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1.
Infect Dis Poverty ; 9(1): 29, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32183901

RESUMO

BACKGROUND: The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern. METHODS: A scoping review was conducted following the methodological framework suggested by Arksey and O'Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors' affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references. RESULTS: Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus' origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care. CONCLUSIONS: There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças/prevenção & controle , Controle de Infecções , Pneumonia Viral , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Tosse/etiologia , Dispneia/etiologia , Fadiga/etiologia , Febre/etiologia , Cefaleia/etiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão
2.
Obes Rev ; 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32167233

RESUMO

The aim of this study was to conduct a systematic review and meta-analysis on the effectiveness of interventions to increase children's water consumption. A systematic literature search was conducted in seven electronic databases. Studies published in English before 18 February 2019 that evaluated any type of intervention that measured change in water consumption among children aged 2 to 12 years by applying any type of design were included. Of the 47 interventions included in the systematic review, 24 reported a statistically significant increase in water consumption. Twenty-four interventions (17 randomized controlled trials and seven studies with other controlled designs) were included in the meta-analysis. On average, children in intervention groups consumed 29 mL/d (confidence interval [CI] = 13-46 mL/d) more water than did children in control groups. This effect was larger in eight interventions focused specifically on diet (MD = 73 mL/d, CI = 20-126 mL/d) than in 16 interventions focused also on other lifestyle factors (MD = 15 mL/d, CI = 1-29 mL/d). Significant subgroup differences were also found by study setting and socioecological level targeted but not by children's age group, intervention strategy, or study design. In conclusion, there is evidence that, on average, lifestyle interventions can lead to small increases in children's daily water consumption. More research is needed to further understand the specific intervention elements that have the greatest effect.

3.
J Am Geriatr Soc ; 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32196638

RESUMO

OBJECTIVES: To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty. DESIGN: Longitudinal cohort study. SETTING: Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom. PARTICIPANTS: A total of 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years). MEASUREMENTS: The frequency of self-reported moderate PA was measured and classified into two categories: "regular frequency" and "low frequency." The 12-month change in frequency of moderate PA between baseline and follow-up was classified into four categories: "continued regular frequency," "decreased frequency," "continued low frequency," and "increased frequency." The 15-item Tilburg Frailty Indicator assessed overall, physical, psychological, and social frailty. RESULTS: Participants who undertook moderate PA with a regular frequency at baseline were less frail at 12-month follow-up than participants with a low frequency. Participants who undertook moderate PA with a continued regular frequency were least frail at baseline and at 12-month follow-up. After controlling for baseline frailty and covariates, compared with participants with a continued regular frequency, participants with a decreased frequency were significantly more overall (B = 1.31; 95% confidence interval [CI] = 0.99-1.63), physically (B = 0.80; 95% CI = 0.58-1.03), psychologically (B = 0.43; 95% CI = 0.30-0.56), and socially frail (B = 0.14; 95% CI = 0.04-0.23) at 12-month follow-up; participants with a continued low frequency were significantly more overall (B = 1.16; 95% CI = 0.84-1.49), physically (B = 0.73; 95% CI = 0.51-0.96), psychologically (B = 0.42; 95% CI = 0.29-0.55), and socially frail (B = 0.13; 95% CI = 0.04-0.23) at 12-month follow-up; the 12-month follow-up frailty level of participants who undertook moderate PA with an increased frequency was similar to those with a continued regular frequency. CONCLUSION: Maintaining a regular frequency of PA as well as increasing to a regular frequency of PA are associated with maintaining or improving overall, physical, psychological, and social frailty among European community-dwelling older adults older than 70 years.

4.
Sci Total Environ ; 709: 136246, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-31927434

RESUMO

BACKGROUND: Previous studies examined the associations of particulate matters (PM) with fetal growth in utero or birth weight with inconsistent results, and few studies investigated that whether the associations of PM with fetal growth in utero also present at birth. We aimed to investigate the associations of PM with both fetal growth in utero and birth weight. METHODS: We established a birth cohort (2014-2017) with 18,863 singleton pregnancies in Tongzhou Maternal and Child Hospital of Beijing, China. Maternal exposure to PM with aerodynamic diameters ≤2.5 µm and ≤ 10 µm (PM2.5/PM10) during pregnancy was estimated using the inverse distance weighting method. Estimated birth weight (EFW) was assessed by ultrasound measurements and birth weight was measured at birth, which were both standardized as gestational-age- and gender-adjusted Z-score. EFW undergrowth, low birth weight (LBW) and small-for-gestational-age were defined as the categorized outcomes. Generalized estimating equations and generalized linear regression were used to examine the associations of PM with quantitative and categorized outcomes, controlling for temperature, greenspace and individual covariates. RESULTS: A 10 µg/m3 increase in PM2.5 and PM10 were associated with lower EFW Z-score [-0.031, 95% confident interval (CI): -0.047, -0.016 and -0.030, 95% CI: -0.043, -0.017]. A 10 µg/m3 increase in PM2.5 was associated with lower birth weight Z-score (-0.035, 95% CI: -0.061, -0.010) and higher risk of LBW (OR = 1.240, 95% CI: 1.019, 1.508). These results remained robust in co-pollutant models and sensitivity analyses. We didn't find significant results in other analyses. CONCLUSIONS: The study identified an inverse association between PM and fetal growth in utero. The association between PM2.5 and fetal growth persisted from pregnancy to birth. This study supported that further actions towards controlling air pollution are strongly recommended for promoting early-life health.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31963427

RESUMO

Background: This study aimed to assess the association between loneliness and Health-Related Quality of Life (HR-QoL) among community-dwelling older citizens in five European countries. We characterize loneliness broadly from an emotional and social perspective. Methods: This cross-sectional study measured loneliness with the 6-item De Jong Gierveld Loneliness Scale and HR-QoL with the 12-Item Short-Form Health Survey. The association between loneliness and HR-QoL was examined using multivariable linear regression models. Results: Data of 2169 citizens of at least 70 years of age and living independently (mean age = 79.6 ± 5.6; 61% females) were analyzed. Among the participants, 1007 (46%) were lonely; 627 (29%) were emotionally and 575 (27%) socially lonely. Participants who were lonely experienced a lower HR-QoL than participants who were not lonely (p ≤ 0.001). Emotional loneliness [std-ß: -1.39; 95%-CI: -1.88 to -0.91] and social loneliness [-0.95; -1.44 to -0.45] were both associated with a lower physical HR-QoL. Emotional loneliness [-3.73; -4.16 to -3.31] and social loneliness [-1.84; -2.27 to -1.41] were also both associated with a lower mental HR-QoL. Conclusions: We found a negative association between loneliness and HR-QoL, especially between emotional loneliness and mental HR-QoL. This finding indicates that older citizens who miss an intimate or intense emotional relationship and interventions targeting mental HR-QoL deserve more attention in policy and practice than in the past.

6.
Matern Child Nutr ; 16(2): e12936, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31943779

RESUMO

Economic growth has brought improvements in many areas of child health, but its effects on anaemia among school-aged children remain unknown. However, this is important because iron deficiency anaemia is common and is the main cause of disability-adjusted life years for school-aged children. In this study, we included 429,222 Chinese children aged 7-17 years from five consecutive national cross-sectional surveys during 1995-2014. Using altitude-adjusted haemoglobin concentration measured from capillary blood samples, we defined anaemia status according to World Health Organization's recommendation. We used logistic regressions weighted by provincial population to examine the association between provincial gross domestic product (GDP) per capita and anaemia, adjusting for sex, age, urban-rural location, regional socio-economic status (SES), fixed effect of province, and clustering of schools. We used generalised additive mixed models to evaluate a potentially non-linear relationship. For each 100% growth in GDP per capita, there was a 40% (odds ratio [OR] = 0.60; 95% confidence interval [CI; 0.56, 0.65]) reduction in anaemia. However, the association was weaker for girls and in cities with a lower SES. The association was weaker across 2005-2014 (OR = 0.75, 95% CI [0.62, 0.90]) compared with 1995-2005 (OR = 0.52; 95% CI [0.44, 0.61]), reflecting a weaker association when GDP per capita reaches around $2,000. The results were similar for moderate-to-severe anaemia. We concluded that economic growth has been associated with reductions in anaemia among school-aged children in China but with fewer benefits for girls and those in poorer settings. Further economic development in China is unlikely to bring similar reductions in anaemia, suggesting that additional population level and targeted interventions will be needed.

7.
Prev Med ; 132: 105988, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31954142

RESUMO

Environmental factors are important in the development of myopia. There is still limited evidence as to whether computer use is a risk factor. The aim of this study is to investigate the association between computer use and myopia in the context of other near work activities. Within the birth cohort study Generation R, we studied 5074 children born in Rotterdam between 2002 and 2006. Refractive error and axial length was measured at ages 6 and 9. Information on computer use and outdoor exposure was obtained at age 3, 6 and 9 years using a questionnaire, and reading time and reading distance were assessed at age 9 years. Myopia prevalence (spherical equivalent ≤-0.5 dioptre) was 11.5% at 9 years. Mean computer use was associated with myopia at age 9 (OR = 1.005, 95% CI = 1.001-1.009), as was reading time and reading distance (OR = 1.031; 95% CI = 1.007-1.055 (5-10 h/wk); OR = 1.113; 95% CI = 1.073-1.155 (>10 h/wk) and OR = 1.072; 95% CI = 1.048-1.097 respectively). The combined effect of near work (computer use, reading time and reading distance) showed an increased odds ratio for myopia at age 9 (OR = 1.072; 95% CI = 1.047-1.098), while outdoor exposure showed a decreased odds ratio (OR = 0.996; 95% CI = 0.994-0.999) and the interaction term was significant (P = 0.036). From our results, we can conclude that within our sample of children, increased computer use is associated with myopia development. The effect of combined near work was decreased by outdoor exposure. The risks of digital devices on myopia and the protection by outdoor exposure should become widely known. Public campaigns are warranted.

8.
Prev Med ; 132: 105997, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31981642

RESUMO

Targeted screening for childhood high blood pressure may be more feasible than routine blood pressure measurement in all children to avoid unnecessary harms, overdiagnosis or costs. Targeting maybe based e.g. on being overweight, but information on other predictors may also be useful. Therefore, we aimed to develop a multivariable diagnostic prediction model to select children aged 9-10 years for blood pressure measurement. Data from 5359 children in a population-based prospective cohort study were used. High blood pressure was defined as systolic or diastolic blood pressure ≥ 95th percentile for gender, age, and height. Logistic regression with backward selection was used to identify the strongest predictors related to pregnancy, child, and parent characteristics. Internal validation was performed using bootstrapping. 227 children (4.2%) had high blood pressure. The diagnostic model included maternal hypertensive disease during pregnancy, maternal BMI, maternal educational level, parental hypertension, parental smoking, child birth weight standard deviation score (SDS), child BMI SDS, and child ethnicity. The area under the ROC curve was 0.73, compared to 0.65 when using only child overweight. Using the model and a cut-off of 5% for predicted risk, sensitivity and specificity were 59% and 76%; using child overweight only, sensitivity and specificity were 47% and 84%. In conclusion, our diagnostic prediction model uses easily obtainable information to identify children at increased risk of high blood pressure, offering an opportunity for targeted screening. This model enables to detect a higher proportion of children with high blood pressure than a strategy based on child overweight only.

9.
Pediatr Res ; 87(1): 163-168, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31421634

RESUMO

BACKGROUND: Acute otitis media (AOM) is a common pediatric disease and frequent reason for antibiotic treatment. We aimed to identify environmental and host factors associated with AOM and assess which determinants were associated with AOM at specific ages. METHODS: This study among 7863 children was embedded in the Generation R Study: a population-based prospective cohort study from fetal life onwards. Data on outcome and possible determinants were collected using questionnaires until 6 years. We used generalized estimating equation models to examine associations with AOM with longitudinal odds at different ages, considering correlations between repeated measurements. RESULTS: Male gender increased odds of AOM in children at 2, 3, and 4 years but not at other ages. Postnatal household smoking, presence of siblings, and pet birds increased odds of AOM. Breastfeeding decreased AOM odds, most notably in the first 2 months of life. No association was found for season of birth, maternal age, ethnicity, aberrant birth weight for gestational age, prenatal smoking, furry pets, and daycare attendance. CONCLUSIONS: Risk of childhood AOM varies with age. Significant association with AOM was found for gender and breastfeeding at specific ages and for household smoking, presence of siblings, and pet birds at all the studied ages.

10.
Neuroimage ; 205: 116258, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31605827

RESUMO

Physical activity and sedentary behaviors have been linked to a variety of general health benefits and problems. However, few studies have examined how physical activity during childhood is related to brain development, with the majority of work to date focusing on cardio-metabolic health. This study examines the association between physical activity and screen time with white matter microstructure in the general pediatric population. In a sample of 2532 children (10.12 ±â€¯0.58 years; 50.04% boys) from the Generation R Study, a population-based cohort in Rotterdam, the Netherlands, we assessed physical activity and screen time using parent-reported questionnaires. Magnetic resonance imaging of white matter microstructure was conducted using diffusion tensor imaging. Total physical activity was positively associated with global fractional anisotropy (ß = 0.057, 95% CI = 0.016, 0.098, p = 0.007) and negatively associated with global mean diffusivity (ß = -0.079, 95% CI = -0.120, -0.038, p < 0.001), two commonly derived scalar measures of white matter microstructure. Two components of total physical activity, outdoor play and sport participation, were positively associated with global fractional anisotropy (ß = 0.041, 95% CI=(0.000, 0.083), p = 0.047; ß = 0.053, 95% CI=(0.010, 0.096), p = 0.015, respectively) and inversely associated with global mean diffusivity (ß = -0.074, 95% CI= (-0.114, -0.033), p < 0.001; ß = -0.043, 95% CI=(-0.086, 0.000), p = 0.049, respectively). No associations were observed between screen time and white matter microstructure (p > 0.05). This study provides new evidence that physical activity is modestly associated with white matter microstructure in children. In contrast, complementing other recent evidence on cognition, screen time was not associated with white matter microstructure. Causal inferences from these modest associations must be interpreted cautiously in the absence of longitudinal data. However, these data still offer a promising avenue for future work to explore to what extent physical activity may promote healthy white matter development.

11.
BMJ Open ; 9(12): e032073, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31857305

RESUMO

INTRODUCTION: More than 70% of world mortality is due to chronic conditions. Furthermore, it has been proven that social determinants have an enormous impact on both health-related behaviour and on the received attention from healthcare services. These determinants cause health inequalities. The objective of this study is to reduce the burden of chronic diseases in five European regions, hereby focusing on vulnerable populations, and to increase the sustainability of health systems by implementing a chronic disease self-management programme (CDSMP). METHODS AND ANALYSIS: 2000 people with chronic conditions or informal caregivers belonging to vulnerable populations, will be enrolled in the CDSMP in Spain, Italy, the UK, France and the Netherlands. Inclusion of patients will be based on geographical, socioeconomic and clinical stratification processes. The programme will be evaluated in terms of self-efficacy, quality of life and cost-effectiveness using a combination of validated questionnaires at baseline and 6 months from baseline. ETHICS AND DISSEMINATION: This study will follow the directives of the Helsinki Declaration and will adhere to the European Union General Data Protection Regulation. The project's activities, progress and outcomes will be disseminated via promotional materials, the use of mass media, online activities, presentations at events and scientific publications. TRIAL REGISTRATION NUMBER: ISRCTN70517103; Pre-results.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31683775

RESUMO

The objective of this study was to assess associations between maternal health-related quality of life (HRQoL) in early, mid-, and late pregnancy and birth outcomes and to assess the differences in birth outcomes between subgroups of mothers reporting relatively "low" and relatively "high" HRQoL. HRQoL was measured by the 12-item Short Form Health Survey in early (n = 6334), mid- (n = 6204), and late pregnancy (n = 6048) in a population-based mother and child cohort; Physical and Mental Component Summary (PCS/MCS) scores were calculated. Birth outcomes included pregnancy duration, preterm birth, birth weight, low birth weight, and small for gestational age. We defined very high PCS/MCS scores as the >90th percentile and very low score as the <10th percentile. The lower PCS score in late pregnancy was significantly associated with a higher chance of having small-for-gestational-age birth (per 10 points: OR = 1.20, 95% CI: 1.08, 1.33, p value = 0.0006). In early, mid-, and late pregnancy, the subgroup mothers with a low MCS score had infants with a lower average birth weight than those with very high scores (p < 0.05). The association between higher physical HRQoL in late pregnancy and a higher chance of having small-for-gestational-age birth needs further research. The role of mother's mental HRQoL during pregnancy and the potential consequences for the child require further study.

13.
BMC Public Health ; 19(1): 1462, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694586

RESUMO

BACKGROUND: The number of interventions to support parents is growing. The level of evidence regarding these intervention varies. In this paper we describe a study that aims to assess the effectiveness of specific 'elements' within such parenting interventions for families with children up to 7 years. A naturalistic effect evaluation will be applied. Study questions are: 1. What is the exposure of parents to (elements of) parenting interventions in the daily practice of preventive youth health care? 2. What are the associations between the exposure to (elements of) parenting interventions and outcomes in parents/children related to parenting and child development? METHODS/DESIGN: Thousand parents/caregivers are recruited by preventive youth health care providers in the Netherlands. Measurements will be performed after inclusion and after 12-months follow up. Data regarding child/parent/caregiver characteristics, use of (parenting) interventions and care, and outcomes with regard to parenting skills, family functioning and child development will be collected. Outcomes will be compared between parents/children exposed and non-exposed to the (elements of) parenting interventions (adjusting for confounders). DISCUSSION: We hypothesize that parents/caregivers with exposure to (elements of) parenting interventions show (relatively more) improvements in parenting outcomes. Results will support intervention selection/development, and support communities/professionals to select appropriate intervention-elements. TRIAL REGISTRATION: Netherlands National Trial Register number NL7342 . Date of registration: 05-November-2018, retrospectively registered.


Assuntos
Poder Familiar , Medicina Preventiva/métodos , Apoio Social , Adolescente , Criança , Desenvolvimento Infantil , Educação Infantil , Pré-Escolar , Educação não Profissionalizante , Feminino , Humanos , Masculino , Países Baixos , Relações Pais-Filho , Pais/psicologia , Ensaios Clínicos Pragmáticos como Assunto , Projetos de Pesquisa
14.
J Med Internet Res ; 21(11): e14947, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31714252

RESUMO

BACKGROUND: The lack of continuity between health-related quality of life (HRQoL) instruments designed for children and adults hinders change analysis with a life course approach. To resolve this gap, EuroQol (EQ) developed the EQ-5D-Youth (EQ-5D-Y), derived from the EQ-5D for adults. Few studies have assessed the metric properties of EQ-5D-Y in children with specific chronic conditions, and none have done so for children with type I diabetes mellitus (T1DM). OBJECTIVE: This study aimed to evaluate the acceptability, validity, reliability, and responsiveness of the EQ-5D-Y in children and adolescents with T1DM, when administered online. METHODS: Participants with T1DM were consecutively recruited from July to December 2014, from a list of potential candidates aged 8-19 years, who attended outpatient pediatric endocrinology units. Before every quarterly routine visit, participants received an email/telephone reminder to complete the online version of two generic HRQoL questionnaires: EQ-5D-Y and KIDSCREEN-27. The EQ-5D-Y measures five dimensions, from which an equally weighted summary score was constructed (range: 0-100). Completion rate and distribution statistics were calculated. Construct validity was evaluated through known group comparisons based on general health, acute diabetic decompensations, mental health, family function, and a multitrait, multimethod matrix between EQ-5D-Y and KIDSCREEN by using Spearman correlations. Construct validity hypotheses were stated a priori. Reliability was assessed with the intraclass correlation coefficient and responsiveness by testing changes over time and calculating the effect size. Reliability and responsiveness were tested among the stable and improved subsamples defined by a KIDSCREEN-10 index change of <4.5 points or ≥4.5 points, respectively, from the first to the fourth visit. RESULTS: Of the 136 participants, 119 (87.5%) responded to the EQ-5D-Y at the last visit. The dimensions that showed higher percentages of participants with problems were "having pain/discomfort" (34.6%) and "worried/sad/unhappy" (28.7%). The mean (SD) of the EQ-5D-Y summary score was 8.5 (10.9), with ceiling and floor effects of 50.7% and 0%, respectively. Statistically significant HRQoL differences between groups defined by their general health (excellent/very good and good/regular/bad) and mental health (Strengths and Difficulties Questionnaire score ≤15 and >16, respectively) were found in three EQ-5D-Y dimensions ("doing usual activities," "having pain/discomfort," and "feeling worried/sad/unhappy"), summary score (effect size for general health and mental health groups=0.7 and 1.5, respectively), and KIDSCREEN-10 index (effect size for general health and mental health groups=0.6 and 0.9, respectively). Significant differences in the EQ-5D-Y dimensions were also found according to acute diabetic decompensations in "looking after myself" (P=.005) and according to family function in "having pain/discomfort" (P=.03). Results of the multitrait, multimethod matrix confirmed three of the four relationships hypothesized as substantial (0.21, 0.58, 0.50, and 0.46). The EQ-5D-Y summary score presented an intraclass correlation coefficient of 0.83. Statistically significant change between visits was observed in the improved subsample, with an effect size of 0.7 (P<.001). CONCLUSIONS: These results support the use of the EQ-5D-Y administered online as an acceptable, valid, reliable, and responsive instrument for evaluating HRQoL in children and adolescents with T1DM.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31731611

RESUMO

The goal of the Supportive Parenting Intervention is to prevent and/or decrease parenting stress and provide a sense of empowerment to parents with a newborn child. We evaluated the effectiveness of the Supportive Parenting Intervention in terms of parenting skills, social support, self-sufficiency, resilience, and child psychosocial health. A controlled trial with pre- and post-intervention testing was conducted in the setting of community pediatrics among parents at risk for developing parenting stress. The 177 parents in the control group received care-as-usual, whereas the 124 parents in the intervention group received six home visits by a trained Youth Health Care nurse during the first 18 months of the child's life. The result with respect to parenting skills, social support (both from family and friends, and the partner), self-sufficiency, and resilience at the 18-month follow-up was either unchanged or (p < 0.05) worse compared to the respective baseline score for both groups. We found no significant difference between intervention and control group with respect to the child's Child Behavior Check List (CBCL). This study shows no positive effect with respect to the indicators of parental empowerment. We recommend research to strengthen the intervention and its application in daily practice, for example by increasing the intervention duration, and to evaluate it in a large randomized controlled trial.

16.
J Sex Res ; : 1-10, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31751153

RESUMO

The role of peers in adolescents' sexual behaviors is not yet fully understood. We investigated the association between sexual communication with friends (at T1) and subsequent changes in adolescents' experience with sexual behaviors (between T1-T3), and examined whether this association was explained by adolescents' perceptions of three sexual peer norms (at T2): (1) peers' sexual behaviors (descriptive norms), (2) peers' approval of sexual behaviors (injunctive norms), and (3) peer pressure to have sex. The data source was Project STARS, a longitudinal study on adolescent sexual development in the Netherlands, collected via online self-report questionnaires from 1,116 adolescents (11.5-17.9 years). Adolescents who communicated more frequently with their friends about sexuality-related topics at T1 reported significantly larger increases in their experience with different sexual behaviors between T1-T3. More sexual communication with friends also predicted adolescents subsequently perceiving more 1) peer sexual behaviors, 2) peer approval of sex, and 3) peer pressure to have sex. These stronger perceptions, in turn, predicted larger increases in their sexual behaviors between T1-T3. After adjusting for the three norms simultaneously, the main association between sexual communication with friends and sexual behavior change weakened but remained significant. Inspection of specific indirect effects showed this link was explained by injunctive norms only. No gender differences were found.

17.
PLoS One ; 14(10): e0224160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31613928

RESUMO

[This corrects the article DOI: 10.1371/journal.pone.0217261.].

18.
Diabetes Res Clin Pract ; 156: 107834, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31550487

RESUMO

This meta-analysis of randomized controlled trials (RCTs) aims to investigate how to perform better interventions targeting modifiable risk factors of diabetic retinopathy (DR) to prevent and control DR in patients with type 2 diabetes by comparing different intervention types and follow-up intervals. Literature published before June 1st, 2019 were searched on Pubmed, Embase and ScienceDirect. RCTs targeting modifiable risk factors of DR (including blood glucose, blood pressure, lipid, dietary, physical activity and smoking) were selected by two reviewers and double checked for accuracy. Random effects models were estimated to calculate pooled Odds Ratios (OR). Twenty-two RCTs (n = 22,511) were included. In general, interventions targeting modifiable risk factor of DR reduced the risk of developing DR (I2 = 26.7%; OR = 0.60; 95% CI 0.45 to 0.79) and DR worsening (I2 = 0.0%; OR = 0.62; 95% CI 0.47 to 0.80; P < 0.001). Multifactorial interventions had better effect on reducing the risk of development and progression of DR in comparison with other interventions, while only blood-pressure-control interventions showed significant effect on slowing down DR worsening. Additionally, interventions with follow-up >5 years had better effect on reduction of DR development, and interventions with follow-up >2 years had better effect on reducing the risk of DR worsening.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/prevenção & controle , Retinopatia Diabética/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
19.
Artigo em Inglês | MEDLINE | ID: mdl-31505862

RESUMO

This study examines the association between school absenteeism, health-related quality of life (HRQOL) and happiness among young adults aged 16-26 years attending vocational education. Cross-sectional data from a survey among 676 young adults were analyzed. School absenteeism was measured by the self-reported number of sick days in the past eight weeks and hours of truancy in the past four weeks. HRQOL was measured by the 12-item Short Form Health Survey; physical and mental component summary scores were calculated. General happiness was assessed on a scale of 0-10, higher scores indicating greater happiness. Linear regression analyses were performed. The study population had a mean age of 18.5 years (SD 2.2); 26.1% were boys. Young adults with ≥5 sick days or ≥6 h of truancy reported lower mental HRQOL compared to young adults without sickness absence or truancy (p < 0.05). Young adults with 1-4 and ≥5 sick days reported lower physical HRQOL compared to young adults who had not reported to be sick (p < 0.05). Young adults with 1-5 h and ≥6 h of truancy reported higher physical HRQOL compared to young adults who were not truant (p < 0.05). No associations were observed between school absence and happiness. Lower self-reported mental HRQOL was observed among young adults with more school absenteeism due to sickness or truancy. Sickness absence was additionally associated with lower physical HRQOL.


Assuntos
Absenteísmo , Felicidade , Qualidade de Vida , Instituições Acadêmicas/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Países Baixos , Autorrelato , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31484357

RESUMO

Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, Qinghai, China). The theory of reasoned action (TRA) was applied. Data was collected by questionnaire. Structural equation modeling (SEM) analysis showed that students' attitude (ß = 0.22, 95% CI 0.13-0.31) and subjective norms in terms of compliance to teachers', parents' and peers' suggestions to wash hands (ß = 0.09, 95% CI 0.01-0.18) were directly associated with students' handwashing behavior. Students' knowledge (ß = 0.04, 95% CI 0.03-0.07) had an indirect association with handwashing behavior, mediated by students' attitudes and subjective norms. Subjective norms (ß = 0.12, 95% CI 0.07-0.17) were also indirectly correlated with handwashing through students' attitudes. Therefore, our study supported the theory of reasoned action through our findings that students' attitude and knowledge, and also attitudes from teachers, parents and peers were correlated with student handwashing behavior. Students reported higher level of compliance to teachers than to their parents and classmates. Based on this information, we recommend teacher-involved participatory hygiene education to promote students' handwashing behaviors in areas at high risk for infectious diseases that can be prevented by handwashing.


Assuntos
Higiene das Mãos , Comportamentos Relacionados com a Saúde , Instituições Acadêmicas , Atitude Frente a Saúde , Criança , Feminino , Humanos , Masculino , Grupo Associado , Estudantes , Inquéritos e Questionários , Tibet
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