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J Med Internet Res ; 23(1): e25535, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33404516


BACKGROUND: Effectively identifying patients with COVID-19 using nonpolymerase chain reaction biomedical data is critical for achieving optimal clinical outcomes. Currently, there is a lack of comprehensive understanding in various biomedical features and appropriate analytical approaches for enabling the early detection and effective diagnosis of patients with COVID-19. OBJECTIVE: We aimed to combine low-dimensional clinical and lab testing data, as well as high-dimensional computed tomography (CT) imaging data, to accurately differentiate between healthy individuals, patients with COVID-19, and patients with non-COVID viral pneumonia, especially at the early stage of infection. METHODS: In this study, we recruited 214 patients with nonsevere COVID-19, 148 patients with severe COVID-19, 198 noninfected healthy participants, and 129 patients with non-COVID viral pneumonia. The participants' clinical information (ie, 23 features), lab testing results (ie, 10 features), and CT scans upon admission were acquired and used as 3 input feature modalities. To enable the late fusion of multimodal features, we constructed a deep learning model to extract a 10-feature high-level representation of CT scans. We then developed 3 machine learning models (ie, k-nearest neighbor, random forest, and support vector machine models) based on the combined 43 features from all 3 modalities to differentiate between the following 4 classes: nonsevere, severe, healthy, and viral pneumonia. RESULTS: Multimodal features provided substantial performance gain from the use of any single feature modality. All 3 machine learning models had high overall prediction accuracy (95.4%-97.7%) and high class-specific prediction accuracy (90.6%-99.9%). CONCLUSIONS: Compared to the existing binary classification benchmarks that are often focused on single-feature modality, this study's hybrid deep learning-machine learning framework provided a novel and effective breakthrough for clinical applications. Our findings, which come from a relatively large sample size, and analytical workflow will supplement and assist with clinical decision support for current COVID-19 diagnostic methods and other clinical applications with high-dimensional multimodal biomedical features.

/diagnóstico , Sistemas de Apoyo a Decisiones Clínicas , Salud , Aprendizaje Automático , Neumonía Viral/diagnóstico , /diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Persona de Mediana Edad , Neumonía Viral/diagnóstico por imagen , Máquina de Vectores de Soporte , Tomografía Computarizada por Rayos X
Water Res ; 188: 116501, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33091804


Natural swimming ponds (NSPs) are artificially created bodies of water intended for human recreation, characterised by the substitution of chemical disinfection with natural biological processes for water purification. NSPs are growing in popularity, however little is known regarding the public health risks. A screening level risk assessment was undertaken as an initial step in assessing the first Canadian public NSP located in Edmonton, Alberta. Risk of enteric pathogens originating from pool bathers was assessed under normal conditions and following accidental faecal release events. The performance of the natural treatment train for health protection was quantified with and without the addition of UV disinfection of naturally-treated water, and compared to the US EPA benchmark to provide a reference point to consider acceptability. Estimated levels of pathogen contamination of the pond were dependant upon the discrete number of shedders present, which in turn depended upon the prevalence of infection in the population. Overall performance of the natural disinfection system was dependant upon the filtration rate of the natural treatment system or turnover time. Addition of UV disinfection reduced the uncertainty around the removal efficacy, and mitigated the impact of larger shedding events, however the impact of UV disinfection on the natural treatment biome is unknown. Further information is needed on the performance of natural barriers for pathogen removal, and therefore challenge studies are recommended. Given the identified risks, the pool is posted that there is risk from accidental faecal releases, as in any natural water body with swimmers. Screening level risk assessment was a valuable first step in understanding the processes driving the system and in identifying important data gaps.

Estanques , Piscinas , Alberta , Salud , Humanos , Tamizaje Masivo , Medición de Riesgo , Natación , Microbiología del Agua
Food Chem ; 337: 127726, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32795854


Phenolic compounds contribute to the bioactive properties of olive oil. However, olive oils can only support a health claim concerning the protection against oxidative stress depending on the polyphenolic concentration, requiring effective measures during extraction to preserve/enhance their concentrations. The effect of the malaxation temperature (22, 28 and 34 °C) on the phenolic profile was studied for industrially extracted cv. Cobrançosa oils. Higher malaxation temperatures decreased the contents of the majority of the chromatographically detected compounds (P < 0.05, one-way ANOVA), enabling oils' differentiation. This decreasing trend was observed for hydroxytyrosol and tyrosol bound forms, determinant for the health claim, which were also negatively affected by temperature, despite revealing that all the industrially extracted oils tested supported the health claim. The observed constant free to bound forms ratio showed that the temperature range tested had a minor effect on bound-forms hydrolysis, being both free and bound forms equally affected by temperature.

Salud , Aceite de Oliva/química , Fenoles/análisis , Temperatura , Fenómenos Mecánicos , Fenoles/química
Food Chem ; 340: 127940, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-32889216


The aim of this review is to provide new findings on health effects of edible flowers since 2015. The antioxidant, anti-inflammatory, anti-cancer, hepatoprotective, neuroprotective, anti-diabetic, anti-osteoporosis, anti-obesity, and anti-hypertensive have been reviewed, and the effective concentrations of flower extracts have been summarized. Among all the health benefits mentioned, anti-osteoporosis, anti-obesity, and anti-hypertensive have rarely been mentioned before 2015. Some health benefits mechanisms of edible flowers were discussed frequently after 2015. Some newly found phytochemicals such as polysaccharides were shown to be beneficial to human health. Species of Rosa, Chrysanthemum, and Osmanthus have been reported to exert different health effects on human. For the toxicity studies, the safe level of flower extracts in cell and animal models were at hundreds of parts per million (ppm) level. In consideration of health promoting effects and toxicities of edible flowers, they could serve as potential natural health products for different health benefits.

Flores/química , Salud , Fitoquímicos/farmacología , Animales , Humanos , Fitoquímicos/química
Ecotoxicol Environ Saf ; 207: 111512, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33254392


This study investigated 324 groundwater samples collected from the southwest plain of Shandong Province during the dry and wet seasons. Groundwater fluoride in the study area and the influencing factors were characterized and discussed using statistical analysis, ion ratios, Piper diagrams, the saturation index (SI) and ArcGIS software. In addition, the risk posed by groundwater fluoride to human health was assessed. The results showed that groundwater in the study area had elevated fluoride concentrations, with average dry and wet season concentrations of 1.15 mg·L-1 and 1.08 mg·L-1, respectively. Groundwater fluoride showed consistent spatial variations during the dry and wet seasons, with a significant regionalization pattern of low concentrations in the east and high concentrations in the west. Groundwater F- was significantly negatively correlated with Ca2+ and positively correlated with pH, HCO3- and Na+. Important factors identified as having an effect on groundwater F- in the study area included the balance of dissolution of fluorite and calcite, the weakly alkaline environment and cation exchange. In addition, hydrochemical types of high-fluoride groundwater in the study area were identified as mainly HCO3-Na and SO4·Cl-Na. The assessment of the risk of high groundwater fluoride to human health showed that children are more at risk compared to adults, with the risk during the dry season exceeding that over the wet season. It is recommended that water quality management in the study area prioritize the formulation of measures to mitigate high concentrations of fluoride in groundwater .

Monitoreo del Ambiente , Fluoruros/análisis , Contaminantes Químicos del Agua/análisis , Adulto , Carbonato de Calcio/química , Niño , China , Agua Subterránea/química , Salud , Humanos , Minerales/análisis , Sodio/análisis , Calidad del Agua
Crit Rev Food Sci Nutr ; 61(1): 85-96, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-31983216


Pulses are nutrient-dense foods that have for a long time been empirically known to have beneficial effects in human health. In the last decade, several studies have gathered evidence of the metabolic benefits of pulse intake. However, it remains unclear at what amounts these effects may be attained. This study aimed to systematically review the scientific outputs of the last two decades regarding health benefits of pulse consumption and the amounts necessary for positive outcomes to be achieved. A PubMed search including keywords [("dietary pulses", "pulses", "legumes", "grain legumes", "bean", "chickpea", "pea", "lentil", "cowpea", "faba bean", "lupin") and ("inflammation", "inflammatory markers", "C-reactive protein", "blood lipids", "cholesterol", "cardiometabolic health", "cardiovascular disease", "diabetes", "glycaemia", "insulin", "HOMA-IR", "body weight", "body fat", "obesity", "overweight", "metabolome", "metabolic profile", "metabolomics", "biomarkers", "microbiome", "microbiota", "gut")] was performed. Only English written papers referring to human dietary interventions, longer than one day, focusing on whole pulses intake, were included. Most of the twenty eligible publications reported improvements in blood lipid profile, blood pressure, inflammation biomarkers, as well as, in body composition, resulting from pulse daily amounts of 150 g (minimum-maximum: 54-360 g/day; cooked). Concerns regarding methodological approaches are evident and the biochemical mechanisms underlying such effects require further investigation.

Dieta , Obesidad , Peso Corporal , Salud , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
Crit Rev Food Sci Nutr ; 61(1): 139-148, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-31997655


Under the control of the host circadian rhythms, intestinal microbiota undergoes dietary-dependent diurnal fluctuations in composition and function. In addition, microbiome plays a critical role in maintaining the host circadian rhythms and metabolic homeostasis. The interactions between host circadian rhythms and intestinal microbiota suggest that intervention with prebiotics or probiotic is a possible way to alleviate circadian rhythm misalignment and related metabolic diseases. This review discusses the circadian rhythm oscillations of gut flora, relationship between host circadian rhythms and microbiome and related effects on metabolism. The influence on circadian rhythms by the interactions between tea polyphenols (TP) and intestinal microbiota is highlighted.

Microbioma Gastrointestinal , Ritmo Circadiano , Señales (Psicología) , Salud , Polifenoles/farmacología ,
PLoS One ; 15(12): e0242664, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33264331


Subjective well-being has captured the interest of scientists and policy-makers as a way of knowing how individuals and groups evaluate and experience their lives: that is, their sense of meaning, their satisfaction with life, and their everyday moods. One of the more striking findings in this literature is a strong association between age and subjective well-being: in Western countries it has a U-shaped association over the lifespan. Despite many efforts, the reason for the curve is largely unexplained, for example, by traditional demographic variables. In this study we examined twelve social and psychological variables that could account for the U-shaped curve. In an Internet sample of 3,294 adults ranging in age from 40 to 69 we observed the expected steep increase in a measure of subjective well-being, the Cantril Ladder. Regression analyses demonstrated that the social-psychological variables explained about two-thirds of the curve and accounting for them significantly flattened the U-shape. Perceived stress, distress-depression, an open perspective about the future, wisdom, satisfaction with social relationships, and family strain were measures that had pronounced impacts on reducing the curve. These findings advance our understanding of why subjective well-being is associated with age and point the way to future studies.

Envejecimiento/psicología , Salud , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión
Artículo en Inglés | MEDLINE | ID: mdl-33255383


International governments' COVID-19 responses must balance human and economic health. Beyond slowing viral transmission, strict lockdowns have severe economic consequences. This work investigated response stringency, quantified by the Oxford COVID-19 Government Response Tracker's Stringency Index, and examined how restrictive interventions affected infection rates and gross domestic product (GDP) in China and OECD countries. Accounting for response timing, China imposed the most stringent restrictions, while Sweden and Japan were the least stringent. Expected GDP declines range from -8% (Japan) to -15.4% (UK). While greater restrictions generally slowed viral transmission, they failed to reach statistical significance and reduced GDP (p = 0.006). Timing was fundamental: governments who responded to the pandemic faster saw greater reductions in viral transmission (p = 0.013), but worse decreases in GDP (p = 0.044). Thus, response stringency has a greater effect on GDP than infection rates, which are instead affected by the timing of COVID-19 interventions. Attempts to mitigate economic impacts by delaying restrictions or decreasing stringency may buoy GDP in the short term but increase infection rates, the longer-term economic consequences of which are not yet fully understood. As highly restrictive interventions were successful in some but not all countries, decision-makers must consider whether their strategies are appropriate for the country on health and economic grounds.

/economía , Pandemias , China/epidemiología , Salud , Humanos , Japón/epidemiología , Suecia/epidemiología
Texto & contexto enferm ; 29: e2018068, Jan.-Dec. 2020.
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1094543


ABSTRACT Objective: to analyze the narrative of users about the assistance received by the professionals of the Mais Médicos (More Doctors) Program. Method: qualitative, exploratory, descriptive, comprehensive research carried out from August to December 2015. 16 interviews were carried out in four Basic Health Units that hired doctors who spoke the Spanish language. Systematic observation was performed with 30 hours of registration, and the respondents answered a socio-demographic questionnaire and a semi-structured interview. The analysis followed the triangulation of data from participant observation, interviews and the theoretical framework, using thematic analysis in the light of dialectical hermeneutics. Three operational categories have been developed: Quality and welcoming in consultation, Doctor-patient communication and foreign Doctor Results: the interviewees stated that making an appointment for a medical appointment, unlike before, became possible and less time consuming with the arrival of new doctors. The interviewees were satisfied with the medical care received, highlighting the quality of care. Conclusion: the medical reception received at the consultation, and the prescribed medications, seem to have a greater weight for the perception of the quality of the consultation, and to be more important for users than the understanding of the foreign language and the doctor's language. The low structural and operational competence of Primary Care remains the limit for the Mais Médicos Program.

RESUMEN Objetivo: analizar la narrativa de los usuarios sobre la asistencia recibida por los profesionales del Programa Mais Médicos. Método: investigación cualitativa, exploratoria, descriptiva, exhaustiva, realizada entre agosto y diciembre de 2015. Se realizaron 16 entrevistas en cuatro Unidades Básicas de Salud que contrataron médicos que hablaban español. La observación sistemática se realizó con 30 horas de registro, y los encuestados respondieron un cuestionario sociodemográfico y una entrevista semiestructurada. El análisis siguió la triangulación de datos de la observación participante, entrevistas y el marco teórico, utilizando análisis temáticos a la luz de la hermenéutica dialéctica. Se han desarrollado tres categorías operativas: calidad y bienvenida en la consulta, comunicación médico-paciente y médico extranjero. Resultados: los entrevistados declararon que hacer una cita para una cita médica, a diferencia de antes, se hizo posible y llevó menos tiempo con la llegada de nuevos médicos. Los entrevistados quedaron satisfechos con la atención médica recibida, destacando la calidad de la atención. Conclusión: la recepción médica recibida en la consulta, y los medicamentos recetados, parecen tener un mayor peso para la percepción de la calidad de la consulta, y son más importantes para los usuarios que la comprensión del idioma extranjero y el idioma del médico. La baja competencia estructural y operativa de Atención Primaria sigue siendo el límite para el Programa Mais Médicos.

RESUMO Objetivo: analisar a narrativa de usuários sobre a assistência recebida pelos profissionais do Programa Mais Médicos. Método: pesquisa qualitativa, exploratória, descritiva, de natureza compreensiva, realizada no período de agosto a dezembro de 2015. Foram realizadas 16 entrevistas em quatro Unidades Básicas de Saúde que contrataram médicos que se expressavam no idioma espanhol. Foi realizada observação sistemática com 30 horas de registro, e os depoentes responderam a um questionário sócio demográfico e a uma entrevista semiestruturada. A análise obedeceu à triangulação dos dados da observação participante, das entrevistas e do referencial teórico, utilizando-se a análise temática à luz da hermenêutica dialética. Foram elaboradas três categorias operacionais: Qualidade e acolhimento na consulta, Comunicação médico-paciente e Médico estrangeiro. Resultados: os entrevistados afirmaram que marcar uma consulta médica, diferente de antes, tornou-se possível e menos demorado com a chegada dos novos médicos. Os entrevistados mostraram-se satisfeitos com o atendimento médico recebido, realçando a qualidade na assistência. Conclusão: o acolhimento médico recebido na consulta, e as medicações prescritas, parecem ter um peso maior para a percepção da qualidade da consulta, e serem mais importantes para os usuários do que a compreensão do idioma estrangeiro e da linguagem do médico. A baixa competência estrutural e operacional da Atenção Básica permanece como limite para o Programa Mais Médicos.

Humanos , Adulto , Salud , Atención Médica , Consorcios de Salud , Médicos , Atención Primaria de Salud , Política Pública , Calidad de la Atención de Salud , Sistema Único de Salud , Investigación Cualitativa
Texto & contexto enferm ; 29: e20190198, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1101985


ABSTRACT Objective: describe the experience of the proposal, process and results of a training program on qualitative research for nursing teachers based on the constructivist pedagogic model. Method: implementation of a course at a Nursing School in Uruguay from November 3, 2016 to October 12, 2017, in which thirty-nine teachers participated voluntarily. The description of the experience presented in this article is based on the assessment of the course made through participant observation, surveys and a dialogue session with the participants in which the results of the course were discussed. Results: through the implementation of the course, several achievements were accomplished, as well as challenges detected. We would like to highlight the interest received from the course managers and participants in the subject, the nine new research projects, the creation of a bibliographic material, videos and recordings repository, as well as the financial resource mobilization. The challenges were mainly structural and organizational; such as the limited time the participants had to do research and work in teams, the trouble to adopt a critical approach and difficulties with the communication systems. Conclusion: this article contributes to fill the existing gap in qualitative research teaching, and invites to reconsider iniciatives regarding the training of health personnel in the countries of the region, mainly through constructivist and participative models.

RESUMO Objetivo: descrever o relato de uma experiência sobre a proposta, o processo e os resultados de um programa de formação em pesquisa qualitativa, dirigido a professores de enfermagem, baseado no modelo pedagógico construtivista. Método: de 3 de novembro de 2016 a 12 de outubro de 2017entre 3/11/2016 e 12/10/2017 implementamos um curso, em uma faculdade de enfermagem no Uruguai, do qual participaram de forma voluntária 39 professores. O relato da experiência que apresentamos é baseado na avaliação do curso, que foi feito por meio da observação participante, questionários e uma sessão de diálogo com os alunos, na qual se discutiram os resultados do curso. Resultados: a implementação do curso permitiu alcançar conquistas e vislumbrar desafios. Destaca-se o interesse dos gerentes e participantes no tema, contando com nove projetos de pesquisa, um repositório com material bibliográfico, vídeos e gravações, além da mobilização de recursos financeiros. Os desafios foram estruturais e organizacionais; dentre eles, o pouco tempo das participantes para pesquisar ou trabalhar em equipe, dificuldades para adotar uma perspectiva crítica e problemas com os sistemas de comunicação. Conclusão: este trabalho visa a preencher uma lacuna existente sobre o ensino da pesquisa qualitativa, convidando a repensar iniciativas tendentes à formação do pessoal da saúde nos países da região, principalmente desde modelos construtivistas e participativos.

RESUMEN Objetivo: describir el relato de experiencia sobre la propuesta, el proceso y los resultados de un programa de formación en investigación cualitativa dirigido a docentes de enfermería basado en el modelo pedagógico constructivista. Método: entre 3 de octubre de 2016 a 12 de noviembre de 2017, implementamos un curso en una facultad de enfermería en Uruguay, en el que participaron de forma voluntaria 39 docentes. El relato de la experiencia que se presenta se basa en la evaluación del curso, que se hizo por medio de observación participante, cuestionarios y una sesión de dialogo con los alumnos en la que se discutieron los resultados del curso. Resultados: la implementación del curso permitió alcanzar logros y entrever desafíos. Se destaca el interés de los gestores y participantes en el tema, el contar con nueve proyectos de investigación, un repositorio con material bibliográfico, videos y grabaciones, así como la movilización de recursos financieros. Los desafíos fueron estructurales y organizativos; entre ellos, el poco tiempo de las participantes para investigar o trabajar en equipo, dificultades para adoptar una perspectiva crítica y problemas con los sistemas de comunicación. Conclusión: este trabajo abona a llenar una laguna existente sobre la enseñanza de la investigación cualitativa, invitando a repensar iniciativas tendientes a la formación del personal de la salud en los países de la región, principalmente desde modelos constructivistas y participativos.

Humanos , Adulto , Persona de Mediana Edad , Enseñanza , Enfermería , Investigación Cualitativa , Docentes , Facultades de Enfermería , Salud , Educación , Docentes de Enfermería , Formación del Profesorado
Texto & contexto enferm ; 29: e20180399, Jan.-Dec. 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1101980


ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: "hipertensão" (hypertension), "educação em saúde" (health education) and "qualidade de vida" (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.

RESUMO Objetivo: evaluar la eficacia de las intervenciones educativas en el mejoramiento de la calidad de vida de personas con hipertensión arterial. Método: revisión integradora de la literatura que incluyó estudios que han realizado intervenciones educativas direccionadas al público hipertenso con el objetivo de mejorar su calidad de vida. La búsqueda se realizó en las bases de datos MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sin restricción de idioma, fecha ni tamaño de muestra. A tal efecto, se utilizaron los descriptores "hipertensión", "educación en salud" y "calidad de vida". Se tomaron 619 artículos y luego de un proceso de selección y análisis esta revisión se compone de un total de 10. La extracción y el análisis de datos se realizaron con el auxilio de instrumentos validados e se procedió a la síntesis de los resultados. Resultados: la mayor parte de los estudios se desarrolló con carácter casi experimental mediante el uso instrumentos genéricos para medir la calidad de vida, con significativa mejoría después de realizadas las intervenciones educativas, siendo la tecnología grupal la estrategia educacional más utilizada. Apenas un estudio utilizó un instrumento específico para la evaluación de hipertensos. Conclusión: estos resultados pueden direccionar las intervenciones que deben llevarse a cabo por profesionales de la salud en el manejo de la presión arterial. Es necesario profundizar las investigaciones para identificar y verificar las intervenciones más eficientes en pacientes hipertensos, considerando perfiles heterogéneos a fin de mejorar su calidad de vida.

RESUMO Objetivo: avaliar a efetividade de intervenções educativas na melhora da qualidade de vida de pessoas com hipertensão arterial. Método: revisão integrativa da literatura que incluiu estudos que realizaram intervenções educacionais direcionadas ao público hipertenso com vistas à melhora da qualidade de vida. Busca realizada nas bases de dados: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sem restrição de idioma, data e tamanho amostral. Para tal, cruzaram-se os descritores: "hipertensão", "educação em saúde" e "qualidade de vida". Foram resgatados 619 artigos e após o processo de seleção e análise, um total de 10 compuseram esta revisão. A extração e análise dos dados foram realizadas com auxílio de instrumentos validados e o resultado sumarizado. Resultados: a maioria dos estudos foi desenvolvida em caráter quase experimental, utilizando-se de instrumentos genéricos para mensuração da qualidade de vida com melhora significativa após a realização de intervenções educativas, sendo a tecnologia grupal a estratégia educacional mais utilizada. Apenas um estudo utilizou instrumento específico para avaliação em hipertensos. Conclusão: estes resultados podem direcionar as intervenções a serem implementadas por profissionais de saúde no manejo da hipertensão arterial. Futuras investigações são necessárias para identificar e verificar as intervenções mais eficazes aos pacientes hipertensos, considerando perfis heterogêneos e visando à melhora da qualidade de vida.

Calidad de Vida , Enfermedad Crónica , Hipertensión , Salud , Educación en Salud , Revisión , Presión Arterial , Análisis de Datos
Texto & contexto enferm ; 29: e20180376, Jan.-Dec. 2020. graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059136


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.

Enfermedades Cardiovasculares , Sentido de Coherencia , Calidad de Vida , Salud , Revisión , Adulto , Estilo de Vida Saludable
Texto & contexto enferm ; 29: e20180348, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059138


ABSTRACT Objective: To identify the factors associated with clinical deterioration recognized by a Pediatric Early Warning Score. Method: A cross-sectional study conducted in a tertiary pediatric public hospital with 271 children aged from zero to ten, hospitalized between May and October 2015. For the identification of the children with and without signs of clinical deterioration, the translated, adapted and validated version of the Brighton Pediatric Early Warning Score was applied to the Brazilian context. Logistic regression analysis and prevalence ratio (PR) were used to measure the association between the variables studied. A 95% Confidence Interval (CI) and p value were adopted as a measure of statistical significance to identify potential associated factors. Results: The factors associated with the clinical deterioration of the children studied were age ≤ 2 years old (p=0.000), hospitalization in the emergency unit (p=0.000), comorbidity (p=0.020) and clinical diagnosis of respiratory disease (p=0.000). Conclusion: Children ≤ 2 years old, with comorbidity, diagnosed with respiratory disease and hospitalized in the emergency unit showed an increased likelihood of clinical deterioration. The identification of factors associated with clinical deterioration may alert and direct the health team to children more susceptible to this phenomenon.

RESUMEN Objetivo: identificar los factores asociados al deterioro clínico reconocido por una Puntuación Pediátrica de Alerta Temprana. Método: estudio de corte transversal realizado en un hospital público pediátrico terciario con 271 niños de cero a diez años de edad, hospitalizados entre mayo y octubre de 2015. Para identificar a los niños con y sin signos de deterioro clínico, se aplicó la versión traducida, adaptada y validad del Brighton Pediatric Early Warning Score para el contexto brasileño. Se utilizaron el análisis de regresión logística y la relación de prevalencia (RP) para medir la asociación entre las variables estudiadas. Se adoptaron el Intervalo de Confianza (IC) del 95% y el Valor de p como medida de significancia estadística para identificar los potenciales factores asociados. Resultados: los factores asociados al deterioro clínico de los niños estudiados fueron los siguientes: edad ≤ 2 años (p=0,000), internación en la unidad de emergencia (p=0,000), comorbilidad (p=0,020) y diagnóstico clínico de enfermedad respiratoria (p=0,000). Conclusión: los niños con una edad máxima de 2 años, con alguna comorbidad, con diagnóstico de enfermedad respiratoria e internadas en la unidad de emergencia presentaron una mayor probabilidad de deterioro clínico. Identificar factores asociados al deterioro clínico puede servir como alerta y orientar al equipo de salud hacia los niños más susceptibles a este fenómeno.

RESUMO Objetivo: identificar os fatores associados à deterioração clínica reconhecida por um Escore Pediátrico de Alerta Precoce. Método: estudo de corte transversal, realizado num hospital público pediátrico terciário, com 271 crianças de zero a dez anos, hospitalizadas entre maio e outubro de 2015. Para a identificação das crianças com e sem sinais de deterioração clínica, foi aplicada a versão traduzida, adaptada e validada do Brighton Pediatric Early Warning Score para o contexto brasileiro. Foram utilizadas a análise de regressão logística e a razão de prevalência (RP) para medir a associação entre as variáveis estudadas. O Intervalo de Confiança (IC) de 95% e Valor de p foram adotados como medida de significância estatística para a identificação dos potenciais fatores associados. Resultados: os fatores associados à deterioração clínica das crianças estudadas foram idade ≤ 2 anos (p=0,000), internamento na unidade de emergência (p=0,000), comorbidade (p=0,020) e diagnóstico clínico de doença respiratória (p=0,000). Conclusão: crianças ≤ 2 anos, portadoras de comorbidade, com diagnóstico de doença respiratória e internadas na unidade de emergência apresentaram aumento da probabilidade de deterioração clínica. A identificação de fatores associados à deterioração clínica pode alertar e direcionar a equipe de saúde para crianças mais suscetíveis a esse fenômeno.

Humanos , Recién Nacido , Lactante , Preescolar , Niño , Enfermería Pediátrica , Niño Hospitalizado , Salud , Salud del Niño , Deterioro Clínico , Alertas , Hospitalización
Texto & contexto enferm ; 29: e20180471, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059140


ABSTRACT Objective: to analyze the knowledge of the elderly assisted by the Unified Health System (Sistema Único de Saúde, SUS) about HIV/AIDS infection in a health unit, before and after an educational intervention. Method: a quasi-experimental study analyzing the changes related to the knowledge about HIV/AIDS of 60 elderly individuals divided into two groups, who participated in an educational intervention, in an outpatient clinic of a SUS rehabilitation center in the second half of 2016. To evaluate the effectiveness of the teaching/learning process, a semi-structured questionnaire called QHIV3I was applied before and after the intervention. For data analysis, the generalized version of McNemar's chi-square test was used. Results: comparing the knowledge of the elderly before and after the educational intervention showed a higher number of correct answers, with a minimum percentage of 3.34% and a maximum of 75%. Significant statistical differences were found in one of the questions in the concept, transmission and treatment domains; and in the two vulnerability questions. Conclusion: it was found that the educational intervention contributed to the improvement of knowledge about HIV/AIDS in the elderly population. Thus, it is reasserted that the health promotion policy finds its essential foundation in health education strategies.

RESUMEN Objetivo: analizar el conocimiento de los ancianos atendidos por el Sistema Único de Salud (SUS) acerca de la infección por VIH/SIDA en una unidad de salud, tanto antes como después de una intervención educativa. Método: estudio cuasi-experimental en el que se analizaron los cambios relacionados con el conocimiento sobre VIH/SIDA de 60 ancianos subdivididos en dos grupos y que participaron de una intervención educativa en el área de atención ambulatoria de un centro especializado en rehabilitación del SUS, durante el segundo semestre de 2016. Para evaluar la eficacia del proceso de enseñanza/aprendizaje se aplicó un cuestionario semiestructurado denominado QHIV3I, antes y después de la intervención. En el análisis de los datos se utilizó la versión generalizada de la prueba de chi-cuadrado de McNemar. Resultados: en la comparación de los conocimientos de los ancianos antes y después de la intervención educativa se evidenció una mayor cantidad de respuestas correctas, con un porcentaje mínimo de 3,34% y uno máximo de 75%. Se encontraron diferencias significativas en una de las preguntas de los dominios de concepto y de transmisión y tratamiento, además de en las dos preguntas sobre vulnerabilidad. Conclusión: se constató que la intervención educativa contribuyó a mejorar los conocimientos sobre VIH/SIDA en la población de la tercera edad. Esto reafirma que la política de promoción de la salud encuentra sus fundamentos esenciales en las estrategias de educación en salud.

RESUMO Objetivo: analisar o conhecimento dos idosos atendidos pelo Sistema Único de Saúde (SUS) acerca da infecção do HIV/aids numa unidade de saúde, antes e após intervenção educativa. Método: estudo quase-experimental, em que se analisou as mudanças relativas ao conhecimento sobre HIV/aids de 60 idosos subdivididos em dois grupos, que participaram de intervenção educativa, num ambulatório de um centro especializado em reabilitação do SUS no segundo semestre de 2016. Para avaliar a eficácia do processo de ensino/aprendizagem, aplicou-se questionário semiestruturado denominado QHIV3I, antes e após a intervenção. Na análise dos dados, utilizou-se a versão generalizada do teste qui-quadrado de McNemar. Resultados: a comparação dos conhecimentos dos idosos antes e depois da intervenção educativa evidenciaram maior número de acertos, com percentual mínimo de 3,34% e máximo de 75%. Diferenças estatísticas significativas foram encontradas em uma das questões nos domínios conceito, transmissão e tratamento; e nas duas questões sobre vulnerabilidade. Conclusão: constatou-se que a intervenção educativa contribuiu para o aprimoramento de conhecimentos sobre HIV/aids na população idosa. Com isso, reafirma-se que a política de promoção da saúde encontra nas estratégias de educação em saúde seu alicerce essencial.

Humanos , Anciano , Salud del Anciano , Educación en Salud , Síndrome de Inmunodeficiencia Adquirida , VIH , Sistema Único de Salud , Salud , Transmisión de Enfermedad Infecciosa , Promoción de la Salud , Aprendizaje
Artículo en Inglés | MEDLINE | ID: mdl-33266386


The global spread of COVID-19 requires not only national-level responses but also active compliance with individual-level prevention measures. Because COVID-19 is an infectious disease that spreads through human contact, it is impossible to end its spread without individuals' active cooperation and preventive behavior. This study analyzes the effects of health beliefs and resource factors on behaviors to prevent COVID-19. In particular, it analyzes how resource factors moderate the impact of health beliefs on preventive behavior. A regression analysis showed that gender (female), age, number of elderly people in one's family, perceived severity, perceived benefit, self-efficacy, poor family health, media exposure, knowledge, personal health status, and social support positively affected preventive actions, whereas perceived susceptibility negatively affected them. In explaining preventive actions, self-efficacy had the greatest explanatory power, followed by gender (female), knowledge, personal health status, perceived severity, and social support. In addition, an analysis of moderating effects shows that resource variables, such as education level, personal health status, and social support, play moderating roles in inducing preventive actions.

/prevención & control , Cultura , Conductas Relacionadas con la Salud , Control de Enfermedades Transmisibles/estadística & datos numéricos , Femenino , Salud , Humanos , Masculino , Pandemias
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(10): 1204-1214, 2020 Oct 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-33268582


OBJECTIVES: Sleep disorders directly affect health-related quality of life, so it is of great significance to investigate the risk factors of sleep disorders and to actively intervene. This study aims to investigate the relationship between dietary patterns and associated factors and sleep disorders among the health screening populations in Changsha. METHODS: A cross-sectional study was carried out in 86 073 subjects aged 18-70 years old who underwent the health screening. The association between dietary patterns and sleep disorders was analyzed. The associated factors for sleep disorders were identified via by principal component analysis and classification tree model. RESULTS: The overall prevalence of reporting sleep disorders was 18.64%. Four major dietary patterns (healthy, snacks, whole-grain, and fried food patterns) were identified. In logistic regression, snacks and fried food patterns had higher risk of sleep disorders. The whole-grain pattern was a protective factor for sleep disorders. Nine associated factors including age, susceptibility to anxiety, snacking parterns, feelings of depression, chronic pain, physical activity, educational level, gender, and weight, and 9 groups at high risk for sleep disorders were identified by classification tree model. CONCLUSIONS: Sleep disorders are prevalent in the health screening population of Changsha. There is a close association between snacks dietary patterns and sleep disorders. It is necessary to promote healthy and reasonable diet, and keep good lifestyle for the prevention and control of sleep disorders. Health management after physical examination should take different health interventions for high-risk groups with different characteristics of sleep disorders.

Calidad de Vida , Trastornos del Sueño-Vigilia , Adolescente , Adulto , Anciano , Estudios Transversales , Dieta , Conducta Alimentaria , Salud , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/epidemiología , Adulto Joven
Georgian Med News ; (307): 158-161, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33270596


The present study was aimed to determine the parents' knowledge level about vit D importance for children normal health state, functions of vit D, sources, recommended duration of supplementation or treatment.The questionnaire was utilized as cross-sectional survey to determine the awareness of parents about vit D influence and importance for child health. The questionnaire was designed by the author. The survey questions covered the topics of parents'/caregivers' information needs; understanding of importance of vit D supplementation, causes of vit D deficiency, duration of supplementation, importance of screening adolescent girls for vit D deficiency. The survey was administered to parents/ caregivers of children of age from 1 to 15 years old living in Tbilisi and different regions of Georgia. The data were analyzed using Excel.A total 850 individuals participated in the study. Most of them 88,3% believed vit D to be important for health of a child, but could not explain why. 74% of respondents could identify oily fish or eggs as main source of vit D. However, 46% believed dairy products to be a good dietary source of vitamin D. More than 59% of participants supported their children by vit D drops up to age of 1 year, 40% by themselves decide to give it only 1-2-months. Only 12% of mothers continue to support her child by vit D till 24 months and more. About the importance for vit D deficiency prevention among adolescent girls, as for future mothers, 85,3 % of participants answered they have no information about this. According to received results, the parental awareness and level of knowledge about vit D importance for child normal growth and health is poor.Sothere is a need for increased levels of parental education to ensure children have a better chance of maintaining adequate vitamin D levels.

Padres , Vitamina D , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Georgia (República) , Salud , Humanos , Lactante , Encuestas y Cuestionarios
Z Psychosom Med Psychother ; 66(4): 337-354, 2020 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-33284068


The application of the BL-38 subjective complaints scale in an epidemiological cohort study (Study of Health in Pomerania) Objective: We provide an overview of the application of the BL-38 complaints scale in the epidemiological Study of Health in Pomerania. We examine the influence of socio-demographic variables on complaint burden and the stability of complaint burden over time. Methods: 16 studies that used the BL-38 in analyses of SHIP-data were examined in terms of how the BL-38 was operationalised and the statistically significant results yielded. We conduct linear regression analyses to assess effects of sociodemographic variables on complaint burden in four SHIP populations and assess test-retest-reliability over a 17-year period. Results: The BL-38 is predominantly used flexibly to depict specific complaints in analyses covering a heterogeneous range of disciplines and study questions. Total, somatic and mental complaint burden have different determinant, predictive and confounding effects. Test-retest-reliability was moderate. Conclusions: The BL-38 allows consideration of (specified) health complaint patterns across many research disciplines. Cross-sectional and longitudinal reproducibility of significant results underlines its validity. The results underscore the importance of subjective health complaints in epidemiological and psychosomatic research.

Salud , Estudios de Cohortes , Estudios Transversales , Demografía , Alemania/epidemiología , Encuestas Epidemiológicas , Humanos , Modelos Lineales , Polonia/epidemiología , Medicina Psicosomática , Reproducibilidad de los Resultados