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1.
Artigo em Inglês | MEDLINE | ID: mdl-36361407

RESUMO

Screening tests for body posture defects and abnormalities conducted over the past several decades have revealed a significant and constantly increasing problem of health risks in children. A sedentary lifestyle, which is considered to be the primary cause, can result in proprioceptive disorders leading to postural instability. The aim of the study was to find the correlation between the level of proprioceptive control and the number of postural disorders. The study involved a representative group of 1090 children aged 8-10 years, from randomly selected primary schools. Subjects who scored from 1 to 5 points in a prior postural screening test were qualified for the examination of the postural control system. The examination of the postural control system was carried out using an electronic station enabling assessment of postural stability and proprioception. A single leg stance test showed that the number of postural disorders does not significantly impact proprioceptive control. Proprioceptive control was found to significantly increase with the age of the children, and girls presented significantly better proprioceptive control in relation to the boys in each age group.


Assuntos
Estado Funcional , Equilíbrio Postural , Masculino , Feminino , Criança , Humanos , Postura , Propriocepção
2.
Sci Rep ; 12(1): 19575, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36380000

RESUMO

Patients with Post-COVID syndrome (PCS) are frequently referred for cardiologic evaluation. We assessed cardiac function and biomarkers in relation to functional status and fatigue in patients with PCS. This prospective single-center cohort study included 227 patients with persisting symptoms after COVID-19 infection. Most frequent complaints were fatigue (70%), dyspnea (56%), neurocognitive symptoms (34%) and chest pain (28%). Standardized questionnaires were used to assess Post-COVID-Functional-Scale (PCFS) and fatigue (MFI-20). The fatigue severity was inversely related to age and did not correlate with cardiovascular diseases, echocardiographic findings, or biomarkers. Similarly, mild to moderate functional impairment (PCFS 1-3) did not correlate with cardiovascular alterations. However, the subgroup of patients with significant functional impairment (PCFS = 4) had more frequent cardiovascular comorbidities, biomarkers and impaired global longitudinal strain (GLS). Patients with elevated troponin T showed abnormal GLS, reduced left ventricular ejection fraction and impaired tricuspid annular plane systolic excursion. The majority of patients with PCS shows a normal cardiac function. Only the small subgroup of patients with severe functional impairment and patients with elevated troponin T is at risk for impaired cardiac function and likely to benefit from specialized care by a cardiologist.


Assuntos
COVID-19 , Função Ventricular Esquerda , Humanos , Volume Sistólico , Estudos Prospectivos , Troponina T , Estudos de Coortes , Estado Funcional , COVID-19/complicações , Biomarcadores , Fadiga/etiologia
3.
Health Informatics J ; 28(4): 14604582221140975, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36413427

RESUMO

A history of brain tumor strongly affects children's cognitive abilities, performance of daily activities, quality of life, and functional outcomes. In light of the difficulties in cognition, communication, physical skills, and behavior that these patients may encounter, occupational therapists should perform a comprehensive needs-led assessment of their global functioning after recovery. Such an assessment would ensure that the patients receive adequate support and services at school, at home, and in the community. By predicting the functional activity performance of children with a history of brain tumor, clinical workers can determine the progress of their ability recovery and the optimal treatment plan. We selected several features for testing and employed common machine learning models to predict Functional Independence Measure (WeeFIM) scores. The ensemble learning models exhibited stronger predictive performance than did the individual machine learning models. The ensemble learning models effectively predicted WeeFIM scores. Machine learning models can help clinical workers predict the functional assessment scores of patients with childhood brain tumors. This study used machine learning models to predict the WeeFIM scores of patients with childhood brain tumors and to demonstrate that ensemble machine learning models are more suitable for this task than are individual machine learning models.


Assuntos
Neoplasias Encefálicas , Estado Funcional , Criança , Humanos , Qualidade de Vida , Aprendizado de Máquina , Sobreviventes , Neoplasias Encefálicas/terapia
4.
Ann Intern Med ; 175(11): JC125, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36315954

RESUMO

SOURCE CITATION: Fischer U, Kaesmacher J, Strbian D, et al. Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial. Lancet. 2022;400:104-15. 35810756.


Assuntos
AVC Isquêmico , Humanos , Estado Funcional , AVC Isquêmico/tratamento farmacológico , AVC Isquêmico/cirurgia , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do Tratamento , Estudos de Equivalência como Asunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Trombectomia
5.
BMC Nephrol ; 23(1): 341, 2022 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-36273118

RESUMO

BACKGROUND: Data on the functional status (FS) of patients on maintenance haemodialysis (MHD) and their caregiver burden (CGB) in SSA where patients have fewer weekly dialysis sessions and pay out-of-pocket for dialysis-related costs is sparse.  OBJECTIVES: To assess the functional status of Patients on MHD in Cameroon, and the burden of their Caregivers, and to determine the factors associated with functional status impairment (FSI), and high caregiver burden (HCGB).  METHODS: We consecutively enrolled patients on MHD at the Bamenda Regional, and Yaounde General Hospitals over a period of 3 months. We included patients on MHD for ≥ 3 months and their caregivers. Patients and/or caregivers with documented dementia were excluded. Through a face-to-face interview, FS was assessed by combining self-reports of 8 instrumental, and 5 basic activities of daily living using the Lawton-Brody and the Katz (LBKQ) scales, and CGB was assessed using the Zarit Caregiver Burden Scale (ZCGBS). We defined functional status impairment (FSI) as a score ≥ 1 on the LBKQ scale, and a high CGB as a ZCGBS score ≥ 41. Data were analysed using the IBM-SPSS version 26.0 RESULTS: A total of 115 patients and 51 caregivers (CGs) were enrolled. The mean age of the patients was 46.9 ± 15.0 years, and 54.8% (n = 63) were males, whereas the mean age of the CGs was 38.30 ± 13.10 years with 72.5% (n = 39) being females. A total of 90 (78.3%) patients had functional status impairment (FSI), while 78.4% (n = 40) of caregivers experienced a burden (41.2% classified as moderate, and 37.2% as high). Anaemia (aOR = 9.2, CI = 3.9-29.4, p < 0.001), and a high daily pill burden (aOR = 4.4, CI = 1.1-18.5, p = 0.043) were independently associated with FSI, while age of caregiver ≥ 45 years (aOR 9.9, CI = 1.7-56.8, P = 0.01) was independently associated with a high CGB. There was a strong positive correlation between FS and CGB. CONCLUSION: There is a high prevalence of functional status impairment in patients on maintenance haemodialysis in Cameroon, resulting in high a physical and psychological burden on their caregivers.


Assuntos
Atividades Cotidianas , Fardo do Cuidador , Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Atividades Cotidianas/psicologia , Efeitos Psicossociais da Doença , Diálise Renal , Camarões/epidemiologia , Estado Funcional , Cuidadores/psicologia
6.
BMC Geriatr ; 22(1): 815, 2022 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-36273139

RESUMO

BACKGROUND: Functional independence limitations restrict older adult self-sufficiency and can reduce quality of life. This systematic review and cost of impairment study examined the costs of functional independence limitations among community dwelling older adults to society, the health care system, and the person. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines this systematic review included community dwelling older adults aged 60 years and older with functional independence limitations. Databases (Cochrane Database of Systematic Reviews, EconLit, NHS EED, Embase, CINAHL, AgeLine, and MEDLINE) were searched between 1990 and June 2020. Two reviewers extracted information on study characteristics and cost outcomes including mean annual costs of functional independence limitations per person for each cost perspective (2020 US prices). Quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS: 85 studies were included. The mean annual total costs per person (2020 US prices) were: $27,380.74 (95% CI: [$4075.53, $50,685.96]) for societal, $24,195.52 (95% CI: [$9679.77, $38,711.27]) for health care system, and $7455.49 (95% CI: [$2271.45, $12,639.53]) for personal. Individuals with cognitive markers of functional independence limitations accounts for the largest mean costs per person across all perspectives. Variations across studies included: cost perspective, measures quantifying functional independence limitations, cost items reported, and time horizon. CONCLUSIONS: This study sheds light on the importance of targeting cognitive markers of functional independence limitations as they accounted for the greatest costs across all economic perspectives.


Assuntos
Estado Funcional , Qualidade de Vida , Humanos , Pessoa de Meia-Idade , Idoso , Análise Custo-Benefício , Vida Independente
7.
Prog Transplant ; 32(4): 345-350, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36253720

RESUMO

INTRODUCTION: The effect of sarcopenia, malnutrition, and functional status on immediate post liver transplantation outcome is not well established. Most studies on sarcopenia are related to 1 and 3-year mortality. Studies evaluating the effect of malnutrition are at least a decade old. PROJECT AIMS: We evaluated the effect of preoperative sarcopenia, malnutrition, and functional status on postoperative length of hospital and ICU stay, incidence of complications, and mortality. DESIGN: In this prospective study conducted on living donor liver transplant recipients, sarcopenia and malnutrition were identified using the psoas muscle thickness to height and the Royal Free Hospital- Nutritional Prioritizing Tool respectively. The Eastern Cooperative Oncology Group performance status score was noted. Postoperatively, length-of-hospital stay, ICU stay, duration of mechanical ventilation and incidence of postoperative complications were noted. RESULTS: Hospital and ICU length of stay, and duration of mechanical ventilation were greater in sarcopenic versus non-sarcopenic patients (35.9 (14.6) versus 26.7 (10.7) days, P = 0.02; 12.9 (4.8) versus 9.6 (3.8) days, P = 0.02 and 8 [5,23] versus 5 [4,7] days, P = 0.01 respectively). The incidence of acute kidney injury was higher in patients with sarcopenia (53.3% vs 19.4%, P = 0.02). Patients with malnutrition and repeated hospitalizations had higher ICU stays but hospital length of stay duration of mechanical ventilation or the incidence of postoperative complications were not affected. The Eastern Cooperative Oncology Group score did not affect postoperative outcome. CONCLUSION: In living donor liver transplant recipients, sarcopenia increased hospital and ICU stays, and duration of mechanical ventilation postoperatively. Malnutrition increased ICU stays.


Assuntos
Transplante de Fígado , Desnutrição , Sarcopenia , Humanos , Sarcopenia/epidemiologia , Sarcopenia/complicações , Transplante de Fígado/efeitos adversos , Estudos Prospectivos , Doadores Vivos , Estado Funcional , Desnutrição/epidemiologia , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Morbidade , Estudos Retrospectivos
8.
Medicine (Baltimore) ; 101(41): e31108, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36253995

RESUMO

This study revealed the effects of tissue plasminogen activator (tPA) on medium-term functional independence in patients with stroke. We retrospectively examined 240 patients from April 2016 to March 2019 and selected 68 who met our criteria. After adjusting the functional status at the onset by propensity score matching, the functional independence measure (FIM) on admission to and discharge from the convalescent rehabilitation wards was compared between the groups classified by the presence or absence of tPA. Twelve pairs were derived by propensity score matching. Upon admission to the convalescent rehabilitation ward, the median score of the FIM was significantly higher in the tPA group than in the non-tPA group (P = .028). Patients in the tPA group had higher median FIM scores at discharge than those in the non-tPA group (P = .060). The difference in the independence level of activities of daily living (ADL) between the groups with and without tPA may gradually decrease with continuous inpatient rehabilitation. However, the tPA group tended to have high levels of independence in ADL at the time of discharge.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Estado Funcional , Humanos , Pontuação de Propensão , Recuperação de Função Fisiológica , Estudos Retrospectivos , Ativador de Plasminogênio Tecidual
9.
Photobiomodul Photomed Laser Surg ; 40(10): 691-697, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36219758

RESUMO

Objective: To investigate the effect of intravascular laser irradiation of blood (ILIB) in patients with post-stroke disability. Background: Helium-neon intravascular laser at a wavelength of 632.8 nm has been applied in post-stroke rehabilitation for many years in Taiwan. Data were collected from our practice to validate its effectiveness. Materials and methods: This was a single-center, retrospective, observational study. Data from 34 patients with first-episode ischemic stroke who participated in the post-acute care program and had an initial modified Rankin Scale (mRS) score of 4 between July 2018 and June 2021 were retrospectively reviewed. Twelve patients who received conventional rehabilitation plus ILIB were in the ILIB group. Twenty-two patients who received conventional rehabilitation only were in the control group. Assessments, including the mRS, Barthel Index (BI), Berg Balance Scale (BBS), 6-min walk test (6MWT), and Fugl-Meyer Assessment of the upper extremity (FMA-UE), were performed to evaluate any post-treatment improvement. Results: Patients who received ILIB had significantly superior mRS scores than those who received only conventional rehabilitation (p = 0.028). Patients in the ILIB group experienced more improvements in the BI, 6MWT, and FMA-UE; however, these were nonsignificant. In addition, the control group experienced a greater improvement in the BBS than the ILIB group. Further studies are required to elucidate the mechanism of action of ILIB therapy fully. There was no major adverse event reported in patients receiving ILIB therapy. Conclusions: ILIB improved independence in post-stroke patients, suggesting that ILIB is a promising treatment for facilitating post-stroke recovery.


Assuntos
Estado Funcional , Acidente Vascular Cerebral , Humanos , Estudos Retrospectivos , Cuidados Semi-Intensivos , Taiwan , Hélio , Neônio , Acidente Vascular Cerebral/radioterapia
10.
Arq. ciências saúde UNIPAR ; 26(3): 748-763, set-dez. 2022.
Artigo em Português | LILACS | ID: biblio-1399462

RESUMO

Introdução: Pacientes submetidos a grandes cirurgias abdominais apresentam riscos de complicações pós-operatórias. A mobilização precoce vem sendo implementada e cada vez mais aplicada, no intuito de prevenir esses eventos. Objetivo: Demonstrar se a mobilização precoce está associada à melhor funcionalidade no pós-operatório de cirurgias abdominais. Métodos: Revisão integrativa de literatura realizada por meio de uma busca bibliográfica junto aos bancos de dados: BVS, Scielo, PedRO e Pubmed por meio dos descritores: mobilização precoce, deambulação precoce, cuidados pós-operatórios, período pós-operatório, estado funcional, exercício físico, reabilitação, funcionalidade e cirurgia abdominal, nos idiomas inglês, português e espanhol. Resultados: A amostra final foi constituída por 08 artigos científicos, que foram estruturados em forma de quadro para apresentação de suas principais características, dos métodos e os principais resultados. Conclusão: A mobilização precoce está associada ao retorno rápido à funcionalidade da linha de base pré- operatória, as atividades de vida diária, independência funcional, além do tempo de internação mais curto e menor duração dos desagradáveis sintomas pós-operatórios.


Introduction: Patients undergoing major abdominal surgery are at risk of postoperative complications. Early mobilization has been implemented and increasingly applied in order to prevent these events. Objective: to demonstrate whether early mobilization is associated with better functionality in the postoperative period of abdominal surgeries. Methods: an integrative literature review carried out through a literature search in the following databases: BVS, Scielo, PedRO and Pubmed using the descriptors: early mobilization, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, in English, Portuguese and Spanish. Results: The final sample consisted of 08 scientific articles, which were structured in the form of a table to present their main characteristics, methods and main results. Conclusion: Early mobilization interferes with the rapid return to preoperative baseline functionality, activities of daily living, functional independence, in addition to a shorter hospital stay and shorter duration of unpleasant postoperative symptoms.


Introducción: Los pacientes sometidos a cirugías abdominales mayores corren el riesgo de sufrir complicaciones postoperatorias. La movilización temprana se ha implementado y aplicado cada vez más para prevenir estos eventos. Objetivo: Demostrar si la movilización temprana se asocia con una mejor funcionalidad después de la cirugía abdominal. Métodos: Revisión bibliográfica integrativa realizada a través de una búsqueda bibliográfica en las siguientes bases de datos: BVS, Scielo, PedRO y Pubmed utilizando los descriptores: early mobilisation, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, en inglés, portugués y español. Resultados: La muestra final consistió en 08 artículos científicos, que se estructuraron en forma de tabla para presentar sus principales características, los métodos y los principales resultados. Conclusión: La movilización temprana se asocia con un rápido retorno a la funcionalidad de base preoperatoria, a las actividades de la vida diaria, a la independencia funcional, así como a una estancia hospitalaria más corta y a una menor duración de los síntomas postoperatorios desagradables.


Assuntos
Humanos , Masculino , Feminino , Adulto , Cuidados Pós-Operatórios , Cirurgia Torácica , Deambulação Precoce , Complicações Pós-Operatórias , Período Pós-Operatório , Reabilitação , Exercício Físico , Bibliotecas Digitais , Abdome , Estado Funcional
11.
Seizure ; 102: 61-73, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36208570

RESUMO

Functional status (FSt) describes the phenomenon of prolonged non-epileptic attacks that may be misidentified as Status Epilepticus (SE). The early differentiation between epileptic and functional status is crucial in order to avoid unnecessarily invasive and costly medical escalation in the latter group, including the hazards of overmedication, intubation and intensive care admission. The authors conducted a literature review of available studies describing cases of functional status to extract the common aspects of FSt seizure semiology, investigations used to differentiate from SE, and guidance for managing FSt. A search was carried out using Medline, Embase and PsychInfo databases and 3909 papers were extracted for review. 30 papers were found relevant for inclusion, describing 260 cases of FSt. FSt was found to occur more commonly in younger, female patients with a family history of epilepsy, co-morbid psychiatric diagnosis and following a recent traumatic event. Common clinical features of FSt during and after, the events were identified. While video-EEG remains the gold standard investigation for differentiating FSt from SE, many of the included studies considered the utility of other investigation modalities including serum markers and neuroimaging. One key shortcoming identified within the literature reviewed was a lack of well-defined guidance on the acute management of FSt. We offer an A-F step management plan for the immediate and longer term assessment and treatment of FSt.


Assuntos
Epilepsia , Estado Epiléptico , Humanos , Feminino , Estado Funcional , Convulsões , Epilepsia/diagnóstico , Eletroencefalografia/métodos , Estado Epiléptico/diagnóstico , Estado Epiléptico/terapia
12.
Pol J Vet Sci ; 25(3): 397-402, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36156608

RESUMO

Nowadays, a high incidence of cutaneous tumors is observed in domestic carnivorous in pet clinic, the sebaceous glands being the starting point for the development of these tumors. The hormonal imbalances are considered to be the most common etiology for these tumors, so the current research is based on the effects of an androgenic like hormonal drug on the functionality of the sebaceous glands in dogs. For this purpose, 32 dogs were distributed in 4 groups: control group 1 (8 dogs - females), control group 2 (8 dogs - males), experimental group 1 (8 dogs - females) and experimental group 2 (8 dogs - males). The investigation targeted the pH of skin and the rate of sebum's secretion. The animals from the experimental groups were treated with Anabolin forte for 2 days at a dose of 1 mg/kg body weight/day, intramuscular. The obtained results revealed that administration of Anabolin forte in males induced a significantly distinct intensification (with 10.66%) of sebum's secretion and a significant decrease of pH of the skin (with 17.1%) compared to the animals from the control group. The administration of Anabolin forte in females induced a significantly distinct intensification (with 17.47%) of sebum's secretion and a significant decrease of the pH of the skin (with 14.32%) compared to the animals from the control group.


Assuntos
Doenças do Cão , Neoplasias Cutâneas , Androgênios/farmacologia , Animais , Doenças do Cão/tratamento farmacológico , Doenças do Cão/patologia , Cães , Feminino , Estado Funcional , Masculino , Glândulas Sebáceas/patologia , Pele , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/veterinária
13.
BMJ Open ; 12(9): e051307, 2022 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-36109034

RESUMO

OBJECTIVES: This study was designed to evaluate the effect of rehabilitation in preventing decreased functional status (FS) after community-acquired pneumonia (CAP) in elderly patients. DESIGN: This was a retrospective observational study. SETTING: Multicentre study was conducted in two medical facilities from January 2016 to December 2018. PARTICIPANTS: Hospitalised patients with CAP aged over 64 years were enrolled. FS was assessed by the Barthel Index (BI) (range, 0-100, in 5-point increments) at admission and before discharge and graded into three categories: independent, BI 80-100; semidependent, BI 30-75; and dependent, BI 0-25. Multivariable analysis of factors contributing to decreased FS was conducted with two groups: with a decrease of at least one category (decreased group) or without a decrease of category (maintained group). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the effect of rehabilitation in preventing decreased FS. The secondary outcomes were factors associated with decreased FS. RESULTS: The maintained and decreased groups included 400 and 138 patients, respectively. A high frequency of rehabilitation therapy was observed in the decreased group (189 (47.3%) vs 104 (75.4%); p<0.001). Multivariable analysis showed that the factors affecting FS were aspiration pneumonia, Pneumonia Severity Index (PSI) category V, length of stay and age (OR 2.66, 95% CI 1.58 to 4.49; OR 1.92, 95% CI 1.29 to 3.44; OR 1.05, 95% CI 1.04 to 1.07; and OR 1.05, 95% CI 1.02 to 1.09, respectively). After adjusting for factors contributing to decreased FS, rehabilitation showed a limited effect in preventing decreased FS in 166 matched pairs by McNemar's test (p=0.327). CONCLUSIONS: Aspiration and PSI played important roles in reducing FS. The effect of rehabilitation remains unclear in CAP. TRIAL REGISTRATION NUMBER: UMIN000046362.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia , Idoso , Infecções Comunitárias Adquiridas/terapia , Estado Funcional , Humanos , Pneumonia/terapia , Estudos Retrospectivos , Índice de Gravidade de Doença
14.
BMC Public Health ; 22(1): 1836, 2022 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-36180950

RESUMO

BACKGROUND: Subjective well-being (SWB) is of particular interest among gerontologists and health researchers with important implications for interventions especially in poor-resource settings. This study aimed to explore the possible pathways from socioeconomic status (SES), functional independence and social capital towards SWB among older adults in India. METHODS: Cross-sectional data from the "Building a Knowledge Base on Population Aging in India" (BKPAI) survey with a total sample of 9231 older adults aged 60 years and above were used. The outcome variable was low SWB (LSWB). The study used univariate and bivariate analysis for reporting the initial results. Further, the study employed the structural equation modeling (SEM) technique using maximum likelihood estimation (MLE) procedure to estimate the covariance matrix. RESULTS: Overall, about 27% of older adults reported LSWB. Reporting LSWB was more prevalent among older adults who had no income (30.8%) and those who had income but not sufficient to fulfil their basic needs (39.4%, p < 0.001). The prevalence of reporting LSWB was significantly higher among older adults who had no asset ownership (36.5%, p < 0.001) than those who had asset ownership. The path from the SEM shows that LSWB and SES are negatively related to each other. Moreover, LSWB had significant negative relationship with independence (ß = -0.032, p < 0.001) and social capital (ß = -0.020; p < 0.001). In addition, results found a positive relationship between SES and independence (ß = 0.019; p < 0.001), SES and social capital (ß = 0.016; p < 0.001), and independence and social capital (ß = 0.033; p < 0.001). CONCLUSIONS: The findings highlight that higher SES, good physical functioning as well as favorable social capital are interdependent factors of late-life wellbeing and a multidimensional approach in policymaking can ensure a successful and active ageing among older Indian adults.


Assuntos
Capital Social , Idoso , Estudos Transversais , Estado Funcional , Humanos , Análise de Classes Latentes , Classe Social
15.
J Rehabil Med ; 54: jrm00335, 2022 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-36102195

RESUMO

OBJECTIVE: To investigate longitudinal, predictive associations between community participation, positive affect, social support, and functional independence for individuals post-stroke at 3 and 12 months post-discharge. DESIGN: Longitudinal design. SUBJECTS: Data from 544 participants were obtained from the Stroke Recovery in Underserved Populations (2005-06) database. METHODS: A cross-lagged panel network analysis to identify the complex set of predictive relationships between community participation, positive affect, social support, and functional independence 3 months post-discharge to 12 months post-discharge. RESULTS: Community participation, particularly religious/spiritual activities, was an early predictor of later motor (functional) independence and social support. In addition, positive affect was an early predictor of social support. CONCLUSION: While participation in social situations is a desired outcome post-stroke, the results of this study indicate the importance of identifying early factors that influence community participation throughout the recovery process.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Assistência ao Convalescente , Participação da Comunidade , Estado Funcional , Humanos , Alta do Paciente , Participação Social , Apoio Social , Reabilitação do Acidente Vascular Cerebral/métodos
16.
J Geriatr Oncol ; 13(8): 1162-1171, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36085275

RESUMO

INTRODUCTION: Functional status (FS) and frailty are significant concerns for older adults, especially those with cancer. Data on FS (Activities of Daily Living [ADL]; Instrumental Activities of Daily Living [IADL]) and its evolution during cancer treatment in older patients and a frailty risk profile are scarce. Therefore, this study examines FS and its evolution in older patients with cancer and a frailty risk profile and investigates characteristics associated with functional decline. MATERIAL AND METHODS: This secondary data-analysis, focusing on FS, uses data from a large prospective multicenter observational cohort study. Patients ≥70 years with a solid tumor and a frailty risk profile based on the G8 screening tool (score ≤ 14) were included. A geriatric assessment was performed including evaluation of FS based on ADL and IADL. At approximately three months of follow-up, FS was reassessed. Univariable and multivariable logistic regression analyses were used to identify predictive factors for functional decline in ADL and IADL. RESULTS: Data on ADL and IADL were available at baseline and follow-up in 3388 patients. At baseline 1886 (55.7%) patients were dependent for ADL, whereas 2085 (61.5%) patients were dependent at follow-up. Functional decline was observed in 23.6% of patients. For IADL 2218 (65.5%) patients were dependent for IADL, whereas 2591 (76.5%) patients were dependent at follow-up. Functional decline in IADL was observed in 41.0% of patients. In multivariable analysis, disease stage III or IV, comorbidities, falls history in the past twelve months, and FS measured by IADL were predictive factors for functional decline in both ADL and IADL. Other predictive factors for functional decline in ADL were polypharmacy, Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) score 2-4, and cognitive impairment, and for functional decline in IADL were female sex, fatigue, and risk for depression. DISCUSSION: Functional impairments are frequent in older persons with cancer and a frailty risk profile, and several characteristics are identified that are significantly associated with functional decline. Therefore, FS is an essential part of the geriatric assessment which should be standard of care for this patient population. Next step is to proceed with directed interventions with the aim to limit the risk of functional decline as much as possible.


Assuntos
Fragilidade , Neoplasias , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Fragilidade/epidemiologia , Fragilidade/diagnóstico , Atividades Cotidianas , Estudos Prospectivos , Estado Funcional , Avaliação Geriátrica , Neoplasias/epidemiologia , Neoplasias/terapia
17.
J Cardiothorac Vasc Anesth ; 36(12): 4370-4377, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36163154

RESUMO

OBJECTIVES: To determine if decreases in the Karnofsky Performance Score (KPS) while on the waitlist predict decreased survival after lung transplantation (LTx). DESIGN: A retrospective evaluation of the United Network for Organ Sharing database. The KPS was evaluated at the time of listing for transplant and at the time of transplantation. Group I consisted of patients having a decrease in KPS during the time on the waiting list (from the time of listing to the time of transplant), and Group II consisted of patients whose KPS stayed the same or increased during the same period. The authors used propensity-score weighting for comparisons of these groups. SETTING: Retrospective observational database review. PARTICIPANTS: Adult patients undergoing lung transplantation. INTERVENTIONS: None. Patients were stratified according to a change in their KPS. MEASUREMENTS AND MAIN RESULTS: Patient and graft survival of patients with decreasing or not decreasing KPS were compared. Of the 27,558 subjects included in the analysis, 17,986 (65%) had worsening KPS, which was associated with worse graft (p = 0.0003) and patient (p = 0.0019) survival after LTx. Using multivariate regression, a decrease in KPS of ≥40 was associated with decreased survival, and an increase of ≥40 was associated with improved survival (HR = 1.245, 95% CI [1.181-1.312], p < 0.0001 and HR = 0.866, 95% CI [0.785, 0.955], respectively). Among patients with a KPS <40 at the time of transplant, those with a decrease in KPS of ≥40 had decreased graft and patient survival compared with those with a smaller decrease (p = 0.0002 and p = 0.0021, respectively). CONCLUSIONS: Deterioration of KPS on the waiting list for LTx is associated with significantly greater postoperative mortality in patients after LTx. These results should be taken into consideration when allocating organs. Strategies to increase or to prevent a decrease in KPS before LTx should be evaluated.


Assuntos
Transplante de Pulmão , Listas de Espera , Adulto , Humanos , Estudos Retrospectivos , Estado Funcional , Sobrevivência de Enxerto
18.
Influenza Other Respir Viruses ; 16(6): 1151-1160, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36069297

RESUMO

BACKGROUND: Respiratory syncytial virus (RSV) causes severe respiratory illnesses in infants and older adults. Older adults are frequently hospitalized with RSV illness and may experience loss of function. This study evaluated longitudinal changes in function associated with RSV hospitalization in older adults. METHODS: Adults ≥60 years hospitalized with laboratory-confirmed RSV were enrolled (N = 302). Demographics and comorbidities were collected. Functional status was assessed 2 weeks pre-hospitalization by recall, at enrollment, hospital discharge and 2, 4, and 6 months post-discharge using the Lawton-Brody Instrumental Activities of Daily Living (IADL) (scale 0-8) and Barthel ADL Index (scale 0-100). RESULTS: RSV-associated hospitalization resulted in acute functional loss. Median IADL (5 vs. 3, p < 0.0001) and ADL (90 vs. 70, p < 0.0001) scores decreased significantly from pre-hospitalization to admission and remained decreased at discharge. There were no statistically significant differences between pre-hospitalization and 2-, 4-, or 6-month scores. However, 33% and 32% of subjects experienced decreased 6-month IADL and ADL scores, respectively. Additionally, 14% required a higher level of care at discharge. When stratified by pre-hospitalization living situation, 6-month IADL scores declined significantly for those admitted from a skilled nursing facility (3 vs. 1, p = 0.001). In multivariate analysis, male sex and diabetes were associated with a 6-month decline in ADL score of ≥10. CONCLUSIONS: Older adults hospitalized with RSV demonstrate acute functional decline that may become prolonged. Pre-hospitalization living situation may predict patient outcomes. Further study is needed with hospitalized age-matched controls and refined measurement tools to better define the specific impact of RSV on function.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Atividades Cotidianas , Assistência ao Convalescente , Idoso , Estado Funcional , Hospitalização , Humanos , Lactente , Masculino , Alta do Paciente , Infecções por Vírus Respiratório Sincicial/epidemiologia
19.
J Stroke Cerebrovasc Dis ; 31(11): 106754, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36115107

RESUMO

OBJECTIVE: This retrospective study examined the association between nutritional status at admission and functional independence measure (FIM™) at discharge. MATERIALS AND METHODS: This study included 205 patients, aged ≥ 65, discharged from a convalescent ward between April 2017 and March 2018. The primary outcome was discharge FIMTM, and the secondary outcomes were the length of stay (LOS) and FIM efficiency. The explanatory variables included demographic data, stroke type, admission FIMTM, body mass index (BMI), controlling nutritional status (CONUT), and Geriatric Nutritional Risk Index (GNRI). Patients were divided into three groups based on BMI and GNRI scores and four groups based on the CONUT score. Univariate and multiple regression analyses were performed to predict discharge FIMTM. Kruskal-Wallis and Dunn's tests were also performed for intergroup comparisons. RESULTS: In the univariate analyses, age, sex, onset-to-admission interval, admission FIMTM, GNRI, and BMI (all factors were p<0.001) were significant explanatory variables for discharge FIMTM. In the multiple linear regression analysis, admission FIMTM, LOS, age, and onset-to-admission interval were significant explanatory variables (adjusted R2 = 0.791; p<0.001). Although those with poor nutritional status required a longer hospital stay, they achieved the same FIM gain as those without poor nutritional status. CONCLUSIONS: Nutritional status on admission did not affect the FIMTM at discharge in the convalescent ward. Patients with subacute stroke require adequate rehabilitation regardless of their nutritional status.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Idoso , Estado Nutricional , Alta do Paciente , Estudos Retrospectivos , Recuperação de Função Fisiológica , Estado Funcional , Atividades Cotidianas , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/complicações , Tempo de Internação , Resultado do Tratamento
20.
Artigo em Inglês | MEDLINE | ID: mdl-36141422

RESUMO

Background: Care to Move (CTM) provides a series of consistent 'movement prompts' to embed into existing movements of daily living. We explored the feasibility of incorporating CTM approaches in home care settings. Methods: Feasibility study of the CTM approach in older adults receiving home care. Recruitment, retention and attrition (three time points), adherence, costs to deliver and data loss analyzed and differentiated pre and post the COVID-19 pandemic. Secondary outcomes, including functional status, physical activity, balance confidence, quality of life, cost to implement CTM. Results: Fifty-five home care clients (69.6% of eligible sample) participated. Twenty were unable to start due to COVID-19 disruptions and health issues, leaving 35 clients recruited, mostly women (85.7%), mean age 82.8 years. COVID-19 disruption impacted on the study, there was 60% retention to T2 assessments (8-weeks) and 13 of 35 (37.1%) completed T3 assessments (6-months). There were improvements with small to medium effect sizes in quality of life, physical function, balance confidence and self-efficacy. Managers were supportive of the roll-out of CTM. The implementation cost was estimated at EUR 280 per carer and annual running costs at EUR 75 per carer. Conclusion: Embedding CTM within home support services is acceptable and feasible. Data gathered can power a definitive trial.


Assuntos
COVID-19 , Serviços de Assistência Domiciliar , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Atenção à Saúde , Estudos de Viabilidade , Feminino , Estado Funcional , Humanos , Masculino , Pandemias , Qualidade de Vida
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