , Persona de Mediana Edad , Nueva Zelanda , Sobrepeso/mortalidad , Sobrepeso/fisiopatología , Pronóstico , Factores Protectores , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Delgadez/mortalidad , Delgadez/fisiopatología
20.
Global Health ; 17(1): 34, 2021 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-33781283

RESUMEN

BACKGROUND: Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. METHODS: For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. RESULTS: Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15-0.65) and depression (SMD 0.67; 95% CI 0.07-1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. CONCLUSIONS: This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.


Asunto(s)
/psicología , Trastornos Mentales/etiología , Salud Mental , Pandemias , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Ansiedad/etiología , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Factores Protectores , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/etiología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología
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