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1.
Yakugaku Zasshi ; 140(10): 1275-1284, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32999206

RESUMO

In April 2018, as part of their fifth-year pre-clinical education curriculum, pharmacy students at Setsunan University attended a lecture presented by hepatitis B patients and their lawyer entitled "Lecture by Hepatitis B Patients". This lecture was intended to help the students to understand the circumstances and difficulties encountered by hepatitis B patients on a daily basis. For this study, we conducted questionnaire surveys of the pharmacy students before and after the lecture. The survey items pertained to students' knowledge about hepatitis B (e.g., its spread and infection possibility in daily life). Students' responses before and after the lecture varied depending on the survey topic. Hepatitis B knowledge acquired by the students in their junior year increased after the lecture; moreover, attitudes to hepatitis B patients and understanding of the difficulties and prejudice that they experienced showed a significant change. For example, responses to the items, "Feel sympathy for patients suffering from discrimination and prejudice" and "Hard to work…" were much more sympathetic after the lecture; additionally, students were less likely to "Fear infection when near patients" and more likely "… to associate with patients". Thus, the "Lecture by Hepatitis B Patients" had a significant impact on the pharmacy students' perceptions of these patients, allowing them to cultivate greater empathy. From an educational standpoint, it is of the utmost importance for pharmacy/medical students to develop their humanity as members of healthcare teams. Educational real-world experiences, such as the "Lecture by Hepatitis B Patients", provide opportunities for this development.


Assuntos
Atividades Cotidianas , Educação em Farmácia/métodos , Empatia , Hepatite B/psicologia , Participação do Paciente/métodos , Pacientes/psicologia , Aprendizagem Baseada em Problemas/métodos , Relações Profissional-Paciente , Estudantes de Farmácia/psicologia , Atitude Frente a Saúde , Currículo , Humanos , Conhecimento , Inquéritos e Questionários
2.
Rev Bras Epidemiol ; 23: e200098, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33027435

RESUMO

OBJECTIVE: To assess the association between the impact of oral health on daily life and sociodemographic variables with oral parameters in adolescents living in the State of São Paulo, Brazil. METHODS: A cross-sectional study was conducted with data from 5,409 adolescents who participated in the "State Oral Health Survey of São Paulo - OH", 2015. The impact of oral health on daily life was assessed by the oral impacts on daily performances (OIDP) index, prevalence (presence or absence of impact) and severity of impact (OIDP scores). The negative binomial regression model (zeros-inflated) was used, considering the complex sampling and the sample weights. Prevalence ratio (PR), ratio of means (ROM) and confidence intervals (CI) were calculated. RESULTS: The prevalence of impact was 37.4%. After adjusting for the model, the impact was more prevalent (PR = 1.59; 95%CI 1.22 ‒ 1.81) and more severe (RR = 1.49; 95%CI 1.22 ‒ 1.81) among females. Compared to white-skin people, all remaining groups had a higher prevalence of impact. Among socioeconomic characteristics, family income higher than R$ 2,501 (RR = 0.79; 95%CI 0.64 ‒ 0.98) and household crowding (RR = 1.18; 95%CI 1.00 ‒ 1.39) were associated with the severity of impact. In the oral health conditions, untreated caries (PR = 1.46; 95%CI 1.23 ‒ 1.74) and gingival bleeding (PR = 1.35; 95%CI 1.14 ‒ 1.60) were associated with higher prevalence of impact. CONCLUSION: Females, non-whites, with untreated caries and gingival bleeding were associated with higher impact of oral health on daily life. Family income higher than R$ 2,500 and living in less crowded households were factors associated with less impact.


Assuntos
Atividades Cotidianas , Doenças da Boca/epidemiologia , Adolescente , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores Socioeconômicos
3.
Zhongguo Gu Shang ; 33(8): 788-92, 2020 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-32875774

RESUMO

Joint contracture is one of the common musculoskeletal disorders. It has seriously disturbed patients' activities of daily living in various aspects. The pathogenesis of it is eager to explore to distinct degree. Nowadays the thickeness and fibrosis of joint capsular is redarded as the major reason to joint contracture. It is reported that excessive fibroblasts and myofibroblasts activity, collagen hyperplasia, and extracellular matrix (ECM) deposition in these fibrotic condtions lead to the contracture. In addition, upregulators of myofibroblast and collagen synthesis, transforming growth factor-beta 1 (TGF-ß1), and connective tissue growth factor (CTGF) were shown to be increased. Altered levels of cytokines were also thought to play a role in this process as elevated levelsof tumor necrosis factor-α(TNF-α), matrix metalloproteinases(MMPs) and abnormal distribution tissue inhibitors of MMPs(TIMPs) were demonstrated in contracted capsules. At present, the methods for clinical treatment of joint contracture mainly include two major categories:stretching therapy, physical factor therapy, exercise therapy, botulinum toxin injection and other non-surgical treatments, arthroscopic lysis, open lysis, and other surgical treatments. Surgical treatment is performed when non-surgical treatment is difficult to achieve further improvement. It has a good effect on mild to moderate joint contracture, but it is difficult to completely restore joint activity for serious joint contracture. Although clinical treatment methods are diverse, the clinical effects are staggered and the effectiveness of their treatment is controversial. Joint contracture is an important challenge faced by orthopedics and rehabilitation physicians, therapists and patients. The review summarized the pathogenesisand treatment of joint contracture and provided a theoretical basis for clinical diagnosis and treatment.


Assuntos
Atividades Cotidianas , Contratura , Fibroblastos , Fibrose , Humanos , Cápsula Articular , Fator de Crescimento Transformador beta1
4.
Medicine (Baltimore) ; 99(33): e21695, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872042

RESUMO

BACKGROUND AND OBJECTIVES: Chemotherapy does not only affect cancer cells; it also affects, to a greater or lesser degree, all other cells in the body. This toxicity should be assessed according to its severity, frequency, and duration, taking into account objective and subjective dimensions in its assessment. This assessment is a highly relevant aspect when providing care to chemotherapy patients, mainly due to the impact of the treatment on the patient's quality of life, as well as the vital risk it may imply under certain circumstances. For all this, the objective of this study was to assess the relationship between chemotherapy-associated adverse reactions and health-related quality of life in breast cancer patients. MATERIALS AND METHODS: With this purpose, a descriptive cross-sectional study was developed on 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide. RESULTS: It is worth highlighting the negative effect of nausea, dysgeusia, peripheral neuropathy, loss of appetite, myalgia, and peripheral edema on the quality of life. Likewise, it is worth mentioning peripheral neuropathy as the toxicity that affects a greater number of quality-of-life indicators. CONCLUSIONS: To sum up, it would be necessary to make health professionals aware of the importance of chemotherapy-associated adverse reactions.


Assuntos
Atividades Cotidianas/psicologia , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Qualidade de Vida , Adulto , Idoso , Neoplasias da Mama/psicologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 99(33): e21242, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871984

RESUMO

Currently there is no effective treatment for vascular dementia (VaD). Pharmacological treatment often lead to severe complications and require drug dosage adjustment. This study investigated the effect of scalp electroacupuncture combined with Memantine in VaD. The safety and antioxidative effect of scalp electroacupuncture were also explored.A retrospective study was conducted and data of inpatients of Linyi Central Hospital with VaD between June 2017 and May 2018 were collected and sorted. The patients were divided into scalp electroacupuncture-medication (A), scalp electroacupuncture (B) and medication (control) (C) groups, in which Memantine was prescribed as medication. Cognitive function, activities of daily living and quality of life assessed by Montreal Cognitive Assessment (MoCA), Barthel index and dementia quality of life questionnaire; the contents of superoxide dismutase, lipid peroxide and nitric oxide in blood samples; and adverse reaction were compared.Data from a total of 150 patients were collected (Group A, n = 55; Group B, n = 50; Group C, n = 45). The post-treatment/follow-up Montreal Cognitive Assessment, Barthel index and dementia quality of life questionnaire scores were significantly improved in all groups compared to pre-treatment (groups A and B, P<.01; group C, P<.05). The improvements were significant for groups A vs C, B vs C (P<0.01, both), and group A vs B (P<.05). The post-treatment/follow-up levels of lipid peroxide and nitric oxide decreased significantly while superoxide dismutase increased significantly in groups A and B compared to pre-treatment (P<.01, both). The differences were significant for groups A vs C, and B vs C (P < .01, both), but not significant between groups A and B (P > .05). There were no significant adverse events occurred during the study and follow-up.In combined treatment, scalp electroacupuncture works in parallel with Memantine and significantly increase the therapeutic effect in VaD with no significant adverse events. Scalp electroacupuncture may have the potential to serve as an option or alternative treatment for VaD. Scalp electroacupuncture may alleviate VaD symptoms through its antioxidative mechanism.


Assuntos
Demência Vascular/terapia , Eletroacupuntura , Memantina/uso terapêutico , Nootrópicos/uso terapêutico , Atividades Cotidianas , Idoso , Biomarcadores/sangue , Cognição/efeitos dos fármacos , Terapia Combinada , Demência Vascular/sangue , Eletroacupuntura/efeitos adversos , Eletroacupuntura/métodos , Feminino , Seguimentos , Humanos , Peróxidos Lipídicos/sangue , Masculino , Memantina/efeitos adversos , Óxido Nítrico/sangue , Nootrópicos/efeitos adversos , Qualidade de Vida , Estudos Retrospectivos , Couro Cabeludo , Superóxido Dismutase/sangue , Resultado do Tratamento
6.
J Bras Nefrol ; 42(2 suppl 1): 12-14, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877492

RESUMO

Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Educação de Pacientes como Assunto/normas , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/complicações , Atividades Cotidianas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos , Higiene das Mãos/métodos , Higiene das Mãos/normas , Instalações de Saúde , Pessoal de Saúde , Humanos , Nefrologia/normas , Espaço Pessoal , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Diálise Renal , Fatores de Risco , Avaliação de Sintomas
7.
PLoS One ; 15(9): e0240008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997705

RESUMO

Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Atividades Cotidianas , Adolescente , Adulto , Betacoronavirus , Busca de Comunicante , Estudos Transversais , Equador/epidemiologia , Monitoramento Epidemiológico , Exercício Físico , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Questionário de Saúde do Paciente , Quarentena , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
10.
Am J Alzheimers Dis Other Demen ; 35: 1533317520960875, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969235

RESUMO

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.


Assuntos
Atividades Cotidianas , Ansiedade/psicologia , Disfunção Cognitiva/psicologia , Infecções por Coronavirus , Depressão/psicologia , Transtorno Depressivo/psicologia , Pandemias , Pneumonia Viral , Isolamento Social/psicologia , Idoso , Antidepressivos/uso terapêutico , Betacoronavirus , Disfunção Cognitiva/fisiopatologia , Transtorno Depressivo/tratamento farmacológico , Exercício Físico , Humanos , Vida Independente , Corrida Moderada , Solidão , Masculino , Mirtazapina/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Telemedicina , Trazodona/uso terapêutico
11.
Environ Health Prev Med ; 25(1): 49, 2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32892744

RESUMO

BACKGROUND: The health hazards of indoor air pollution are well-established but studies of the health effects due to pollution from heating are rare. This study investigated the association of heating and disability for activities of daily living among Chinese middle-aged and elderly. METHODS: We used two consecutive surveys in a cohort of over 17,000 adults aged 45 or older, who were interviewed first in 2011-2012 and then in 2013. In these surveys, taking advantage of random survey time, we applied a random effects logit regression model that included an interaction between pollution-producing heating fuel and a dummy variable, which measured interview time based on whether or not it was heating season. RESULTS: Exposure to pollution-producing heating fuel was associated with a 39.9% (OR 1.399; 95%CI 1.227-1.594) and 71.0% (OR 1.710; 95%CI 1.523-1.920) increase in the likelihood of disability in activities of daily living (DADL) and disability in instrumental activities of daily living (DIADL), respectively. In heating season between year 2011 and 2013, moving from clean heating energy for heating to pollution-producing fuel was linked with an increase in the likelihoods having DADL and DIADL, with the OR of 2.014 (95%CI 1.126-3.600) and 1.956 (95%CI 1.186-3.226), respectively. However, disability increases due to change from clean energy to pollution-producing heating energy did not appear in advantaged education respondents. CONCLUSIONS: We found that exposure to heating by burning of coal, wood, or crop residue was associated with disability in performing daily living activities. Health policymakers should take indoor pollution due to heating into consideration as it is a major determinant of activities of daily living in elderly people; especially, such policy should focus on elderly people who have disadvantaged education.


Assuntos
Atividades Cotidianas , Poluição do Ar em Ambientes Fechados/efeitos adversos , Pessoas com Deficiência/estatística & dados numéricos , Calefação/efeitos adversos , Habitação , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar em Ambientes Fechados/análise , China , Feminino , Calefação/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
12.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(9): 964-969, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-32933627

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of tacrolimus in the treatment of children with myasthenia gravis (MG). METHODS: A total of 28 children with MG were treated with tacrolimus. MG-Activities of Daily Living (MG-ADL) scale was used to assess clinical outcome and safety after 1, 3, 6, 9, and 12 months of treatment. RESULTS: After tacrolimus treatment, the MG-ADL score at 1, 3, 6, 9 and 12 months was lower than that at baseline (P<0.05), and the MG-ADL score showed a gradually decreasing trend. The response rates to tacrolimus treatment at 1, 3, 6, 9, and 12 months were 59%, 81%, 84%, 88%, and 88% respectively. At 6, 9, 12, and 18 months of treatment, 4, 13, 14, and 15 children respectively were withdrawn from prednisone. No recurrence was observed during treatment. Major adverse reactions/events were asymptomatic reduction in blood magnesium in 5 children and positive urine occult blood in 1 child, which turned negative without special treatment, and tacrolimus was not stopped due to such adverse reactions/events. One child was withdrawn from tacrolimus due to recurrent vomiting. According to CYP3A5 genotypes, all of the patients were divided into two groups: slow metabolic type (n=19) and non-slow metabolic type (fast metabolic type + intermediate type; n=9). The non-slow metabolism group received a higher dose of tacrolimus, but had a lower trough concentration of tacrolimus than the slow metabolism group (P<0.05). The slow metabolism group had a higher response rates to tacrolimus treatment than the non-slow metabolism group (P<0.05). CONCLUSIONS: Tacrolimus appears to be effective and safe in the treatment of children with MG and is thus an option for immunosuppressive therapy. CYP3A5 genotyping has a certain guiding significance for determining the dosage of tacrolimus.


Assuntos
Miastenia Gravis , Tacrolimo/uso terapêutico , Atividades Cotidianas , Criança , Humanos , Imunossupressores , Miastenia Gravis/tratamento farmacológico , Recidiva Local de Neoplasia
13.
Artigo em Inglês | MEDLINE | ID: mdl-32899534

RESUMO

(1) Objective: The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked to ICF second-level and third-level categories using ICF linking rules and categorized according to an ICF component. (3) Results: In total, 33 outcome measures were identified from 36 studies. Commonly used (a) ICF body function measures were Pulmonary Function Tests (PFT), Impact of event scale (IES-R) and Hospital Anxiety and Depression Scale (HADS); (b) ICF activity was 6-Minute Walking Distance (6MWD); (c) ICF participation measures included Short Form-36 (SF-36) and St George's Respiratory Questionnaire (SGRQ). ICF environmental factors and personal factors were rarely measured. (4) Conclusions: We recommend future COVID-19 follow-up studies to use the ICF framework to select a combination of outcome measures that capture all the components for a better understanding of the impact on survivors and planning interventions to maximize functional return.


Assuntos
Infecções por Coronavirus/diagnóstico , Avaliação de Resultados da Assistência ao Paciente , Pneumonia Viral/diagnóstico , Síndrome Respiratória Aguda Grave/diagnóstico , Atividades Cotidianas , Adulto , Betacoronavirus , Avaliação da Deficiência , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Coronavírus da Síndrome Respiratória do Oriente Médio , Pandemias , Vírus da SARS , Organização Mundial da Saúde
14.
Int Heart J ; 61(5): 879-887, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32921674

RESUMO

Since the number of elderly patients suffering from acute myocardial infarction (AMI) has been increasing in developed countries, primary percutaneous coronary intervention (PCI) for the very elderly aged ≥80 years old is already common. The study aimed to examine the determinants of in-hospital death among the very elderly with AMI in current PCI era. We included 412 consecutive AMI patients aged ≥ 80 years old who received PCI to the culprit lesion; however, 42 patients (10.2%) died during the index hospitalization. Thus, univariate and multivariate logistic regression analyses were performed to identify the determinants of in-hospital death. Of note, the modified KATZ index, which is a seven-point scale ranging from 0 to 6 (0 point indicating no dependence and six points indicating full dependence), was calculated to evaluate pre-admission activity of daily living (ADL). In multivariate analysis, cardiac arrest (OR 4.642, 95% CI 1.177-18.305, P = 0.028), Killip class IV (versus Killip class I: OR 5.732, 95% CI 1.076-16.630, P = 0.001), modified KATZ index (OR 1.212, 95% CI 1.001-1.469, P = 0.049), hemoglobin levels (OR 0.803, 95% CI 0.656-0.983, P = 0.033), use of temporary pacemaker (OR 2.603, 95% CI 1.010-6.709, P = 0.048), final Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 (versus TIMI ≤ 2: OR 0.240, 95% CI 0.093-0.618, P = 0.003), and mechanical circulatory support (OR 4.264, 95% CI 1.818-10.005, P = 0.001) were found to be significantly associated with in-hospital death. In conclusion, in-hospital outcomes of the very elderly with AMI were still poor in the current PCI era. Poor pre-admission ADL as well as cardiogenic shock and anemia were determined to be strongly associated with in-hospital death.


Assuntos
Mortalidade Hospitalar , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Atividades Cotidianas , Idoso de 80 Anos ou mais , Anemia/epidemiologia , Estimulação Cardíaca Artificial/estatística & dados numéricos , Oxigenação por Membrana Extracorpórea/estatística & dados numéricos , Feminino , Parada Cardíaca/epidemiologia , Humanos , Balão Intra-Aórtico/estatística & dados numéricos , Masculino , Análise Multivariada , Infarto do Miocárdio/epidemiologia , Fatores de Risco , Choque Cardiogênico/epidemiologia
15.
Medicine (Baltimore) ; 99(39): e22365, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991455

RESUMO

BACKGROUND: Acupuncture has an unique role in preventing and managing mild cognitive impairment (MCI) in nonpharmaceutical therapies because of its small wound, mild pain, and high security for many years. However, there is no systematic review evaluating safety and efficacy of acupuncture for MCI in elderly people. Therefore, this study will provide a protocol to explore the effectiveness and safety of acupuncture for MCI in the elderly. METHODS: Retrieval from 8 electronic databases was conducted to determine eligible trials published until May, 2019. Homogeneity qualified studies were included for data were extracted such as study country location, demographic characteristics, and measure outcomes, and were analyzed by a random effect model and sensitivity analyses to identify heterogeneity. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. RESULTS: A total of 15 randomized control trials involving 1051 subjects were included. The results were as follows: Compared with the control group, the clinical efficacy rates of acupuncture was better, odds ratio = 2.52, 95% confidence interval (CI) (1.86, 3.42), P < .00001, mini-mental state examination scores (mean difference [MD] = 1.53, 95% CI [1.04, 2.01], P < .00001), Montreal cognitive assessment scores (MD = 2.05, 95% CI [1.17, 1.92], P < .00001), activity of daily living scale (MD = 1.71, 95% CI [-1.38, 4.79], P > .05), and clock drawing task scores (MD = 1.91, 95% CI [1.74, 2.08], P < .00001). CONCLUSION: This study shows that acupuncture is beneficial for improving aspects of cognitive function in elderly people with MCI, which suggests that acupuncture may be an effective alternative and complementary approach to existing therapies for elderly people. More rigorous experimental studies and longer follow-up studies should be conducted in the future.


Assuntos
Terapia por Acupuntura/métodos , Disfunção Cognitiva/terapia , Atividades Cotidianas , Terapia por Acupuntura/efeitos adversos , Fatores Etários , Cognição , Humanos , Testes de Estado Mental e Demência , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Sexuais , Fatores Socioeconômicos
16.
Rev Bras Epidemiol ; 23: e200093, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32997082

RESUMO

OBJECTIVE: Estimate the magnitude of the income inequality in the prevalence of functional dependency for basic and instrumental activities of daily life (BADLs, IADLs) and the abandonment of advanced activities (AADLs). METHODS: This was a cross-sectional, population-based study, developed using sample data of 986 elderly people from a health survey carried out in the municipality of Campinas, São Paulo, in 2014/15. The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita. A multiple regression Poisson analysis was developed to estimate the prevalence ratio (PR) adjusted by gender and age. RESULTS: There was no significant association between income and functional dependency for BADLs. Of the seven IADLs analyzed, five presented a higher prevalence of dependency in the lower-income stratum, with special highlight to using the phone (PR = 3.50), controlling medication usage (PR = 2.44), and use of transportation (PR = 2.35). The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77). CONCLUSIONS: The broad inequality detected among income stratum regarding the functional capability for the IADLs and abandonment of the AADLs emphasize the importance of fully implementing and maintaining the policies and programs directed toward the social protection of elderly adults. The focus should be on the most socially vulnerable segments, with the aim of achieving a population that is more equal, active, independent, and involved in participatory ageing.


Assuntos
Atividades Cotidianas , Renda , Adulto , Idoso , Envelhecimento , Brasil , Estudos Transversais , Humanos , Fatores Socioeconômicos
18.
PLoS One ; 15(9): e0238830, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32903286

RESUMO

We sought to evaluate the adherence of Vietnamese adults to Coronavirus Disease 2019 (COVID-19) preventive measures, and gain insight into the effects of the epidemic on the daily lives of Vietnamese people. An online questionnaire was administered from March 31 to April 6, 2020. The questionnaire assessed personal preventive behavior (such as physical distancing, wearing a face mask, cough etiquette, regular handwashing and using an alcohol hand sanitizer, body temperature check, and disinfecting mobile phones) and community preventive behavior (such as avoiding meetings, large gatherings, going to the market, avoiding travel in a vehicle/bus with more than 10 persons, and not traveling outside of the local area during the lockdown). A total adherence score was calculated by summing the scores of the 9 personal and the 11 community prevention questions. In total, 2175 respondents completed the questionnaire; mean age: 31.4 ± 10.7; (range: 18-69); 66.9% were women; 54.2% were health professionals and 22.8% were medical students. The mean adherence scores for personal and community preventive measures were 7.23 ± 1.63 (range 1-9) and 9.57 ± 1.12 (range 1-11), respectively. Perceived adaptation of the community to lockdown (Beta (ß) = 2.64, 95% Confidence Interval (CI) 1.25-4.03), fears/worries concerning one's health (ß = 2.87, 95% CI 0.04-5.70), residing in large cities (ß = 19.40, 95% CI 13.78-25.03), access to official COVID-19 information sources (ß = 16.45, 95% CI 6.82-26.08), and working in healthcare/medical students (ß = 22.53, 95% CI 16.00-29.07) were associated with a higher adherence score to anti-COVID instructions. In conclusion, this study confirmed a high degree of adherence to personal and community preventive behavior among Vietnamese people. Our findings are consistent with the epidemiology of COVID-19 in Vietnam, where there have been few infections and no recorded deaths up to the first week of July 2020.


Assuntos
Infecções por Coronavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Atividades Cotidianas , Adolescente , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Feminino , Fidelidade a Diretrizes , Desinfecção das Mãos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Pneumonia Viral/virologia , Inquéritos e Questionários , Viagem , Vietnã , Adulto Jovem
19.
Medicine (Baltimore) ; 99(37): e22154, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925774

RESUMO

The cognitive function of nursing home (NH) residents with cognitive impairment (CI) tends to decline over time. An effective multimodal non-pharmacological intervention (MNPI) strategy is needed to improve the cognitive function of NH residents with CI.The aim of this study was to clarify the cognitive function characteristics of NH residents with CI in whom a non-pharmacological intervention (NPI) can be implemented, consisting of MNPI using a Bayesian analysis, and to incorporate suggestions to make the MNPI strategy as effective as possible.This study had a cross-sectional design. The 61 subjects were selected from the residents of 5 NHs, of whom 90.16% were female, and the mean (standard deviation) age was 87.20 ±â€Š6.90. Analyses were performed using a hierarchical Bayesian model, and the global and specific cognitive functions as assessed by the Japanese version of the Neurobehavioral Cognitive Status Examination were the response variables. Three types of NPI (cognitive enhancement NPI, physical NPI, psychological and psychosocial NPI), and activities of daily living (ADL), as assessed by the Barthel index, were the explanatory variables.Cognitive enhancement NPI was revealed to have no association with any cognitive function. Physical NPI was negatively associated with orientation [OR 0.31 (95% credible interval (95% CI) -2.33, -0.10)], comprehension [OR 0.16 (95% CI -2.78, -0.95)] and naming [OR 0.49 (95% CI -1.47, -0.02)]. Psychological and psychosocial NPI was positively associated with comprehension [OR 3.67 (95% CI 0.52, 2.13)]. Barthel index was positively associated with total Japanese version of the Neurobehavioral Cognitive Status Examination [OR 1.74 (95% CI 0.08, 2.12)], comprehension [OR 3.49 (95% CI 0.45, 4.67)], repetition [OR 10.07 (95% CI 0.53, 9.01)], naming [OR 2.24 (95% CI 0.07, 3.20)], and calculations [OR 18.82 (95% CI 2.71, 9.40)].The implementation of MNPI should be preceded by cognitive enhancement NPI and physical NPI. Providing ADL enhancing NPI in response to cognitive improvement may be an effective strategy. Providing cognitive enhancement NPI, physical NPI, psychological, and psychosocial NPI, as well as ADL-enhancing NPI at the same time, is also an effective strategy for subjects with mild dementia who are considered to have relatively high cognitive functions.


Assuntos
Disfunção Cognitiva/terapia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Terapia Combinada , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Testes Neuropsicológicos , Participação Social
20.
Medicine (Baltimore) ; 99(37): e22187, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925791

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between normal aging and Alzheimer disease, which is the most common form of dementia in the world. In clinical practice, traditional Chinese medicine (TCM) interventions have been administered for MCI, However, there is still uncertain about what strategy of TCM interventions treatment should be preferred in clinical practice. This study aims to evaluate the efficacy and acceptability of different TCM therapies through systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of 7 electronic databases by August 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases. After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of TCM therapies for MCI. The primary outcome of this study is the improvement of cognitive function and the secondary outcome is the activities of daily living, clinical efficacy, and adverse events, and the quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. RESULTS: This study will provide a reliable evidence for the selection of TCM therapies in the treatment of MCI. CONCLUSION: This study will generate evidence for different TCM therapies for MCI and provide a decision-making reference for clinical research. ETHICS AND DISSEMINATION: This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/JV9KG.


Assuntos
Disfunção Cognitiva/terapia , Medicina Tradicional Chinesa/métodos , Atividades Cotidianas , Humanos , Medicina Tradicional Chinesa/efeitos adversos , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
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