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1.
Rev. enferm. UERJ ; 29: e56956, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224594

RESUMO

Objetivo: avaliar o desempenho das atividades de vida diárias e identificar diagnósticos de enfermagem de pessoas em situação de rua. Métodos: estudo transversal, realizado de abril a julho de 2017, com 52 pessoas. Para coleta de dados, foi utilizado instrumento fundamentado no modelo teórico de Roper-Logan e Tierney. Foram consideradas dependentes as atividades de vida com frequência igual ou superior a 40%, para inferência dos diagnósticos utilizou-se referencial de Risner. Resultados: as atividades de vida dependentes foram: trabalho e distração (92,3%), morte (88,5%), sexualidade (76,9%), sono (71,2%), manter ambiente seguro (71,2%), respirar (61,5%), eliminar (53,8%) e alimentar-se (51,9%). Os diagnósticos mais frequentes: Disposição para comunicação melhorada (96%), Desobstrução ineficaz das vias aéreas (94%), Risco de contaminação (77%) e Controle de impulsos ineficaz (73%). Conclusão: evidenciou-se que pessoas em situação de rua possuem dependência de cuidados em atividades de vida diária relacionados a aspectos fisiológicos, sociais e emocionais.


Objective: to evaluate performance of activities of daily living (ADLs) and to identify nursing diagnoses for people living on the streets. Methods: in this cross-sectional study of 52 people, data were collected between April and July 2017 using an instrument based on the Roper-Logan-Tierney theoretical model. ADLs with frequency of 40% or more were considered to be care-dependent; diagnoses were inferred using a Risner framework. Results: dependent ADLs were: working and playing (92.3%), dying (88.5%), expressing sexuality (76.9%), sleeping (71.2%), maintaining a safe environment (71.2 %), breathing (61.5%), eliminating body wastes (53.8%), and eating (51.9%). The most frequent diagnoses were: improved communication disposition (96%), ineffective airway clearance (94%), contamination risk (77%), and ineffective impulse control (73%). Conclusion: people living on the streets were found to be dependent on care in physiological, social and emotional ADLs.


Objetivo: evaluar el desempeño de las actividades de la vida diaria e identificar diagnósticos de enfermería para personas que viven en la calle. Métodos: estudio transversal, realizado entre abril y julio de 2017, con 52 personas. Para la recolección de datos se utilizó un instrumento basado en el modelo teórico de Roper-Logan y Tierney. Se consideraron como dependientes las actividades de vida con una frecuencia igual o superior al 40%. Para inferir los diagnósticos se utilizó el modelo referencial de Risner. Resultados: las actividades de la vida dependientes fueron: trabajo y distracción (92,3%), muerte (88,5%), sexualidad (76,9%), sueño (71,2%), mantener un ambiente seguro (71,2%), respirar (61,5%), eliminar (53,8%) y alimentarse (51,9%). Los diagnósticos más frecuentes: Mejora de la disposición comunicativa (96%), Limpieza ineficaz de la vía aérea (94%), Riesgo de contaminación (77%) y Control ineficaz de los impulsos (73%). Conclusión: se evidenció que las personas que viven en la calle son dependientes de cuidados en las actividades de la vida diaria relacionadas con los aspectos fisiológicos, sociales y emocionales.


Assuntos
Humanos , Masculino , Feminino , Diagnóstico de Enfermagem , Teoria de Enfermagem , Pessoas em Situação de Rua , Atividades Cotidianas , Epidemiologia Descritiva , Estudos Transversais , Cuidados de Enfermagem
2.
An. psicol ; 37(2): 265-275, mayo-sept. 2021. graf
Artigo em Inglês | IBECS | ID: ibc-202550

RESUMO

The main aim of this study was to find out more about the role of great-grandparenthood. A group of participants with greatgrandchildren (n = 78) was interviewed using a questionnaire containing questions that had been put through a previous pilot study, covering participants' sociodemographics, the activities that participants shared with their great-grandchildren, and their view of the role of great-grandparent and their related degree of satisfaction. The data were recorded and analyzed both with frequency tables and descriptive statistics and with the Kruskal-Wallis non-parametric test. The results showed several significant relationships between the shared activities and the sociodemographic variables, such as great-grandparents' age (p ≤ .05), education (p ≤ .01), health status (p ≤ .05), the distance at which they live from their great-grandchildren (p ≤ .05). Also, it was found that participants generally con-sider the role of great-grandparent to be a continuation of their prior role as grandparent, albeit from the perspective of a formal intergenerational typology, distinct from the informal typology and, above all, opposed to the role of substitute/surrogate. Greater perceived satisfaction was associated with this typical interaction of the formal role (p ≤ .01). Great-grandparents may already be fulfilling a notable function in today's four-generation families


El objetivo general de este trabajo es conocer mejor el rol de bisabuelidad. Se entrevistó a un grupo de voluntarios con bisnietos (n = 78) mediante un cuestionario, cuyo contenido fue pilotado previamente, con preguntas sobre sus características sociodemográficas, las actividades que solían compartir con sus bisnietos y su opinión del rol de bisabuelidad, con la satisfacción asociada. Los datos fueron registrados y analizados tanto con tablas de frecuencia y estadísticos descriptivos, como con la prueba no-paramétrica de Kruskal-Wallis. Los resultados obtenidos mostraron numerosas relaciones significativas entre las actividades compartidas y aspectos socio-demográficos de los bisabuelos como la edad (p ≤ .05), el nivel educativo (p ≤ .01), la salud (p ≤ .05), la distancia a la que viven de sus bisnietos (p ≤ .05). Además, de mostrar que perciben su rol de bisabuelidad en general como una continuidad del rol anterior de abuelidad, aunque desde una tipología intergeneracional formal, distinta a la tipología informal y, sobre todo, opuesta a la del rol sustituto/subrogado. La mayor satisfacción percibida estaba asociada a esa interacción típica del rol formal (p ≤ .01). Los bisabuelos podrían estar cumpliendo ya alguna función destacable en las familias actuales de cuatro generaciones


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Idoso , Idoso de 80 Anos ou mais , Avós/psicologia , Relação entre Gerações , Atividades Cotidianas/psicologia , Projetos Piloto , Fatores Socioeconômicos , Inquéritos e Questionários , Satisfação Pessoal
3.
Bragança; s.n; 20210000. tab, ilus.
Tese em Português | BDENF - Enfermagem | ID: biblio-1281601

RESUMO

A desnutrição associada à doença é um grave problema que pode influenciar o prognóstico, aumentar os tempos de internamento, os custos e os resultados em saúde. No doente vítima de AVC, onde são frequentes as alterações do estado de consciência, a presença de disfagia orofaríngea e outras comorbidades, as consequências clínicas da desnutrição poderão afetar os processos de reabilitação e a funcionalidade. Objetivos: O presente estudo teve como objetivo principal avaliar o o risco nutricional em doentes com AVC, aquando da admissão no internamento e aos três meses após a alta hospitalar, e procurar associações entre o estado nutricional e outras variáveis referentes ao estado funcional. Métodos: Foram avaliados 70 doentes ingressados consecutivamente numa Unidade de AVC, na admissão, alta e 3 meses após a alta. Do formulário faziam parte variáveis sociodemográficas e clínicas. Nos 3 momentos de avaliação foi aplicada a Mini Avaliação Nutricional (MNA) para aferir o estado nutricional e a Escala de Rankin Modificada (ERM) e Índice de Barthel (IB) para avaliação da funcionalidade. Resultados: Dos doentes avaliados (76,1±11,2 anos) (80%) apresentavam AVC isquémico e 20% AVC hemorrágico. Os dados relativos ao estado funcional (ERM, IB) e ao estado nutricional (MNA) variaram significativamente de acordo com os vários momentos de avaliação (p<0,05). Observou-se uma correlação entre o estado nutricional e a funcionalidade em todos os momentos de avaliação (p< 0,05). Conclusão: Pela análise estatística realizada conclui-se que um bom estado nutricional prognostica uma melhor funcionalidade, analisando esta última variável quer através da ERM quer através do IB.


Malnutrition associated with the disease is a serious problem that can influence the prognosis, increase hospitalization times, costs and health outcomes. In a stroke victim, where changes in the state of consciousness are frequent, the presence of oropharyngeal dysphagia and other comorbidities, the clinical consequences of malnutrition may affect the rehabilitation processes and functionality. Aim: The main objective of this study was to assess the nutritional risk in stroke patients, upon admission to hospital and three months after hospital discharge, and to look for associations between nutritional status and other variables related to functional status. Methods: Seventy patients admitted consecutively to a stroke unit were evaluated on admission, discharge and 3 months after discharge. The form included sociodemographic and clinical variables. In the 3 assessment moments, the Mini Nutritional Assessment (MNA) was applied to assess the nutritional status and the Modified Rankin Scale (mRS) and Barthel Index (BI) to assess functionality. Results: Of the patients evaluated (76.1 ± 11.2 years) 80% had ischemic stroke and 20% hemorrhagic stroke. The data related to functional status (mRS, BI) and nutritional status (MNA) varied significantly according to the various moments of assessment (p <0.05). There was a correlation between nutritional status and functionality at all times of assessment (p <0.05). Conclusion: From the statistical analysis performed, we concluded that a good nutritional status predicts a better functionality, analyzing this last variable either through the mRS or through the BI.


Assuntos
Humanos , Idoso , Repertório de Barthel , Acidente Vascular Cerebral , AVC Isquêmico , AVC Hemorrágico , Deficiência de Proteína , Atividades Cotidianas
4.
Sensors (Basel) ; 21(11)2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34199814

RESUMO

The health status of an elderly person can be identified by examining the additive effects of aging along with disease linked to it and can lead to 'unstable incapacity'. This health status is determined by the apparent decline of independence in activities of daily living (ADLs). Detecting ADLs provides possibilities of improving the home life of elderly people as it can be applied to fall detection systems. This paper presents fall detection in elderly people based on radar image classification by examining their daily routine activities, using radar data that were previously collected for 99 volunteers. Machine learning techniques are used classify six human activities, namely walking, sitting, standing, picking up objects, drinking water and fall events. Different machine learning algorithms, such as random forest, K-nearest neighbours, support vector machine, long short-term memory, bi-directional long short-term memory and convolutional neural networks, were used for data classification. To obtain optimum results, we applied data processing techniques, such as principal component analysis and data augmentation, to the available radar images. The aim of this paper is to improve upon the results achieved using a publicly available dataset to further improve upon research of fall detection systems. It was found out that the best results were obtained using the CNN algorithm with principal component analysis and data augmentation together to obtain a result of 95.30% accuracy. The results also demonstrated that principal component analysis was most beneficial when the training data were expanded by augmentation of the available data. The results of our proposed approach, in comparison to the state of the art, have shown the highest accuracy.


Assuntos
Atividades Cotidianas , Radar , Idoso , Algoritmos , Humanos , Aprendizado de Máquina , Redes Neurais de Computação , Caminhada
5.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34212738

RESUMO

BACKGROUND: The responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria. AIM: To assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer. SETTING: The study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria. METHODS: A cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained. RESULTS: Over half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78). CONCLUSION: Family caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.


Assuntos
Neoplasias da Mama/radioterapia , Fardo do Cuidador , Cuidadores/psicologia , Radioterapia (Especialidade) , Atividades Cotidianas , Adulto , Idoso , Neoplasias da Mama/patologia , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença
6.
Artigo em Russo | MEDLINE | ID: mdl-34223749

RESUMO

Ischemic stroke (IS) is a serious medical and social problem due to the widespread prevalence, profound and long-term disability of patients. The effectiveness of pharmaceutical neuroprotection in IS remains low which necessitates the investigation of new therapeutic methods in post-stroke patients. OBJECTIVE: The rationale for the use of infrared (IR) radiation with terahertz (THz) modulation in the complex treatment of patients in the acute period of IS. MATERIAL AND METHODS: The results of transcranial application of IR radiation with THz modulation in 112 patients in the acute period of IS are presented. In the main group (38 patients) the infrared radiation with THz modulation was used on the projection of the IS focus in addition to basic drug therapy; in the control group (37 patients) - basic drug therapy; in the placebo group (37 patients) the physiotherapy was mimicked. The data of neurological status and neuro-functional indicators were assessed using the NIHSS, MMSE, Rankin, and Rivermid scales. Cerebral blood flow was examined using duplex scanning of brachiocephalic vessels. RESULTS: The inclusion in the complex treatment of IR radiation with THz modulation on the projection of the IS focus in the acute period contributed to a significant regression of neurological deficit, a complete recovery of cognitive functions and an increase in daily activity due to the restoration of adequate blood supply on the side of the affected hemisphere. CONCLUSION: A pathogenesis justified method of treating acute IS is proposed which can increase the effectiveness of early neurorehabilitation measures. An early improvement in cerebral hemoperfusion led to the creation of optimal conditions for the survival of neural structures and the preservation of their functional activity that demonstrated the neuroprotective feasibility of early inclusion of IR radiation with THz modulation in the complex treatment of patients in the acute period of IS.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Atividades Cotidianas , Cognição , Humanos
7.
F1000Res ; 10: 214, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249338

RESUMO

Background: Despite the potential benefits, the effects of Hybrid Assistive Limb (HAL) gait training on changes in neuromuscular activation that accompany functional gains in individuals with spinal muscular atrophy (SMA) type III is not well known. In this article, we quantify the effects of HAL gait training on spatial muscle activity patterns in a patient with SMA type III using multi-channel surface electromyography (SEMG). Methods: A 21-years old male (168 cm, 47.8 kg) with spinal muscular atrophy type III, when diagnosed at 18-years old by genetic screening, participated in this case study. Although he presented with forearm distal muscle weakness, atrophy of the intrinsic muscles of the hand, and neuromuscular fatigue, his activities of daily living is independent. The patient underwent a separate, single 33-minute session of both HAL and treadmill gait training. To evaluate the coefficient of variation (CoV) of force and alterations in the SEMG spatial distribution patterns, modified entropy and CoV of root mean square (RMS) were calculated from the vastus lateralis (VL) muscle before and after the intervention of HAL and treadmill gait training. Each training session was separated by a period of one month to avoid cross-over effects. Results: There was a greater decrease in the ΔCoV of force and an increase in the magnitude of whole VL muscle activation from pre-intervention to post-intervention with the HAL gait training as compared to the treadmill gait training. In response to only HAL gait training, the CoV of RMS was higher, and the modified entropy was lower post-intervention than pre-intervention. Conclusions: Our results support the notion that HAL gait training has a positive benefit on motor output not only in the magnitude of SEMG generated but also the patterns of neural activation.


Assuntos
Atividades Cotidianas , Atrofias Musculares Espinais da Infância , Adolescente , Adulto , Marcha , Humanos , Masculino , Músculos , Caminhada , Adulto Jovem
8.
J Foot Ankle Res ; 14(1): 46, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193240

RESUMO

BACKGROUND: In response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals' engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living. METHODS: A population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to closed and open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation. RESULTS: Two hundred fifty-five respondents completed the survey. Most (n = 193, 75.69%) reported an ongoing foot pain or problem that had been present for 4 weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n = 139, 54.51%), whilst change in appearance of the foot was also commonly reported (n = 122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n = 123, 48%), and were significantly associated with reported reduced physical activity (X2 = 6.61, p = 0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. 'cope or crumble' scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity. CONCLUSIONS: Pain was the most frequently reported foot problem during COVID-19 lockdown restriction. Lockdown restrictions disrupted support networks integral to maintaining foot health. Poor foot health impacted people's ability to remain physically active. Complaints previously considered relatively 'minor' such as support for skin and nail care, were found to be exacerbated by restricted support networks, leading to greater negative impact.


Assuntos
COVID-19/prevenção & controle , Exercício Físico/psicologia , Pé/patologia , Dor Musculoesquelética/epidemiologia , Isolamento Social/psicologia , Atividades Cotidianas/psicologia , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Estudos de Avaliação como Assunto , Feminino , Regulamentação Governamental , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/diagnóstico , Participação do Paciente , SARS-CoV-2/genética , Comportamento Sedentário , Autocuidado/psicologia , Grupos de Autoajuda/organização & administração , Inquéritos e Questionários
9.
Artigo em Inglês | MEDLINE | ID: mdl-34205457

RESUMO

BACKGROUND: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention).


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Terapia por Exercício , Marcha , Humanos , Estudos Multicêntricos como Assunto , Equilíbrio Postural , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Postura Sentada , Resultado do Tratamento
10.
Artigo em Inglês | MEDLINE | ID: mdl-34205495

RESUMO

Vulvodynia is one the most common causes of pain during sexual intercourse in premenopausal women. The burden of vulvodynia in a woman's life can be devastating due to its consequences in the couple's sexuality and intimacy, in activities of daily living, and psychological well-being. In recent decades, there has been considerable progress in the understanding of vulvar pain. The most significant change has been the differentiation of vulvar pain secondary to pathology or disease from vulvodynia. However, although it is currently proposed that vulvodynia should be considered as a primary chronic pain condition and, therefore, without an obvious identifiable cause, it is still believed that different inflammatory, genetic, hormonal, muscular factors, etc. may be involved in its development. Advances in pain neuroscience and the central sensitization paradigm have led to a new approach to vulvodynia from a neurobiological perspective. It is proposed that vulvodynia should be understood as complex pain without relevant nociception. Different clinical identifiers of vulvodynia are presented from a neurobiological and psychosocial perspective. In this case, strategies to modulate altered central pain processing is necessary, changing the patient's erroneous cognitions about their pain, and also reducing fear avoidance-behaviors and the disability of the patient.


Assuntos
Vulvodinia , Atividades Cotidianas , Coito , Feminino , Humanos , Comportamento Sexual , Parceiros Sexuais , Vulvodinia/epidemiologia , Vulvodinia/etiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34207132

RESUMO

The household registration system (Hukou) in China classifies persons into rural or urban citizens and determines eligibility for state-provided services and welfare. Not taking actual residence into account may underestimate rural-urban differences. This study investigates rural-urban inequalities in self-reported health outcomes among older adults aged 60+, taking into account both Hukou and actual residence, adjusting for sociodemographic determinants, based on the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Self-Rated Health (SRH) was assessed with a single question, functional abilities were assessed with the Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs) scales, and depression was assessed with the 10-item version of the Center for Epidemiologic Studies Depression Scale. Rural respondents had poorer socioeconomic status and higher prevalence of poor SRH, functional disabilities, and depression than urban respondents in both years, which were closely related to rural-urban differences in educational level and income. Impairments appeared at a younger age among rural respondents. Analyses using only Hukou registration and not actual residence resulted in underestimation of rural-urban differences. This study may serve as a basis for interventions to address rural-urban differences in health and social services and reduce health inequalities among Chinese older adults.


Assuntos
Depressão , Aposentadoria , Atividades Cotidianas , Idoso , China/epidemiologia , Depressão/epidemiologia , Humanos , Estudos Longitudinais , População Rural , Autorrelato , População Urbana
12.
Artigo em Inglês | MEDLINE | ID: mdl-34207323

RESUMO

South Korea recently expanded its coverage rate of long-term care insurance (LTCI) by adding a "dementia special grade" in 2014 to improve care service accessibility and extend health life for older adults with dementia. In this study, we propose a multifaceted policy to reduce the suicide risk among older adults with dementia by evaluating the effectiveness of using the long-term care services (LTCS). A sample of 62,282 older adults was selected from the "Older Adults Cohort DB" of the National Health Insurance Service. We conducted Kaplan-Meier and Cox regression to represent the yearly survival curve from 2002 to 2015 according to the individual characteristics. Difference-in-difference estimation was conducted to identify the effect of LTCS on suicide rates by using LTCS before and after 2014. The suicide risk of older adults using LTCS was about 0.256-times lower than those who did not use it (OR = 0.296, 95% CI = 0.183-0.478), whereas it increased after the expansion of the dementia grading (OR = 2.131, 95% CI = 1.061-4.280). To prevent the risk of suicide among older adults with dementia, not only did the mortality rate vary depending on the sex, activities of daily living (ADL), and type of caregiver at the individual level but appropriate national intervention and management, such as improving the accessibility of LTCS, are also needed.


Assuntos
Demência , Suicídio , Atividades Cotidianas , Idoso , Humanos , Seguro de Assistência de Longo Prazo , Assistência de Longa Duração , República da Coreia/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34200564

RESUMO

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults' level of independence.


Assuntos
Pessoas com Deficiência , Perda Auditiva , Atividades Cotidianas , Idoso , Estudos Transversais , Feminino , Perda Auditiva/epidemiologia , Humanos , Malásia/epidemiologia , Masculino , Transtornos da Visão/epidemiologia
14.
Bone Joint J ; 103-B(7 Supple B): 25-32, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34192905

RESUMO

AIMS: Adverse local tissue reactions associated with abnormal wear considerably slowed down the general use of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), now limited to a few specialized centres. In this study, we provide the clinical results of 400 consecutive MoM HRAs implanted more than 20 years ago in one such centre. METHODS: A total of 355 patients (400 hips) were treated with Conserve Plus HRA between November 1996 and November 2000. There were 96 female (27%) and 259 male patients (73%). Their mean age was 48.2 years (SD 10.9). The University of California, Los Angeles (UCLA) hip scores and 12-item Short Form Survey (SF-12) quality of life scores were reported. Survivorship was assessed using Kaplan-Meier analyses. RESULTS: The mean follow-up was 16.5 years (0.1 to 24.0), including 34 patients (37 hips) who died. The mean UCLA hip scores were 9.3 (2 to 10), 9.1 (3 to 10), 9.0 (3 to 10), and 6.9 (2 to 10) for pain, walking, function, and activity, respectively. The mean SF-12 scores were 48.4 (16.0 to 62.1) for the physical component and 48.5 (10.5 to 66.5) for the mental component, and did not differ from those of the general population of the USA. A total of 60 hips in 55 patients were revised. Using revision for any indication as the endpoint, the Kaplan-Meier survivorship was 83.5% at 20 years. A diagnosis of developmental dysplasia (hazard ratio (HR) 2.199 (95% confidence interval (CI) 1.140 to 4.239); p = 0.019) and a low BMI (HR 0.931 (95% CI 0.873 to 0.994); p = 0.032) were risk factors for revision. Female sex was a risk factor only because of hip dysplasia and small component size. There were no cases of metal sensitivity associated with revision surgery. Radiological analysis showed persistent fixation in all but one hip. CONCLUSION: The 83.5% 20-year survivorship of this initial series surpasses that of total hip arthroplasties in use 20 years ago in these young patients, suggesting satisfactory lifelong durability of the device for almost all of the remaining patients. Cite this article: Bone Joint J 2021;103-B(7 Supple B):25-32.


Assuntos
Artroplastia de Quadril/métodos , Prótese de Quadril/efeitos adversos , Próteses Articulares Metal-Metal/efeitos adversos , Atividades Cotidianas , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Medição da Dor , Falha de Prótese , Qualidade de Vida , Recuperação de Função Fisiológica , Fatores de Risco , Fatores Sexuais
15.
Sensors (Basel) ; 21(13)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202820

RESUMO

Automatic fall detection systems ensure that elderly people get prompt assistance after experiencing a fall. Fall detection systems based on accelerometer measurements are widely used because of their portability and low cost. However, the ability of these systems to differentiate falls from Activities of Daily Living (ADL) is still not acceptable for everyday usage at a large scale. More work is still needed to raise the performance of these systems. In our research, we explored an essential but often neglected part of accelerometer-based fall detection systems-data segmentation. The aim of our work was to explore how different configurations of windows for data segmentation affect detection accuracy of a fall detection system and to find the best-performing configuration. For this purpose, we designed a testing environment for fall detection based on a Support Vector Machine (SVM) classifier and evaluated the influence of the number and duration of segmentation windows on the overall detection accuracy. Thereby, an event-centered approach for data segmentation was used, where windows are set relative to a potential fall event detected in the input data. Fall and ADL data records from three publicly available datasets were utilized for the test. We found that a configuration of three sequential windows (pre-impact, impact, and post-impact) provided the highest detection accuracy on all three datasets. The best results were obtained when either a 0.5 s or a 1 s long impact window was used, combined with pre- and post-impact windows of 3.5 s or 3.75 s.


Assuntos
Acidentes por Quedas , Atividades Cotidianas , Acelerometria , Idoso , Algoritmos , Humanos , Monitorização Ambulatorial
16.
Ann Palliat Med ; 10(6): 6678-6686, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34237971

RESUMO

BACKGROUND: Frailty is a common biological syndrome in elderly people, and the aging process regulates thyroid function. The present study aimed to determine the prevalence of frailty in an older inpatient cohort using the FRAIL scale and to evaluate the association of frailty with thyroid hormone levels. METHODS: This cross-sectional study was performed in the Department of Geriatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China. From November 2019 to April 2020, 146 inpatients aged ≥65 years were recruited for the study and demographic data, frailty, geriatric assessment, and thyroid hormone levels were evaluated. Frailty was determined by the FRAIL scale, and geriatric assessment was based on activities of daily living (ADL) and instrumental activities of daily living (IADL). The data were analyzed using appropriate parametric and nonparametric statistical tests. RESULTS: At enrollment, 31 (21.23%) of the total participants were robust, 31 (21.23%) were pre-frail, and 84 (57.53%) were frail. The frail patients were significantly older than the robust patients and pre-frail patients (P<0.001 for both). The percentages of ADL disability differed significantly among the patients for frail versus robust, frail versus pre-frail, and pre-frail versus robust, as did the percentages of IADL disability among patients for frail versus robust and frail versus pre-frail (P<0.01 for all). In binary logistic regression analyses adjusted for age, sex, body mass index, HbA1c (%), and smoking, frailty was significantly associated with serum thyroid stimulating hormone (TSH) concentration [odds ratio (OR): 1.704], T3 concentration (OR: 0.102), ADL score (OR: 0.793), and IADL score (OR: 0.413). CONCLUSIONS: In our study population, the prevalence of frailty was higher in older geriatric inpatients in China than other studies. Inpatients with high TSH levels were at increased risk of frailty. Conduction of future longitudinal studies is warranted to determine the relationship between thyroid hormone levels and frailty.


Assuntos
Fragilidade , Pacientes Internados , Atividades Cotidianas , Idoso , China/epidemiologia , Estudos Transversais , Idoso Fragilizado , Fragilidade/epidemiologia , Humanos , Glândula Tireoide , Hormônios Tireóideos
17.
Ann Palliat Med ; 10(6): 6909-6918, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34237988

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is a common joint disease worldwide, and the main cause of pain and disability in the elderly. Due to increased aging and rates of obesity of the global population, the number of patients with KOA is expected to increase. To reduce the burden of KOA, effective and safe interventions should be developed to reduce pain and improve range of motion, functionality, and quality of life. The aim of the proposed randomized controlled study was to evaluate the efficacy and safety of a traditional Chinese medicine (TCM) rehabilitation therapy in the treatment of KOA. METHODS: This multicenter, randomized, double-blind, parallel group, placebo-controlled trial will include a total of 200 patients with KOA. The enrolled patients will be randomly divided into the experimental group (n=100) and control group (n=100). The experimental group will receive basic treatment plus TCM rehabilitation therapy, while the control group will receive basic treatment plus physiotherapy regimen. Primary endpoints will include clinical efficacy outcomes, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index score, and Knee Outcome Survey Activities of Daily Living Scale score. The data will help determine whether TCM rehabilitation therapy is beneficial for the treatment of KOA. DISCUSSION: The results will provide high-quality guidance for the current clinical treatment of KOA, and provide patients with more options for symptom relief. The findings from this study may provide updated evidence concerning the efficacy and safety of TCM for patients with KOA.


Assuntos
Osteoartrite do Joelho , Atividades Cotidianas , Idoso , Humanos , Medicina Tradicional Chinesa , Estudos Multicêntricos como Assunto , Medição da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
18.
Artigo em Inglês | MEDLINE | ID: mdl-34204141

RESUMO

Home-based models represent one of the solutions to respond to the poor accessibility of pulmonary rehabilitation (PR) services in patients with chronic respiratory disease (CRD). The main goal of this protocol is to present the implementation of the first nationwide home-based PR program-reabilitAR-in Portugal and the strategies to assess its benefits in patients with CRD. The program consists of 2 phases: a 12-week intensive phase and a 40-week maintenance phase (total: 52 weeks, 1 year). The intervention in both phases is composed of presential home visits and phone-call follow ups, including exercise training and the self-management educational program Living Well with COPD. Dyspnea, impact of the disease, emotional status, and level of dyspnea during activities of daily living are used as patient-reported outcomes measures. A one-minute sit-to-stand test is used as a functional outcome, and the number of steps as a measure of physical activity. To ensure safety, fall risk and the cognitive function are assessed. Data are collected at baseline, at 12 weeks, at 26 weeks and at 52 weeks. This is the first nationwide protocol on enhancing access to PR, providing appropriate responses to CRD patients' needs through a structured and personalized home-based program in Portugal.


Assuntos
Atividades Cotidianas , Doença Pulmonar Obstrutiva Crônica , Dispneia , Terapia por Exercício , Tolerância ao Exercício , Humanos , Portugal , Qualidade de Vida , Resultado do Tratamento
19.
Trials ; 22(1): 439, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243808

RESUMO

BACKGROUND: Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. METHODS: This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. STUDY OUTCOME: The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. RESULTS: A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. CONCLUSION: The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT04542772 . Registered on 9 September 2020. Protocol version: Final 1.0.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Humanos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Resultado do Tratamento , Extremidade Superior
20.
Health Qual Life Outcomes ; 19(1): 181, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284776

RESUMO

BACKGROUND: The study aimed to appraise the health-related quality of life (HRQoL) measured by the five-level EuroQol-5 dimensions (EQ-5D-5L) in amyotrophic lateral sclerosis (ALS), and to explore the associations between non-motor symptoms (mood changes, cognitive disturbances and sleep disturbances). METHODS: EQ-5D-5L descriptive scores were converted into a single aggregated "health utility" score. A calibrated visual analog scale (EQ-VAS) was used for self-rating of current health status. Multiple logistic regression analysis was used to explore the factors associated with HRQoL. RESULTS: Among the 547 enrolled ALS patients who were assessed using EQ-5D-5L, the highest frequency of reported problems was with usual activities (76.7%), followed by self-care (68.8%) and anxiety/depression (62.0%). The median health utility score was 0.78 and the median EQ-VAS score was 70. Clinical factors corresponding to differences in the EQ-5D-5L health utility score included age of onset, onset region, the ALS Functional Rating Scale-Revised (ALSFRS-R) score, and King's College stages. Patients with depression, anxiety, and poor sleep had lower health utility scores. Patients with excessive daytime sleepiness and rapid eye movement sleep behavior disorder had lower EQ-VAS scores. Multivariate logistic analysis indicated that ALSFRS-R scores, depression, and anxiety were associated with health utility scores. After adjusting other parameters, ALSFRS-R score, stages, and depression were significantly associated with EQ-VAS scores (P < 0.05). CONCLUSION: This study examined HRQoL in ALS patients using the Chinese version of the EQ-5D-5L scale across different stages of the disease. We found that HRQoL is related to disease severity and to mood disturbances. Management of non-motor symptoms may help improve HRQoL in ALS patients.


Assuntos
Esclerose Amiotrófica Lateral/diagnóstico , Qualidade de Vida , Atividades Cotidianas , Adulto , Idoso , Esclerose Amiotrófica Lateral/psicologia , Ansiedade , Disfunção Cognitiva , Depressão , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Medição da Dor , Autocuidado , Índice de Gravidade de Doença , Inquéritos e Questionários , Escala Visual Analógica
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