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1.
PLoS One ; 17(6): e0269727, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35687609

RESUMO

As a member state of the European Union, where vaccines against COVID-19 are available and affordable, Bulgaria reports the lowest immunization coverage and the most pronounced vaccine distrust. The present study aimed to assess the self-reported adverse reactions following COVID-19 vaccination as a possible tool to increase the trust in vaccines. A cross-sectional survey-based study, covering 761 vaccinated respondents, was conducted in Plovdiv (469 with an mRNA vaccine and 292 with an adenoviral vector vaccine). Descriptive statistics parametric and non-parametric methods were applied. Statistical significance was set at p<0.05. The median age of the respondents was 42 years, females (72.5%). At least one adverse reaction was reported in 89.9% of those immunized with mRNA vaccine and 93.8% in the adenoviral vector vaccine group (p>0.05). They were mild to moderate and resolved within several days. The levels of local reactions were comparable: 91.7% in those who received mRNA and 89.7% in those who received an adenoviral vector vaccine (p = 0.366). The most common types of systemic reactions were fatigue, headache, and muscle pains. An association was found between the systemic reactions and the type of vaccine administered: 59.7% in mRNA recipients and 89.4% in adenoviral vector vaccinees (p<0.001). None of the registered systemic reactions required medical attention. There were 3 reports of generalized urticaria after an mRNA and 2 after an adenoviral vector vaccine. The reported reactions are relatively high but expected and no adverse events have been reported that are not listed in the official Summary of Product Characteristics.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Vacinas Virais , Adulto , Bulgária , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Estudos Transversais , Feminino , Humanos , RNA Mensageiro , Autorrelato , Vacinação , Vacinas Sintéticas/efeitos adversos , Vacinas Virais/efeitos adversos
2.
Cien Saude Colet ; 27(7): 2643-2653, 2022 Jul.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35730835

RESUMO

This study aims to analyze the prevalence of self-reported diabetes and its associated factors in the Brazilian adult population. It is a cross-sectional study using the 2019 National Health Survey. Prevalence and crude prevalence ratios (PRc) and adjusted prevalence ratios (PRa) of self-reported diabetes were estimated, with confidence intervals (95% CI), using Poisson regression. In the 82,349 adults, the prevalence of self-reported diabetes was 7.7%. Positively associated factors were: advanced age with greater association after 60 years (PRa 24.87; 95%CI 15.78-39.18); living in the Northeast (PRa 1.16; 95%CI 1.04-1.29), Southeast (PRa 1.27; 95% CI 1.14-1.43), South (PRa 1.18; 95%CI 1, 05-1.34), and Midwest (PRa 1.21; 95%CI 1.06-1.38); being a former smoker (PRa 1.17; 95%CI 1.09-1.27); self-assessment of regular health (PRa 2.41; 95%CI 2.21-2.64), bad/very bad (PRa 3.45; 95%CI 3.06-3.88); having heart disease (PRa 1.81; 95%CI 1.64-2.00), hypertension (PRa 2.84; 95%CI 2.60-3.69), high cholesterol (PRa 2.22; 95%CI 2.05-2.41), overweight (PRa 1.49; 95%CI 1.36-1.64), and obesity (PRa 2.25; 95%CI 2.05-2.47). It could be concluded that diabetes in Brazilian adults is associated with sociodemographic factors, aging, lifestyle, and morbidities. These results can guide public policies for the prevention and control of disease in Brazil.


O estudo analisa a prevalência de diabetes autorreferido e fatores associados na população adulta brasileira. Estudo transversal usando a Pesquisa Nacional de Saúde 2019. Estimaram-se as prevalências e razões de prevalência brutas (RPb) e ajustadas (RPa) de diabetes autorreferido, com intervalos de confiança (IC95%), empregando-se regressão de Poisson. Nos 82.349 adultos, a prevalência de diabetes autorreferido foi de 7,7%. Associaram-se positivamente: idade avançada, sendo maior após 60 anos (RPa 24,87; IC95%: 15,78-39,18); residir nas regiões Nordeste (RPa 1,16; IC95%: 1,04-1,29), Sudeste (RPa 1,27; IC95%: 1,14-1,43), Sul (RPa 1,18; IC95%: 1,05-1,34) e Centro-Oeste (RPa 1,21; IC95%: 1,06-1,38), ser ex-fumante (RPa 1,17; IC95%: 1,09-1,27), autoavaliação de saúde regular (RPa 2,41; IC95%: 2,21-2,64), ruim/muito ruim (RPa 3,45; IC95%: 3,06-3,88), ter doença cardíaca (RPa 1,81; IC95%: 1,64-2,00), hipertensão (RPa 2,84; IC95%: 2,60-3,69), colesterol elevado (RPa 2,22; IC95%: 2,05-2,41), sobrepeso (RPa 1,49; IC95%: 1,36-1,64) e obesidade (RPa 2,25; IC95%: 2,05- 2,47). Conclui-se que o diabetes nos adultos brasileiros se associa a fatores sociodemográficos, envelhecimento, estilos de vida e morbidades. Esses resultados podem orientar políticas públicas para prevenção e controle da doença no Brasil.


Assuntos
Diabetes Mellitus , Adulto , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Prevalência , Autorrelato , Fatores Socioeconômicos
3.
Epidemiol Serv Saude ; 31(spe 1): e2021386, 2022.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35730889

RESUMO

OBJECTIVE: To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. METHODS: This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. RESULTS: This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. CONCLUSION: NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.


Assuntos
Doenças não Transmissíveis , Transtornos do Sono-Vigília , Adolescente , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Multimorbidade , Doenças não Transmissíveis/epidemiologia , Prevalência , Autorrelato , Transtornos do Sono-Vigília/epidemiologia
4.
JMIR Mhealth Uhealth ; 10(6): e38991, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35724966

RESUMO

BACKGROUND: Alcohol misuse is higher in the UK armed forces (AF) than in the general population. Research demonstrates that alcohol misuse persists after an individual leaves service, and this is notably the case for those who are seeking help for a mental health difficulty. Despite this, there is no work on testing a mobile alcohol reduction intervention that is personalized to support the UK AF. OBJECTIVE: To address this gap, we investigated the efficacy of a 28-day brief alcohol intervention delivered via a mobile app in reducing weekly self-reported alcohol consumption among UK veterans seeking help for mental health difficulties. METHODS: We performed a 2-arm participant-blinded randomized controlled trial (RCT). We compared a mobile app that included interactive features designed to enhance participants' motivation and personalized messaging (intervention arm) with a version that provided government guidance on alcohol consumption only (control arm). Adults were eligible if they had served in the UK AF, were currently receiving or had received clinical support for mental health symptoms, and consumed 14 units (approximately 112 g of ethanol) or more of alcohol per week. Participants received the intervention or the control mobile app (1:1 ratio). The primary outcome was a change in self-reported weekly alcohol consumption between baseline and day 84 assessed using the validated Timeline Follow Back for Alcohol Consumption (TLFB) (prior 7 days), with a secondary outcome exploring self-reported change in the Alcohol Use Disorder Identification Test (AUDIT) score. RESULTS: Between October 2020 and April 2021, 2708 individuals were invited to take part, of which 2531 (93.5%) did not respond, 54 (2%) were ineligible, and 123 (4.5%) responded and were randomly allocated (62, 50.4%, intervention; 61, 49.6%, control). At day 84, 41 (66.1%) participants in the intervention arm and 37 (60.7%) in the control arm completed the primary outcome assessment. Between baseline and day 84, weekly alcohol consumption reduced by -10.5 (95% CI -19.5 to -1.5) units in the control arm and -28.2 (95% CI -36.9 to -19.5) units in the intervention arm (P=.003, Cohen d=0.35). We also found a significant reduction in the AUDIT score of -3.9 (95% CI -6.2 to -1.6) in the intervention arm (Cohen d=0.48). Our primary and secondary effects did not persist over the longer term (day 168). Two adverse events were detected during the trial. CONCLUSIONS: This study examined the efficacy of a fully automated 28-day brief alcohol intervention delivered via a mobile app in a help-seeking sample of UK veterans with hazardous alcohol consumption. We found that participants receiving Drinks:Ration reduced their alcohol consumption more than participants receiving guidance only (at day 84). In the short term, we found Drinks:Ration is efficacious in reducing alcohol consumption in help-seeking veterans. TRIAL REGISTRATION: ClinicalTrials.gov NCT04494594; https://tinyurl.com/34em6n9f. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/19720.


Assuntos
Alcoolismo , Aplicativos Móveis , Veteranos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/prevenção & controle , Humanos , Autorrelato
5.
Reprod Health ; 19(1): 143, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725562

RESUMO

BACKGROUND: Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of training with onsite clinical mentorship towards self-reported performance in RMNH among healthcare workers in Mwanza Region, Tanzania. METHODS: The study used a quasi-experimental design with pre-and post-intervention evaluation strategy. The baseline was compared with two endline groups: those with intervention (training and onsite mentorship) and those without. The differences among the three groups in the sociodemographic characteristics were analyzed by using chi-square test for categorical variables, independent-sample t-test for continuous variables and Mann-Whitney U test for ordinal or skewed continuous data. The independent sample t-test was used to determine the effect of the intervention by comparing the computed self-reported performance on RMNH services between the intervention and control groups. The paired-samples t-test was used to measure the differences between before and after intervention groups. Significance was set at a 95% confidence interval with p ≤ 0.05. RESULTS: The study included a sample of 216 participants with before and after intervention groups comprising of 95 (44.0%) and 121 (56.0%) in the control group. The comparison between before and after intervention groups revealed a statistically significant difference (p ≤ 0.05) in all the dimensions of the self-reported performance scores. However, the comparison between intervention groups and controls indicated a statistical significant difference on intra-operative care (t = 3.10, df = 216, p = 0.002), leadership skills (t = 1.85, df = 216, p = 0.050), Comprehensive emergency obstetric and newborn care (CEMONC) (t = 34.35, df = 216, p ≤ 0.001), and overall self-reported performance in RMNH (t = 3.15, df = 216, p = 0.002). CONCLUSIONS: This study revealed that the training and onsite clinical mentorship to have significant positive changes in self-reported performance in a wide range of RMNH services especially on intra-operative care, leadership skills and CEMONC. However, further studies with rigorous designs are warranted to evaluate the long-term effect of such training programs on RMNH outcomes.


Reproductive maternal and newborn health (RMNH) in low- and middle-income countries continue to face critical challenges. Training healthcare workers especially using a combined approach (training followed by immediate clinical mentorship) in RMNH have been documented as an essential strategy to reduce maternal and neonatal mortality in low-and middle-income countries closer to those in high-income countries. This study investigated the effectiveness of a Continuous Professional Development (CPD) trainings on performance among healthcare workers in Mwanza Region. The study included a sample of 216 participants with before and after intervention groups comprising of 95 participants and control group comprising of 121 participants. The findings revealed that in comparison between before and after intervention groups all dimensions of the self-reported TNA questionnaire had a statistically significant difference. However, the comparison between intervention and controls groups indicated a statistical significant difference on leadership skills, intra-operative care, Comprehensive emergency obstetric and newborn care (CEMONC) and overall RMNH self-reported performance. In conclusion, the findings demonstrated that healthcare workers' self-identified and prioritized training needs that are supported with clinical mentorship results in significant positive changes in performance across a wide range of RMNH tasks. Therefore, conducting TNA that is followed by training and mentorship according to the identified needs among healthcare workers plays a significant role in improving performance on RMNH services among healthcare workers.


Assuntos
Saúde do Lactente , Serviços de Saúde Materna , Feminino , Pessoal de Saúde/educação , Humanos , Recém-Nascido , Gravidez , Autorrelato , Tanzânia
6.
PLoS One ; 17(6): e0270258, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35731807

RESUMO

BACKGROUND: The adaptation of living environments can preserve functional independence among older people. A few studies have suggested that this would only benefit the most impaired. But conceptual models theorize that environmental pressure gradually increases with functional decline. OBJECTIVES: We examined (1) how far different environmental barriers increased difficulties and favoured resort to assistance; (2) at what stage in functional decline environmental barriers begin to matter. METHODS: We used the French cross-sectional survey CARE (2015), including 7,451 participants (60+) with at least one severe functional limitation (FL). Multinomial logistic regressions models were used to compare predicted probabilities for outdoor activities of daily living (OADL) difficulties (no OADL difficulties; difficulties but without assistance; use of assistance) among individuals with and without environmental barriers (self-reported or objective), in relation to the number of FLs. RESULTS: Poor-quality pedestrian areas and lack of places to rest were associated with a higher probability of experiencing OADL difficulties, whatever the number of FLs; the association increased with the number of FLs. Up to 6 FLs, individuals with these barriers were more likely to report difficulties without resorting to assistance, with a decreasing association. Living in cities/towns with high diversity of food outlets was associated with a lower probability of reporting assistance, whatever the number of FLs, but with a decreasing association. DISCUSSION: Overall, the results suggest that environmental barriers increasingly contribute to OADL difficulties with the number of FLs. Conclusions differed as to whether they tended to favour resort to assistance, but there was a clear association with food outlets, which decreased with impairment severity. The adaptation of living environments could reduce difficulties in performing activities from the early stages of decline to the most severe impairment. However, the most deteriorated functional impairments seem to generate resort to assistance whatever the quality of the environment.


Assuntos
Atividades Cotidianas , Idoso , Estudos Transversais , França , Humanos , Autorrelato
7.
Adv Mind Body Med ; 36(2): 8-13, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35732064

RESUMO

Context: Higher Brain Living (HBL) is a light-touch therapy, which practitioners claim can increase well-being. Although studies have suggested that its component elements-light touch, focused breathing, and positive self-talk-can increase well-being for specific populations in specific contexts, no empirical research has occurred on HBL's efficacy. Objective: The study intended to measure the effects of HBL therapy on the well-being of individuals who have received it. Design: The research team designed a quasi-experimental controlled trial that used a survey to gather self-reported data related to well-being. Setting: The study took place in individual HBL practitioners' locations throughout the USA. Participants: Participants were adults who had attended an introductory presentation about HBL. Intervention: Participants were assigned to one of three groups: (1) the intervention group, who had responded to the baseline and postintervention surveys and had participated in HBL sessions (n = 14); (2) the control group, who had responded to the baseline and postintervention surveys and had not participated in HBL sessions (n = 9); and (3) the noncompleter group who had responded to the baseline surveys and had not completed the postintervention survey (n = 54). Outcome Measures: Well-being was assessed using five measures that evaluated constructs associated with well-being: (1) happiness using the Subjective Happiness Scale (SHS), (2) anxiety using the Anxiety Index (AI), (3) depression using Depression Index (DI) (4) mastery using the Pearlin Mastery Scale (PM), and (5) flourishing using the Flourishing Scale (FS). Results: The study included baseline data from 77 respondents; 23 participants completed the surveys at baseline and postintervention, 14 in the intervention group and 9 in the control group. A statistically significant, greater improvement occurred for the intervention group in the measures for flourishing, mastery, and happiness compared to the control group. Conclusions: The current study provides a foundation of empirical evidence suggesting the effectiveness of HBL as a potential treatment for improving well-being, upon which further investigation can be based.


Assuntos
Ansiedade , Felicidade , Adulto , Ansiedade/terapia , Encéfalo , Humanos , Autorrelato , Inquéritos e Questionários
8.
Nat Commun ; 13(1): 3569, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35732637

RESUMO

Pain is an individual experience. Previous studies have highlighted changes in brain activation and morphology associated with within- and interindividual pain perception. In this study we sought to characterize brain mechanisms associated with between-individual differences in pain in a sample of healthy adolescent and adult participants (N = 101). Here we show that pain ratings varied widely across individuals and that individuals reported changes in pain evoked by small differences in stimulus intensity in a manner congruent with their pain sensitivity, further supporting the utility of subjective reporting as a measure of the true individual experience. Furthermore, brain activation related to interindividual differences in pain was not detected, despite clear sensitivity of the Blood Oxygenation Level-Dependent (BOLD) signal to small differences in noxious stimulus intensities within individuals. These findings suggest fMRI may not be a useful objective measure to infer reported pain intensity.


Assuntos
Individualidade , Imageamento por Ressonância Magnética , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Mapeamento Encefálico , Humanos , Dor , Medição da Dor , Autorrelato
9.
Sci Rep ; 12(1): 10582, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35732753

RESUMO

Individuals encounter varying environmental exposures throughout their lifetimes. Some exposures such as smoking are readily observed and have high personal recall; others are more indirect or sporadic and might only be inferred from long occupational histories or lifestyles. We evaluated the utility of using lifetime-long self-reported exposures for identifying differential methylation in an amyotrophic lateral sclerosis cases-control cohort of 855 individuals. Individuals submitted paper-based surveys on exposure and occupational histories as well as whole blood samples. Genome-wide DNA methylation levels were quantified using the Illumina Infinium Human Methylation450 array. We analyzed 15 environmental exposures using the OSCA software linear and MOA models, where we regressed exposures individually by methylation adjusted for batch effects and disease status as well as predicted scores for age, sex, cell count, and smoking status. We also regressed on the first principal components on clustered environmental exposures to detect DNA methylation changes associated with a more generalised definition of environmental exposure. Five DNA methylation probes across three environmental exposures (cadmium, mercury and metalwork) were significantly associated using the MOA models and seven through the linear models, with one additionally across a principal component representing chemical exposures. Methylome-wide significance for four of these markers was driven by extreme hyper/hypo-methylation in small numbers of individuals. The results indicate the potential for using self-reported exposure histories in detecting DNA methylation changes in response to the environment, but also highlight the confounded nature of environmental exposure in cohort studies.


Assuntos
Metilação de DNA , Metais Pesados , Exposição Ambiental/efeitos adversos , Humanos , Autorrelato , Fumar
10.
BMC Psychiatry ; 22(1): 421, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35733121

RESUMO

BACKGROUND: This PRISMA systematic literature review examined the use of digital data collection methods (including ecological momentary assessment [EMA], experience sampling method [ESM], digital biomarkers, passive sensing, mobile sensing, ambulatory assessment, and time-series analysis), emphasizing on digital phenotyping (DP) to study depression. DP is defined as the use of digital data to profile health information objectively. AIMS: Four distinct yet interrelated goals underpin this study: (a) to identify empirical research examining the use of DP to study depression; (b) to describe the different methods and technology employed; (c) to integrate the evidence regarding the efficacy of digital data in the examination, diagnosis, and monitoring of depression and (d) to clarify DP definitions and digital mental health records terminology. RESULTS: Overall, 118 studies were assessed as eligible. Considering the terms employed, "EMA", "ESM", and "DP" were the most predominant. A variety of DP data sources were reported, including voice, language, keyboard typing kinematics, mobile phone calls and texts, geocoded activity, actigraphy sensor-related recordings (i.e., steps, sleep, circadian rhythm), and self-reported apps' information. Reviewed studies employed subjectively and objectively recorded digital data in combination with interviews and psychometric scales. CONCLUSIONS: Findings suggest links between a person's digital records and depression. Future research recommendations include (a) deriving consensus regarding the DP definition and (b) expanding the literature to consider a person's broader contextual and developmental circumstances in relation to their digital data/records.


Assuntos
Telefone Celular , Envio de Mensagens de Texto , Depressão/diagnóstico , Avaliação Momentânea Ecológica , Humanos , Autorrelato
11.
Andes Pediatr ; 93(2): 199-205, 2022 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-35735298

RESUMO

INTRODUCTION: Internationally, there are resilience promotion programs applied to children in residential alterna tive care with favorable results. The application of the resilience promotion program "VOLANTÍN" has shown to be effective in different groups of school-age children, favoring the development of resilience. OBJECTIVE: To describe the results of the implementation of the "VOLANTÍN' program on the level of resilience, self-concept, and emotional symptoms in children aged 7-12 years in resi dential alternative care (foster care). SUBJECTS AND METHOD: descriptive, longitudinal study. The "VO LANTÍN" program was implemented in a sample of 15 foster children between 7-12 years old. The variables measured were the "Escala de Resiliencia Escolar" (ERE), the Piers-Harris Children's Self Concept Scale, the Anxiety Self-report for Children and Adolescents (AANA), and the Children's Depression Inventory (CDI) at the beginning, at the end, and 3 months after the end of the program, and then were analyzed statistically by nonparametric test. RESULTS: At the beginning, the end, and three months after the program implementation, there was a significant increase in the total sco res of ERE (p0.045), subscales "networks-models" (p0.002) and "external resources" (p0.018); and Self-concept (p0.005), subscales "behavior" (p0.045) and "popularity" (p0.03). AANA total scores decreased significantly (p0.004) as well as the subscales "panic/somatic" (p0.025) and "generalized anxiety" (p0.009). CDI scores decreased, but not significantly. CONCLUSION: The application of the resilience promotion program "VOLANTÍN' increased resilience and self-concept scores and decrea sed anxious symptoms in children aged 7-12 years.


Assuntos
Ansiedade , Depressão , Adolescente , Ansiedade/prevenção & controle , Criança , Depressão/prevenção & controle , Depressão/psicologia , Humanos , Estudos Longitudinais , Autoimagem , Autorrelato
12.
Int J Clin Pract ; 2022: 4495806, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685528

RESUMO

Background: The aim of the study was to examine changes in the frequency of respiratory diseases during the COVID-19 pandemic and to correlate the changes with nonpharmacological interventions for overcoming the pandemic. In addition, the study explored the predictors of adherence to nonpharmacological interventions among the Jordanian public. Method: The study is survey-based and self-reported, using convenient sampling. The study was conducted during October-November of 2021. Results: The study included 1714 participants. About one-quarter of participants reported decreases in the incidence of cold (21.9%), influenza (24.7%), respiratory infections other than cold and influenza (23.3%), tonsillitis (23.0%), and oral ulcers (23.5%). On the other hand, the majority reported no change in the incidence of the above infections (62.0-64.4%). Adherence of the sample to nonpharmacological interventions of COVID-19 was moderate. The percentages of people who always wear a mask, follow social distancing, and use sanitizing procedures were 47.1%, 37.8%, and 68.8% respectively. ANOVA test showed a significant correlation between the incidence of respiratory/oral infections and adherence to nonpharmacological interventions. The multiple regression test showed that people who followed COVID-19 news, have children, have a job, and being married were more adhered to nonpharmacological measures compared to others. Conclusion: Implementation of nonpharmacological interventions used to overcome the COVID-19 pandemic can be applied to reduce other respiratory infections during their peak seasons.


Assuntos
COVID-19 , Doenças Transmissíveis , Influenza Humana , Infecções Respiratórias , COVID-19/epidemiologia , Criança , Doenças Transmissíveis/epidemiologia , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Pandemias , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/terapia , Autorrelato
13.
Artigo em Inglês | MEDLINE | ID: mdl-35701186

RESUMO

BACKGROUND AND OBJECTIVES: The biologic mechanisms underlying neurologic postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) are incompletely understood. METHODS: We measured markers of neurologic injury (glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL]) and soluble markers of inflammation among a cohort of people with prior confirmed SARS-CoV-2 infection at early and late recovery after the initial illness (defined as less than and greater than 90 days, respectively). The primary clinical outcome was the presence of self-reported CNS PASC symptoms during the late recovery time point. We compared fold changes in marker values between those with and without CNS PASC symptoms using linear mixed-effects models and examined relationships between neurologic and immunologic markers using rank linear correlations. RESULTS: Of 121 individuals, 52 reported CNS PASC symptoms. During early recovery, those who went on to report CNS PASC symptoms had elevations in GFAP (1.3-fold higher mean ratio, 95% CI 1.04-1.63, p = 0.02), but not NfL (1.06-fold higher mean ratio, 95% CI 0.89-1.26, p = 0.54). During late recovery, neither GFAP nor NfL levels were elevated among those with CNS PASC symptoms. Although absolute levels of NfL did not differ, those who reported CNS PASC symptoms demonstrated a stronger downward trend over time in comparison with those who did not report CNS PASC symptoms (p = 0.041). Those who went on to report CNS PASC also exhibited elevations in interleukin 6 (48% higher during early recovery and 38% higher during late recovery), monocyte chemoattractant protein 1 (19% higher during early recovery), and tumor necrosis factor α (19% higher during early recovery and 13% higher during late recovery). GFAP and NfL correlated with levels of several immune activation markers during early recovery; these correlations were attenuated during late recovery. DISCUSSION: Self-reported neurologic symptoms present approximately 4 months after SARS-CoV-2 infection are associated with elevations in markers of neurologic injury and inflammation at earlier time points. Some inflammatory pathways seem to be involved months after acute infection. Additional work will be needed to better characterize these processes and to identify interventions to prevent or treat this condition.


Assuntos
COVID-19 , Biomarcadores , COVID-19/complicações , Humanos , Inflamação , SARS-CoV-2 , Autorrelato
14.
Sci Rep ; 12(1): 9657, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35688956

RESUMO

Motor-assisted movement exercisers (MME) are devices that assist with physical therapy in domestic settings for people living with ALS. This observational cross-sectional study assesses the subjective experience of the therapy and analyzes users' likelihood of recommending treatment with MME. The study was implemented in ten ALS centers between February 2019 and October 2020, and was coordinated by the research platform Ambulanzpartner. Participants assessed symptom severity, documented frequency of MME use and rated the subjective benefits of therapy on a numerical scale (NRS, 0 to 10 points, with 10 being the highest). The Net Promotor Score (NPS) determined the likelihood of a participant recommending MME. Data for 144 participants were analyzed. Weekly MME use ranged from 1 to 4 times for 41% of participants, 5 to 7 times for 42%, and over 7 times for 17%. Particularly positive results were recorded in the following domains: amplification of a sense of achievement (67%), diminution of the feeling of having rigid limbs (63%), diminution of the feeling of being immobile (61%), improvement of general wellbeing (55%) and reduction of muscle stiffness (52%). Participants with more pronounced self-reported muscle weakness were more likely to note a beneficial effect on the preservation and improvement of muscle strength during MME treatment (p < 0.05). Overall, the NPS for MME was high (+ 61). High-frequency MME-assisted treatment (defined as a minimum of five sessions a week) was administered in the majority of participants (59%) in addition to physical therapy. Most patients reported having achieved their individual therapeutic objectives, as evidenced by a high level of satisfaction with MME therapy. The results bolster the justification for extended MME treatment as part of a holistic approach to ALS care.


Assuntos
Esclerose Amiotrófica Lateral , Esclerose Amiotrófica Lateral/terapia , Estudos Transversais , Humanos , Debilidade Muscular , Autorrelato
15.
BMC Public Health ; 22(1): 1139, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672842

RESUMO

BACKGROUND: To promote healthy aging, the information about the development of quality of life (QoL) is of great importance. However, the explorations of the heterogeneity in the change of QoL under the Chinese context were limited. This study aimed to identify potential different development patterns of QoL and the influential factors using a longitudinal, nationally representative sample of the Chinese elderly. METHODS: We adopted a five-wave longitudinal dataset from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and a total of 1645 elderly were obtained. The sample had a mean age of 72.7 years (SD = 6.64) and was 47.2% male. Overall QoL was measured through self-report during the longitudinal process. We utilized the conditional growth mixture model (GMM) with time-invariant covariates (TICs) to explore various development patterns and associated factors. RESULTS: Three distinct trajectories of self-reported overall QoL were identified: the High-level Steady Group (17.08%), the Mid-level Steady Group (63.10%), and the Low-level Growth Group (19.82%). Results also indicated that several factors predicted distinct trajectories of self-reported overall QoL. Those elderly who received enough financial resources, had adequate nutrition, did not exhibit any disability, engaged in leisure activities, and did less physical labor or housework at the baseline were more likely to report a higher level of overall QoL over time. CONCLUSIONS: There existed three development patterns of self-reported overall QoL in elders, and the findings provided valuable implications for the maintenance and improvement of QoL among the Chinese elderly. Future studies could examine the influence of other confounding factors.


Assuntos
Nível de Saúde , Qualidade de Vida , Idoso , China , Feminino , Humanos , Estudos Longitudinais , Masculino , Autorrelato
16.
Stud Health Technol Inform ; 290: 526-530, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673071

RESUMO

Few studies have used the combination of subjective and objective measures to investigate sleep problems as a primary outcome of concern in cancer patients. This study highlights the influence of sleep quality and duration on quality of life among breast and prostate cancer patients. Thirty-one participants were included in this study. Sleep quality and duration was assessed using a wearable actigraphy device and Pittsburgh Sleep Quality Index questionnaire. Quality of life was measured by European-Organization-For-Research-And-Treatment-Of-Cancer Quality of Life Questionnaire. t-test statistics further investigates the influence of sleep quality and duration with quality of life in participants. Results implied that those breast cancer patients who were poor sleepers and short sleepers showed greater deficits in areas of quality of life. In contrast, those prostate cancer patients who were long sleepers and good sleepers displayed poorer quality of life using actigraphy.


Assuntos
Neoplasias da Próstata , Transtornos do Sono-Vigília , Dispositivos Eletrônicos Vestíveis , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Autorrelato , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia
17.
Stud Health Technol Inform ; 290: 536-539, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673073

RESUMO

This study presents an online psoriasis community developed with dermatologists in a PHR. We describe the interaction of users with this platform and the relationship between the use of self-report questionnaires, their results and users' subsequent contact with the healthcare system. Out of 2175 users that interacted with the platform, 477 visited the forums. 60% of those who completed questionnaires presented at least one abnormal result that prompted a recommendation for an outpatient visit. Although our data suggest a trend, we failed to find a statistically significant association between questionnaire severity and visits scheduling. To our knowledge, this is the first study that analyses the relationship between patient self-reported disease severity and the subsequent contact with the healthcare system.


Assuntos
Psoríase , Atenção à Saúde , Humanos , Autorrelato , Inquéritos e Questionários
18.
World J Gastroenterol ; 28(13): 1362-1376, 2022 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-35645538

RESUMO

BACKGROUND: Patients with Hirschsprung disease (HD) are at risk of persistent constipation, fecal incontinence or recurrent enterocolitis after surgical treatment, which in turn may impact physical and psychosocial functioning. Generic health-related quality of life (HRQoL) and disease-specific health-related quality of life are relevant outcome measures to assess the impact of HD on the QoL of these patients. AIM: To summarize all available evidence on HRQoL of patients with HD after surgery and the impact of possible moderating factors. METHODS: Pubmed, Web of Sciences, PsycInfo and Embase were searched with search terms related to 'Hirschsprung disease', 'Pediatrics' and 'Quality of life'. Mean and standard deviation of generic HRQoL overall and domain scores were extracted from each study, as well as data describing potential factors associated with QoL. Random effect models were used for meta-analytic aggregation of generic HRQoL scores. Meta-regression was used to assess the relationship between patient and clinical characteristics and generic HRQoL. Disease-specific HRQoL outcomes of patients with HD were systematically reviewed. RESULTS: Seventeen articles were included in the systematic review (n = 1137 patients) and 15 in the quantitative meta-analysis (n = 1024 patients). Four studies reported disease-specific HRQoL. Patient's age ranged between 0 and 21 years. Meta-analytic aggregation showed a non-significantly impaired generic HRQoL (d = -0.168 [95%CI: -0.481; 0.145], P = 0.293, I 2 = 94.9) in patients with HD compared to healthy controls. Physical (d = -0.042 [95%CI: -0.419; 0.335], P = 0.829, I 2 = 95.1), psychosocial (d = -0.159 [95%CI: -0.458; 0.141], P = 0.299, I 2 = 93.6) and social HRQoL (d = -0.092 [95%CI: -0.642; 0.457], P = 0.742, I² = 92.3) were also not significantly lower compared to healthy controls. There was no relation between health-related outcomes and the sex of the patients and whether generic HRQoL was measured by parental proxy or self-report. Disease-specific complaints of patients with HD impaired physical HRQoL, but not psychosocial and social HRQoL. CONCLUSION: In this systematic review and meta-analysis, no evidence was found for impaired generic HRQoL in patients with HD compared to healthy controls, neither for moderating effects of sex, parental proxy or self-report.


Assuntos
Incontinência Fecal , Doença de Hirschsprung , Adolescente , Adulto , Criança , Pré-Escolar , Constipação Intestinal/psicologia , Incontinência Fecal/etiologia , Doença de Hirschsprung/cirurgia , Humanos , Lactente , Recém-Nascido , Qualidade de Vida/psicologia , Autorrelato , Adulto Jovem
19.
Int J Public Health ; 67: 1604395, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35645699

RESUMO

Objectives: Evidence of the impact of COVID-19 pandemic on mental and physical health behaviours is limited. This study presents results of two cross-sectional surveys on mental health changes and its consequences on healthy and unhealthy lifestyle behaviours. Methods: An online survey was distributed during Spring 2020 (N = 9,168) and Autumn 2020 (N = 1,042) in the Czech Republic. Differences in mental health observed in both surveys were evaluated using Mann-Whitney test and logistic regressions were used to examine demographic and socio-economic determinants of COVID-19-related mental health issues and resulting healthy and unhealthy lifestyle behaviours. Results: In multivariable models, the youngest individuals, females, people with increased work demands and participants with a reduced personal income due to the COVID-19 pandemic were all negatively associated with self-reported mental health issues (p < 0.05). A worsened quality of sleep, dietary habits, physical activity and unhealthy behaviours were highly associated with affected mental health in the models adjusted for potential covariates (p < 0.05). Conclusion: Taken together, these findings suggest that health promotion strategies directed to individuals who are at risk should be encouraged to adopt and/or maintain positive health-related behaviours.


Assuntos
COVID-19 , COVID-19/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Feminino , Humanos , Estilo de Vida , Saúde Mental , Pandemias , Autorrelato
20.
J Pers Disord ; 36(3): 264-276, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35647775

RESUMO

Exposure to childhood maltreatment (CM) increases the risk of developing borderline personality disorder (BPD). However, it remains unclear what mechanisms might mediate this link. One candidate of interest is difficulties with emotion regulation. This study aims to examine the pattern of relations among CM, difficulties with emotion regulation, and the risk of developing BPD. A total of 162 individuals diagnosed with current BPD and 162 matched healthy controls completed self-reported questionnaires assessing CM and difficulties with emotion regulation. The authors found high correlations between CM and BPD diagnosis (r = .73, p < .001). Difficulties with emotion regulation were found to mediate the link between CM and BPD diagnosis (p < .001). Results suggest that CM may play a key role in the etiology of BPD and that difficulties with emotion regulation might be a mediating component between CM and BPD.


Assuntos
Transtorno da Personalidade Borderline , Maus-Tratos Infantis , Regulação Emocional , Transtorno da Personalidade Borderline/psicologia , Criança , Emoções/fisiologia , Humanos , Autorrelato
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