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1.
J Educ Health Promot ; 12: 316, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38023103

RESUMO

BACKGROUND: Children and adolescents with autism spectrum disorder (ASD) have difficulties that limit their opportunities to interact with peers and family members. These behaviors can lead to social exclusion, and consequently social isolation. The aim was to compare social isolation of children and adolescents with ASD according to age, marital status, and number of siblings. MATERIALS AND METHODS: Cross-sectional descriptive study in 37 subjects with ASD. Social isolation was assessed using a 6-item scale (with five alternatives). The sociodemographic variables were age, sex, marital status of parents, and number of siblings. Two groups were formed according to age (children from 4 to 10 years old and adolescents from 11 to 20 years old). RESULTS: For the total score of the social isolation scale, children showed a higher score (21.1 ± 4.7) than adolescents (17.7 ± 5.7). Children living with divorced parents had lower scores (16.2 ± 3.6), compared to married (22.2 ± 4.5) and cohabiting (22.8) children. For the number of siblings, with no siblings 17.2 ± 3.1 points, one sibling 22.2 ± 3.5 points, two siblings 22.1 ± 3.1 points, and three siblings 22.4 ± 3.2 points (P < 0.05). Age was related to social isolation (r = -0.30, P < 0.05). CONCLUSION: Children who live with divorced parents and have no siblings presented a higher degree of isolation in relation to their counterparts who live with both parents and have at least one sibling. Age plays a relevant role, with children aged 4-10 years presenting a lower degree of isolation than the adolescent group. It is suggested that the preservation of a functional family and the presence of siblings could contribute to improving social isolation.

2.
Heliyon ; 9(10): e20353, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37822634

RESUMO

Concern about green practices by companies and people has grown exponentially worldwide, considering them as a key element sustaining the development of competitive advantages. Given the present competitive, dynamic, and turbulent supermarket environment, managing environmental practices is essential for their survival. This study has two objectives: First, studying the relationship between green practices and customer satisfaction and, second, analyzing the impact of green practices and satisfaction on loyalty, word-of-mouth, and willingness to pay more via a quantitative study on a convenience sample of 458 customers from different Chilean supermarkets. Partial least square regression was used to analyze data. Results show the importance of green practices for developing satisfaction and different customer behaviors such as loyalty, word-of-mouth, and willingness to pay more. In addition, results prove satisfaction's positive impact on loyalty, word-of-mouth, and willingness to pay more. Those results also provide empirical evidence about the effects of green practices on the supermarket industry and, in this way, their advancement toward more sustainable management.

3.
Adv Exp Med Biol ; 2023 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-37548871

RESUMO

Chronic obstructive pulmonary disease (COPD) patients manifest muscle dysfunction and impaired muscle oxidative capacity, which result in reduced exercise capacity and poor health status. The aim of this study was to compare the physical performance, systemic inflammation, and oxidative stress of patients with moderate COPD, and to associate physical performance with inflammatory and oxidative stress plasma markers. Twenty CONTROL (n = 10) and moderate COPD (n = 10) patients participated in this study. Systematic inflammation and oxidative stress plasma markers, maximal aerobic capacity (VO2peak), and maximal isometric strength (MVIC) of the knee extensor (KE) muscles were measured. VO2peak was 31.3% greater in CONTROL compared to COPD (P = 0.006). The MVIC strength of the KE was 43.9% greater in CONTROL compared to COPD (P = 0.002). Tumor necrosis factor-alpha (TNF-α) was 79.6% greater in COPD compared to CONTROL (P < 0.001). Glutathione peroxidase activity (GPx) activity was 27.5% lesser in COPD compared to CONTROL (P = 0.05). TNF-α concentration was correlated with KE MVC strength (R = -0.48; P = 0.045) and VO2peak (R = -0.58; P = 0.01). Meanwhile, malondialdehyde (MDA) and GPx activity were not associated with KE strength or VO2peak (P = 0.74 and P = 0.14, respectively). COPD patients showed lesser muscle strength and aerobic capacity than healthy control individuals. Furthermore, patients with COPD showed greater systemic inflammation and lesser antioxidant capacity than healthy counterparts. A moderate association was evident between levels of systemic inflammation and physical performance variables.

4.
Heliyon ; 9(7): e16881, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37496913

RESUMO

E-commerce and the use of social media, particularly Twitter, both grew rapidly during the COVID-19 period. Companies may significantly benefit from social media management, which highlights the significance of responsible consumerism highlighted in SDG 12. This study analyzed the relationship of the level of engagement of leading US e-commerce companies according to their position in the financial market through the use of Twitter. The methodology was a quantitative and longitudinal approach, analyzing statistically (through statistical analysis to descriptive statistics, multiple and simple regressions). The 22,400 tweets during 2020, to estimate their engagement. The results showed that the level of engagement on Twitter is not directly related to the financial ranking, neither to its sales nor to the share price. The main contribution lies in the contribution to the literature, to guide academics, managers and CEOs of companies in efficient decision-making in their business strategies in the areas of marketing with the use of Twitter, where companies can boost loyalty, engagement and sales of their users.

5.
Nutr. hosp ; 40(2): 400-411, mar.-abr. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-219339

RESUMO

Background: lifestyle and cardiometabolic risk factors information is scarce regarding youth and adults of Latin-American ethnics. Objective: the primary aim was to describe the lifestyle and cardiometabolic risk factors for arterial hypertension (HTN) and diabetes in ethnic Latin-American groups (Mapuche and Aymara) and other non-ethnics > 15 years of age in the Chilean population. A secondary aim was to determine the association between physical activity ‘intensity’ with HTN and diabetes markers. Material and methods: a representative sample from the National Chilean Health Survey 2016-2017, included Mapuche (EG-Map; women n = 166, men n = 300; total n = 466), Aymara (EG-Aym; women n = 96, men n = 55; total n = 151), and a non-ethnic population group (No-EG; women n = 2057, men n = 3445; total n = 5502). The main outcomes were; systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (GL), and secondary outcomes were other anthropometric, lipid profile, and lifestyle parameters. Results: GL was significantly associated with nutrition (0.9 %, p < 0.0001), tobacco and alcohol habits (0.6 %, p < 0.0001). SBP was significantly associated with nutrition (whole-grains 0.04, p = 0.001; water consumption 0.07, p < 0.0001), sleep hygiene (week 0.04, p = 0.030; on weekends -0.04, p = 0.026), and alcohol consumption (-0.06, p < 0.0001). Conclusion: in conclusion, lifestyle differences among Mapuche and Aymara ethnic groups in comparison with non-ethnic Chilean peers > 15 years are significantly associated with blood pressure and glycemia. (AU)


Antecedentes: la información sobre estilos de vida y factores de riesgo cardiometabólico es escasa en jóvenes y adultos de etnia latinoamericana. Objetivo: el objetivo principal fue describir el estilo de vida y los factores de riesgo cardiometabólico para la hipertensión arterial (HTA) y la diabetes en grupos étnicos latinoamericanos (Mapuche y Aymara) y otros no étnicos > 15 años de la población chilena. Un objetivo secundario fue determinar la asociación de la “intensidad” de la actividad física con la HTA y los marcadores de diabetes. Material y métodos: muestra representativa de la Encuesta Nacional de Salud de Chile 2016-2017, compuesta por mapuches (EG-Map; mujeres n = 166, hombres n = 300; total n = 466), aymaras (EG-Aym; mujeres n = 96, hombres n = 55; total n = 151) y un grupo poblacional no étnico (No-GE; mujeres n = 2057, hombres n = 3445; total n = 5502). Las principales evaluaciones fueron la presión arterial sistólica (PAS), la presión arterial diastólica (PAD) y la glucosa plasmática en ayunas (GL), y los resultados secundarios fueron otros parámetros antropométricos, del perfil lipídico y del estilo de vida. Resultados: la GL se asoció significativamente a los hábitos nutricionales (0,9 %, p < 0,0001) y los hábitos de tabaco y alcohol (0,6 %, p < 0,0001). La PAS se asoció significativamente con la nutrición (cereales integrales 0,04, p = 0,001; consumo de agua 0,07, p < 0,0001), higiene del sueño (semana 0,04, p = 0,030; fines de semana -0,04, p = 0,026) y consumo de alcohol (- 0,06, p < 0,0001). Conclusión: en conclusión, las diferencias de estilo de vida entre las etnias mapuche y aymara en comparación con sus pares chilenos no étnicos mayores de 15 años se asocian significativamente con la presión arterial y la glucemia. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus , Hipertensão/epidemiologia , Estudos Transversais , Chile/epidemiologia , Pressão Arterial , Etnicidade , Estilo de Vida , Fatores de Risco
6.
Nutr Hosp ; 40(2): 400-411, 2023 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-36748410

RESUMO

Introduction: Background: lifestyle and cardiometabolic risk factors information is scarce regarding youth and adults of Latin-American ethnics. Objective: the primary aim was to describe the lifestyle and cardiometabolic risk factors for arterial hypertension (HTN) and diabetes in ethnic Latin-American groups (Mapuche and Aymara) and other non-ethnics > 15 years of age in the Chilean population. A secondary aim was to determine the association between physical activity 'intensity' with HTN and diabetes markers. Material and methods: a representative sample from the National Chilean Health Survey 2016-2017, included Mapuche (EG-Map; women n = 166, men n = 300; total n = 466), Aymara (EG-Aym; women n = 96, men n = 55; total n = 151), and a non-ethnic population group (No-EG; women n = 2057, men n = 3445; total n = 5502). The main outcomes were; systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (GL), and secondary outcomes were other anthropometric, lipid profile, and lifestyle parameters. Results: GL was significantly associated with nutrition (0.9 %, p < 0.0001), tobacco and alcohol habits (0.6 %, p < 0.0001). SBP was significantly associated with nutrition (whole-grains 0.04, p = 0.001; water consumption 0.07, p < 0.0001), sleep hygiene (week 0.04, p = 0.030; on weekends -0.04, p = 0.026), and alcohol consumption (-0.06, p < 0.0001). Conclusion: in conclusion, lifestyle differences among Mapuche and Aymara ethnic groups in comparison with non-ethnic Chilean peers > 15 years are significantly associated with blood pressure and glycemia.


Introducción: Antecedentes: la información sobre estilos de vida y factores de riesgo cardiometabólico es escasa en jóvenes y adultos de etnia latinoamericana. Objetivo: el objetivo principal fue describir el estilo de vida y los factores de riesgo cardiometabólico para la hipertensión arterial (HTA) y la diabetes en grupos étnicos latinoamericanos (Mapuche y Aymara) y otros no étnicos > 15 años de la población chilena. Un objetivo secundario fue determinar la asociación de la "intensidad" de la actividad física con la HTA y los marcadores de diabetes. Material y métodos: muestra representativa de la Encuesta Nacional de Salud de Chile 2016-2017, compuesta por mapuches (EG-Map; mujeres n = 166, hombres n = 300; total n = 466), aymaras (EG-Aym; mujeres n = 96, hombres n = 55; total n = 151) y un grupo poblacional no étnico (No-GE; mujeres n = 2057, hombres n = 3445; total n = 5502). Las principales evaluaciones fueron la presión arterial sistólica (PAS), la presión arterial diastólica (PAD) y la glucosa plasmática en ayunas (GL), y los resultados secundarios fueron otros parámetros antropométricos, del perfil lipídico y del estilo de vida. Resultados: la GL se asoció significativamente a los hábitos nutricionales (0,9 %, p < 0,0001) y los hábitos de tabaco y alcohol (0,6 %, p < 0,0001). La PAS se asoció significativamente con la nutrición (cereales integrales 0,04, p = 0,001; consumo de agua 0,07, p < 0,0001), higiene del sueño (semana 0,04, p = 0,030; fines de semana -0,04, p = 0,026) y consumo de alcohol (- 0,06, p < 0,0001). Conclusión: en conclusión, las diferencias de estilo de vida entre las etnias mapuche y aymara en comparación con sus pares chilenos no étnicos mayores de 15 años se asocian significativamente con la presión arterial y la glucemia.


Assuntos
Diabetes Mellitus , Hipertensão , Masculino , Adulto , Adolescente , Humanos , Feminino , Etnicidade , Fatores de Risco Cardiometabólico , Chile/epidemiologia , Hipertensão/epidemiologia , Pressão Sanguínea , Estilo de Vida , Fatores de Risco
8.
Obes Rev ; 23(3): e13408, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34927337

RESUMO

Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss, its impact on cardiorespiratory fitness (CRF) is still unclear. We aimed to examine postoperative changes in CRF (VO2max/peak ) and its relationship with weight loss among adults undergoing BS. We systematically searched the WoS, PubMed, MEDLINE, and Scopus databases. Observational and intervention studies were selected reporting the presurgery and postsurgery CRF, measured by breath-by-breath VO2 or its estimation. Eleven articles (312 patients) revealed that BS leads to a reduction in absolute VO2max/peak in the short term (effect size, ES = -0.539; 95%CI = -0.708, -0.369; p < 0.001), and those patients who suffered a more significant decrease in BMI after BS also had a greater loss of absolute VO2max/peak . However, VO2max/peak relative to body weight increased after surgery (ES = 0.658; 95%CI = 0.473, 0.842; p < 0.001). An insufficient number of studies were found investigating medium and long-term changes in CRF after BS. This study provides moderate-quality evidence that the weight loss induced by BS can reduce CRF in the short term, which represents a therapeutic target to optimize BS outcomes. More high-quality studies are needed to evaluate the impact of BS on VO2max/peak in the short, medium, and long term including normalized values for fat-free mass.


Assuntos
Cirurgia Bariátrica , Aptidão Cardiorrespiratória , Adulto , Humanos , Período Pós-Operatório , Redução de Peso
9.
J Cancer Educ ; 37(1): 179-187, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-32666504

RESUMO

Advances in cancer treatment are impeded by low accrual rates of patients to cancer clinical trials (CCTs). The national rates of recruitment of underserved groups, including racial/ethnic minorities, are limiting the generalizability of research findings and are likely to enhance inequities in cancer outcomes. The goal of this study was to examine willingness to participate (WTP) in CCTs and factors associated with this willingness among patients and caregivers attending a minority-serving university cancer center in the Southwest. A cross-sectional survey design was utilized (n = 236, 135 patients and 101 caregivers). Fear was the strongest predictor of WTP in CCTs. The only ethnic differences observed related to Spanish-speaking patients exhibiting increased WTP in CCTs, and Spanish-speaking caregivers' decreased WTP, compared to others. These results underscore the importance of future interventions to reduce CCT-related fear among patients and caregivers, with particular need for family-focused tailored interventions designed to meet the needs of Spanish-speaking patients and caregivers.


Assuntos
Cuidadores , Neoplasias , Estudos Transversais , Hispânico ou Latino , Humanos , Grupos Minoritários , Neoplasias/terapia
10.
Acta Bioeng Biomech ; 24(2): 37-45, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-38314466

RESUMO

PURPOSE: The objective of the study was to describe and compare the acute response of muscle oxygen saturation (SmO2) and hemoglobin concentration (Hgb) in the vastus lateralis (VL) during resistance exercise protocols until failure. METHODS: Sixteen males were considered (mean ± SD, age = 36.12 ± 6.40 years). Two familiarization sessions and one evaluation session were carried out where three force protocols were executed in the VL, one of them was isometric load (P1) and two of dynamic load (P2 and P3). SmO2 [%] and Hgb [g/dL] were measured before and after each of these protocols. For P1, three series of 8 s of maximum isometric strength with the rest of 60 s between each set, the average isometric strength (AIS), and the isometric peak strength (IPS) were also recorded. After five minutes, P2 was performed, with an initial load of 40% of AIS. Then, at 30 minutes, P3 was performed considering an initial load of 40% of IPS. RESULTS: The results suggest (I) minimum levels of SmO2 (66.31 ± 9.38%) and Hgb (12.22 ± 0.55 g/dL) during P2, (II) no significant differences were observed between the average loads of the respective protocols for SmO2 and (III) muscle Hgb differed significantly between rest with P1 and P3. CONCLUSIONS: Exercises of increasing intensity and of short duration do not significantly modify SmO2. However, Hgb increases substantially compared baseline values.

11.
Front Public Health ; 9: 662439, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34368045

RESUMO

Significance: Immigrant day laborers suffer from disproportionate occupational health risks from hazardous reconstruction jobs after natural disasters. Methods: We conducted a randomized controlled trial of a short-video educational intervention to improve safety knowledge and intent to engage in safety preventive behaviors among 98 Hispanic day laborers (49 randomized to video and 49 control). The short video featured a male promotor and a female promotora who narrated 3 stories of day laborers who were injured while doing construction work in post-Katrina New Orleans. The main outcome measures were changes in scores for day laborer-reported safety knowledge and safety behaviors derived from interviewer-delivered baseline and post-intervention surveys. Results: Video participants reported improvement in overall average safety knowledge score (mean score of 11.3 out of a max score of 12 or 94% when standardized to 0-100% scale), as compared to the control group (mean score of 8.6 or 72%) who were not offered the video (p < 0.00001). The intervention was highly successful in workers stating that they learned and were willing to change their safety preventive behaviors to reduce their occupational risk. The average safety behavior score was higher among those watching the video (17.2 out of a max of 22 or 78.1% when standardized on a scale 0-100%) as compared to control (14.5 or 65.9%) (p = 0.0024). Conclusion: A short video intervention can improve knowledge and intent to engage in preventive behaviors among Hispanic workers for which there is a dearth of construction safety preventive research.


Assuntos
Emigrantes e Imigrantes , Saúde Ocupacional , Agentes Comunitários de Saúde , Feminino , Hispânico ou Latino , Humanos , Masculino , Inquéritos e Questionários
12.
Artigo em Inglês | MEDLINE | ID: mdl-34202138

RESUMO

Background: The purpose of this study was to determine the reliability for the strength and movement velocity of the concentric phase from the five Sit-to-Stand (5STS), using three incremental loads measured by a functional electromechanical dynamometer (FEMD) in healthy young adults. Methods: The average and peak strength and velocity values of sixteen healthy adults (mean ± standard deviation (SD): age = 22.81 ± 2.13 years) were recorded at 5, 10 and 15 kg. To evaluate the reliability of FEMD, the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. Results: Reliability was high for the 10 kg (CV range: 3.70-4.18%, ICC range: 0.95-0.98) and 15 kg conditions (CV range: 1.64-3.02%, ICC: 0.99) at average and peak strength, and reliability was high for the 5 kg (CV range: 1.71-2.84%, ICC range: 0.96-0.99), 10 kg (CV range: 0.74-1.84%, ICC range: 0.99-1.00) and 15 kg conditions (CV range: 0.79-3.11%, ICC range: 0.99-1.00) at average and peak velocity. Conclusions: The findings of this study demonstrate that FEMD is a reliable instrument to measure the average and peak strength and velocity values during the five STS in healthy young adults.


Assuntos
Movimento , Força Muscular , Adulto , Humanos , Reprodutibilidade dos Testes , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-33919532

RESUMO

Background: This study aimed to report, through a systematic review of the literature, the baseline and final reference values obtained by near-infrared spectroscopy (NIRS) of muscle oxygen saturation (SmO2) during resistance training in healthy adults. Methods: Original research studies were searched from four databases (Scopus, PubMed, WOS, and SportDiscus). Subsequently, three independent reviewers screened the titles and abstracts, followed by full-text reviews to assess the studies' eligibility. Results: Four studies met the inclusion criteria, data were extracted and methodological quality was assessed using the Downs and Black scale. Muscle oxygen saturation (% SmO2) during reported muscle strength exercises showed a decreasing trend after a muscle strength protocol; that is, before the protocol (range = 68.07-77.9%) and after (range = 9.50-46.09%). Conclusions: The trend of the SmO2 variables is to decrease after a muscle strength protocol. Studies are lacking that allow expanding the use of these devices during this type of training.


Assuntos
Treinamento de Força , Espectroscopia de Luz Próxima ao Infravermelho , Adulto , Humanos , Força Muscular , Músculo Esquelético , Oxigênio
14.
Artigo em Inglês | MEDLINE | ID: mdl-33261036

RESUMO

BACKGROUND: The objective of this study was to establish the reliability of the Humon Hex near-infrared reflectance spectroscopy (NIRS) in determining muscle oxygen saturation (SmO2) and hemoglobin concentration (Hgb) at rest and during isometric and dynamic strength exercises using a functional electromechanical dynamometer (FEMD). METHODS: The SmO2 and Hgb values of sixteen healthy adults (mean ± standard deviation (SD): Age = 36.1 ± 6.4 years) were recorded at rest and during isometry (8 s), dynamic strength I (initial load of 40% of the average isometric load, with 2 kg increments until muscle failure) and dynamic strength II (same as I, but with an initial load of 40% of the maximum isometric load) activity. To evaluate the reliability in the determination of SmO2 and Hgb of this device, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. RESULTS: The main results obtained are SmO2 at rest (CV = 5.76%, SEM = 3.81, ICC = 0.90), isometric strength (CV = 3.03%, SEM = 2.08, ICC = 0.92), dynamic strength I (CV = 10.6, SEM = 7.17, ICC = 0.22) and dynamic strength II (CV = 9.69, SEM = 6.75, ICC = 0.32); Hgb at rest (CV = 1.97%, SEM = 0.24, ICC = 0.65), isometric strength (CV = 0.98%, SEM = 0.12, ICC = 0.96), dynamic strength I (CV = 3.25, SEM = 0.40, ICC = 0.54) and dynamic strength II (CV = 2.74, SEM = 0.34, ICC = 0.65). CONCLUSIONS: The study shows that Humon Hex is a reliable device to obtain SmO2 and Hgb data in healthy adult subjects at rest and during isometric strength, providing precision for measurements made with this device.


Assuntos
Exercício Físico , Espectroscopia de Luz Próxima ao Infravermelho , Adulto , Hemoglobinas , Humanos , Força Muscular , Oxigênio , Reprodutibilidade dos Testes
15.
J Med Econ ; 23(9): 940-951, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32519908

RESUMO

Aims: This study examined the extent to which Marketplace health insurance subscribers re-enroll a second year. Among re-enrollees, we sought to examine movement to more and less generous insurance plans (based on actuarial value), and the extent to which adverse selection, adverse retention, and aging in place are evident from re-enrollment choices made.Methods: Re-enrollment from 2015 to 2016 and 2016 to 2017 and movement to more and less generous insurance plans was examined using enrollment and insurance claims data from two US Federally-facilitated Marketplace insurance carriers operating in the state of New Mexico for 2015-2017. Insurance plans are assigned to metal levels based on estimated plan actuarial value: Bronze (60%), Silver (70%), and Gold (80%). Odds ratios (ORs) and 95% confidence intervals (OR CI) were estimated using logistic regressions for subscribers with base-year healthcare utilization. ORs were estimated for (1) re-enrollment in the year following the base year, and (2) movement to a higher or lower actuarial value plan.Results: Approximately 50% of subscribers re-enrolled with the same carrier for 2016 and 60% for 2017. Being enrolled 12 months was the strongest predictor for second year re-enrollment. Older individuals were more likely to re-enroll. Re-enrollment was lower for the insurance carrier with higher second year premium changes. Chronic condition utilization characteristics were positively associated with re-enrollment. Approximately 12% of Bronze subscribers moved to Silver or Gold, and had higher utilization after re-enrollment. Among Silver subscribers, 6% moved to Gold and 6% to Bronze. Approximately 37% of Gold subscribers moved to Silver or Bronze.Discussion: Re-enrollment was similar to published non-group insurance rates. Adverse selection and aging in place were observed. Evidence was weak for adverse retention. Some coverage change choices were rational, while others suggest subscribers may have difficulty making insurance choice decisions.


Assuntos
Trocas de Seguro de Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Doença Crônica , Custos e Análise de Custo , Feminino , Humanos , Vida Independente/estatística & dados numéricos , Revisão da Utilização de Seguros/estatística & dados numéricos , Cobertura do Seguro/economia , Masculino , Pessoa de Meia-Idade , New Mexico , Razão de Chances , Estados Unidos , Adulto Jovem
16.
J Clin Med ; 9(6)2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32492882

RESUMO

BACKGROUND: In metastatic breast cancer (MBC) patients, no biomarker predicting benefit to a bevacizumab-containing therapy has been established yet. MicroRNAs (miRNAs) are involved in angiogenesis and treatment resistance and therefore could be of predictive value. METHODS: Profiling of 754 miRNAs was performed in tumor samples of 58 MBC patients treated with a bevacizumab-containing first-line regimen (learning set). Based on progression-free survival (PFS), patients were divided into responders (R) and non-responders (NR). Differentially expressed miRNAs between R and NR were analyzed in a cohort of 57 patients treated with first-line chemotherapy without bevacizumab (control set), to exclude miRNAs providing prognostic information. MiRNA candidates significantly associated with PFS in multivariate analysis were further validated in tumor samples of 203 patients treated within the phase III trial TANIA randomizing between chemotherapy either alone or with bevacizumab after progression on first-line bevacizumab. RESULTS: Low expression of miR-20a-5p (multivariate p = 0.035) and miR-21-5p (multivariate p = 0.004) were significantly associated with longer PFS in the learning set, but not in the control set. In samples from the TANIA trial, low expression of miR-20a-5p was also significantly associated with longer PFS (hazard ration (HR) 0.60; 95%-CI 0.37-0.89; p = 0.012) and longer overall survival (OS; HR 0.54; 95%-CI 0.32-0.83; p = 0.007) in the bevacizumab arm but not in the chemotherapy-only arm (PFS: HR 0.73, p = 0.119; OS: HR 1.01; p = 0.964). For miR-21-5p no significant association with PFS or OS in both treatment arms was observed. CONCLUSION: MiR-20a-5p expression in breast cancer tissue was predictive for a greater benefit from bevacizumab-containing therapy in two independent cohorts.

17.
Health Educ Behav ; 47(4): 569-580, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32449396

RESUMO

Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. We formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years). Eligible women (n = 240) from a large public hospital in California were randomly assigned to one of three study arms: Group 1 received the new brochure, Group 2 included a community health worker (CHW) who delivered the new brochure's content, and a control group received a standard educational brochure. Participants completed three surveys (baseline, postintervention, 3-month follow-up) with a 100% completion rate for the first two surveys and 80.4% completion after 3 months. We assessed the difference in outcomes for BC risk knowledge, perceived BC susceptibility, and BC information self-efficacy between groups. Participant mean age was 52.3 years, and 82.1% reported low English proficiency. Mean knowledge scores increased and perceived BC susceptibility improved for all groups (p ≤ .05), yet treatment effects were not significant between groups for these outcomes. BC information self-efficacy also increased from baseline to postintervention for all groups to >80%. After 3 months, only Group 2 and the control group retained their increases and treatment effects were significant only for Group 2 compared to other groups in unadjusted and adjusted models. A CHW-delivered intervention may be more effective in improving BC information self-efficacy among Latinas compared to print material alone. More research is needed to examine the efficacy of CHW-delivered interventions.


Assuntos
Neoplasias da Mama , Comunicação em Saúde , Neoplasias da Mama/prevenção & controle , Feminino , Hispânico ou Latino , Humanos , Pessoa de Meia-Idade , Folhetos , Autoeficácia
18.
Rev Med Inst Mex Seguro Soc ; 58(1): 50-60, 2020 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-32421270

RESUMO

Diabetes mellitus is a highly prevalent disease in the world and in Mexico. Due to its chronic evolution it causes multiple sequelae, disability and mortality. An adequate control of diabetic patients based on reaching glycemic targets, maintenance of healthy weight, as well as lipid and blood pressure control is essential to reduce the risk of progression of its complications. Lifestyle changes are also key for preventing and treating the disease. Knowledge of the relationship and mechanism involved between diabetes and alterations in nutrient metabolism should be considered to provide an adequate nutritional program. This article aims to bring healthcare professionals the concepts and strategies, proposed by several scientific societies, about nutritional management of adult patients with diabetes mellitus.


La diabetes mellitus es una enfermedad altamente prevalente en el mundo y en México. Debido a su evolución crónica, es también causa de múltiples secuelas, discapacidad y mortalidad. Un adecuado control del paciente diabético que se logre a partir de metas de glucemia, mantenimiento de peso sano, así como control de lípidos y presión arterial es indispensable a fin de disminuir el riesgo de progresión de las complicaciones de la diabetes mellitus. Los cambios en el estilo de vida son clave en la prevención y el tratamiento de la enfermedad. El conocimiento de la relación y el mecanismo involucrados entre la diabetes y las alteraciones en el metabolismo de los nutrientes debe ser considerado para brindar un programa nutricional adecuado. Este artículo pretende aproximar a los profesionales de la salud los conceptos y las estrategias nutricionales actuales, propuestos por diversas sociedades científicas, para el manejo nutricional de pacientes adultos con diabetes mellitus.


Assuntos
Diabetes Mellitus , Estilo de Vida , Estado Nutricional , Peso Corporal , Diabetes Mellitus/dietoterapia , Humanos , México
19.
Arch. med. deporte ; 36(194): 345-349, nov.-dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-187292

RESUMO

Introducción: La obesidad es considerada uno de los principales problemas de salud de la sociedad moderna, existiendo variados tratamientos para revertirla, siendo la cirugía bariátrica (CB) el método más efectivo en los casos de obesidad severa. La capacidad cardiorrespiratoria (CCR) es un componente de la condición física valorada a través del consumo máximo de oxígeno (VO2max); la cinética del VO2 es un aspecto poco estudiado de la CCR; se ha descrito que esta variable permite estimar la CCR sin elevados esfuerzos físicos en comparación con otras formas de evaluación; a pesar de lo anterior, no existe información respecto del impacto que tiene la gastrectomía vertical (GV) sobre la CCR evaluada a través de esta variable. Objetivo: Determinar el impacto de la GV en la cinética del VO2 de mujeres con obesidad. Material y método: Estudio de tipo cuasi experimental, participaron 15 mujeres con edad de 32,9±10,3 años y un IMC inicial de 35,2 ± 3,9 kg/m2. La muestra es de tipo no probabilística a través de grupo de voluntarios evaluados en tres momentos: previo a la cirugía (pre), 30 y 90 días post gastrectomía vertical (30post y 90post respectivamente). Se evaluó peso corporal, índice de masa corporal (IMC), circunferencia cintura (CC), VO2peak y cinética del VO2. Resultados: Post cirugía las variables peso corporal, CC e IMC reportan disminución significativa (p < 0,001) respecto del momento pre-cirugía. El VO2peak relativo (ml/kg/min) aumentó entre 30post y 90post (p < 0,001); el VO2peak absoluto (L/min) disminuyó entre los momentos pre con 30post y pre con 90post (p < 0,05); la cinética del VO2 presentó un incremento del tiempo a los 30post (p < 0,05). Conclusión: La cinética del VO2 se ve incrementada en mujeres obesas intervenidas con GV a los 30 días post cirugía, lo que evidencia un deterioro de la capacidad cardiorrespiratoria


Introduction: Obesity is considered one of the main health problems of modern society, there are several treatments to reverse it, being bariatric surgery (BS) the most effective method in cases of severe obesity. Cardiorespiratory fitness (CRF) is an aspect of physical condition assessed through maximum oxygen consumption (VO2max); the kinetics of VO2 is a less studied aspect of CRF; it has been described that this variable allows estimation of the CRF without high physical efforts in comparison with other forms of evaluation; In spite of the above, there is no information regarding the impact that sleeve gastrectomy (SG) has on the CRF evaluated through this variable.Objective: To determine the impact of SG on the VO2 kinetics of women with obesity. Material and method: Quasi-experimental study, 15 women with an age of 32,9 ± 10,3 years and an initial BMI of 35,2 ± 3,9 kg/m2 participated. The sample is non-probabilistic through a group of volunteers evaluated at three times: before surgery (pre), 30 and 90 days post vertical gastrectomy (30post and 90post respectively). Body weight, body mass index (BMI), waist circumference (WC), VO2peak and VO2 kinetics were evaluated. Results: After surgery, the variables body weight, CC and BMI reported a significant decrease (p < 0,001) compared to the pre-surgery moment. The relative VO2peak (ml/kg/min) increases between 30post and 90post (p < 0,001); the absolute VO2peak (L/min) decreased between the pre moments with 30post and pre with 90post (p < 0,05); the kinetics of VO2 showed an increase intime at 30post (p < 0,05). Conclusion: The VO2 kinetics is increased in obese women undergoing SG at 30post surgery, which shows a deterioration of this capacity


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Ventilação Voluntária Máxima/fisiologia , Consumo de Oxigênio/fisiologia , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica , Gastrectomia
20.
Nutr. hosp ; 36(4): 840-845, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184709

RESUMO

Introduction: the increase on prevalence of obesity has been linked to a higher number of bariatric surgeries, being sleeve gastrectomy (SG) the most frequent bariatric procedures in the world. However, there are few studies that determine the impact of SG on health's determinants such as physical fitness (PF) and physical activity (PA). Objectives: to describe the changes in PF and PA of patients after SG. Methods: twenty-three women with obesity (mean 36.1 ± 11.1 years old and body mass index [BMI] of 35.1 ± 3.4 kg/m2) were evaluated preoperatively to SG and at one and three months after surgery. An assessment of PF was conducted, including handgrip (HGS) and quadriceps muscle strength (QMS) with dynamometers and cardiorespiratory fitness (CRF) with an ergospirometer. PA was assessed with a three-axis accelerometer. Results: the absolute VO2 peak decreased after the first and third month (p < 0.001) post SG. The VO2 peak relative to body weight showed an increase from baseline after the SG (p = 0.002). After SG, there was a reduction in absolute values for HGS and QMS (p < 0.001) and an increase in relative HGS after three months post-surgery compared to preoperative (p = 0.011), without changes in relative QMS (p = 0.596). No changes in PA were observed. Conclusions: after SG, there is a short term decline on PF when it is expressed on absolute values. However, when it is expressed in relative terms to body weight, some components of PF improve, while others showed no change. There was no modification in PA levels of the participants


Introducción: el incremento en la prevalencia de la obesidad se ha relacionado con un mayor número de cirugías bariátricas, siendo la gastrectomía vertical (SG) el procedimiento bariátrico más frecuente en el mundo. Sin embargo, hay pocos estudios que analicen el impacto de la SG en determinantes de la salud, como la condición física (PF) y la actividad física (PA). Objetivo: describir los cambios en la PF y la PA después de la SG. Métodos: veintitrés mujeres con obesidad (36,1 ± 11,1 años e índice de masa corporal [IMC] de 35,1 ± 3,4 kg/m2) fueron evaluadas previo a una SG y al primer y tercer mes postoperatorio. Las evaluaciones incluyeron la valoración de fuerza de prensión manual (HGS) y de cuádriceps (QMS) con dinamómetros y de capacidad cardiorrespiratoria (CRF) con ergoespirometría. La PA fue evaluada con acelerómetros triaxiales. Resultados: el VO2 peak absoluto disminuyó al primer y tercer mes (p < 0,001) luego de la SG. El VO2 peak relativo al peso corporal aumentó después de la SG (p = 0,002). Luego de la cirugía disminuyeron HGS y QMS absolutas (p < 0,001) y aumentó HGS relativa al peso corporal al tercer mes postoperatorio (p = 0,011), sin cambios en QMS relativa (p = 0,559). No se observaron cambios en la PA posterior a SG. Conclusiones: después de SG hay un deterioro a corto plazo de la PF expresada en términos absolutos, pero al expresarse en relación al peso corporal, algunos componentes de la PF no cambian y otros mejoran. No se observaron cambios en la PA poscirugía


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Atividade Motora , Obesidade/cirurgia , Gastrectomia/métodos , Cirurgia Bariátrica , Índice de Massa Corporal , Antropometria
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