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1.
Medicine (Baltimore) ; 99(1): e18486, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895781

RESUMO

We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.


Assuntos
Acidente Nuclear de Fukushima , Policitemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Terremotos , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Policitemia/etiologia , Policitemia/psicologia , Prevalência , Tsunamis , Adulto Jovem
2.
Praxis (Bern 1994) ; 109(1): 27-30, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910758

RESUMO

GeoLaus, a Study on the Influence of Geo-Environmental Characteristics on Population Health Abstract. Geographic information on risk factors for health or disease is increasingly being used to understand the determinants of health. GeoLaus is a project initiated in 2015 that studies the impact of living spaces and socio-economic situation, on physical and mental health and on different lifestyle habits. This paper discusses and illustrates the use of spatial information in CoLaus to understand the determinants of obesity and daytime sleepiness. The first results of the GeoLaus study open new perspectives on population health.


Assuntos
Estilo de Vida , Saúde Mental , Obesidade , Geografia , Humanos , Fatores de Risco
3.
BJOG ; 127(1): 39-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31444892

RESUMO

OBJECTIVE: To explore the relation between famine exposure in early life and subsequent pregnancy loss, including stillbirth, and spontaneous abortion in adulthood. DESIGN: A population-based, partly ecological study. SETTING AND POPULATION: Individual data of 58 601 females born around the time of the Great Chinese Famine in 1959-1961. METHODS: Associations between the famine exposure in early life and pregnancy loss (stillbirth and spontaneous abortion) in adulthood were analysed using negative binomial regression, with the non-exposure group as reference, adjusting for region, highest education, monthly income, alcohol consumption, tobacco use, body mass index in 25-year-olds and metabolic equivalent. Further analyses were stratified by rural versus urban region. MAIN OUTCOME MEASURES: Continuous variables of times of stillbirths and spontaneous abortions were used according to the individual self-reported reproductive history. RESULTS: No association was found between famine exposure and spontaneous abortion. In contrast, females experiencing the famine during their prenatal period (incidence rate ratio = 1.15, 95% CI 1.00-1.33) or infant period (incidence rate ratio = 1.27, 95% CI 1.12-1.44) were more likely to report stillbirth in later adult life. Such an association appeared stronger in women living in rural regions. CONCLUSIONS: Early life exposure of famine was associated with an increased risk of stillbirth but not spontaneous abortion in adulthood. The strength of such an association appeared stronger in rural areas. Given the high potential for unmeasured confounding, these associations must be interpreted with caution. Regarding the potential implication that undernutrition in the fetal period is related to reproductive outcome in adulthood, fetal nutritional supply may play an important role in human reproduction. TWEETABLE ABSTRACT: Exposure to famine in early life was associated with increased pregnancy loss in adulthood.


Assuntos
Aborto Espontâneo/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Natimorto/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Gravidez , Saúde da População Rural
4.
Chemosphere ; 240: 124898, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31557644

RESUMO

Urinary polycyclic aromatic hydrocarbon (PAH) metabolites, biomarkers of internal PAH exposure, are commonly used to explore the effects of PAH on human health. However, the correlation between environmental PAH exposure and the species or levels of urinary PAH metabolites remains unclear. We collected detailed information on PAH exposure sources, including cigarette smoking, cooking, traffic and diet habits via structured questionnaires, and determined 12 urinary monohydroxylated PAH metabolites (OH-PAHs) among 4092 participants from the Wuhan-Zhuhai cohort. Linear mixed models and generalized linear models were conducted to explore the associations of urinary metabolite levels with single or multiple PAH exposure sources. We also calculated the standardized regression coefficients to further compare the contributions of different sources to urinary OH-PAH levels. Our results showed that increasing levels of urinary 1-, 2-hydroxynaphthalene (1-, 2- OHNa) and 2-hydroxyfluorene (2-OHFlu) were significantly correlated with tobacco smoking (all P < 0.01). The concentrations of 1-, 2- OHNa and 9-hydroxyfluorene (9-OHFlu) were positively correlated with dietary intake (all P < 0.05). Individuals who spent a long time in traffic showed elevated levels of 9-OHFlu and 1-hydroxyphenanthrene (1-OHPh) compared with individuals who spent a short time in traffic (all P < 0.05). Self-cooking was associated only with elevated 1-hydroxypyrene (1-OHP) levels. Moreover, good kitchen ventilation resulted in significantly decreased urinary low-molecular-weight OH-PAH levels. These findings suggested that cigarette smoking, self-cooking, high dietary PAH intake and a long time spent in traffic were associated with increased levels of specific urinary PAH metabolites, and good kitchen ventilation effectively reduced the exposure to low-molecular-weight PAHs in self-cooking participants.


Assuntos
Exposição Ambiental/análise , Poluentes Ambientais/urina , Hidrocarbonetos Policíclicos Aromáticos/urina , Adulto , Biomarcadores/urina , China , Estudos de Coortes , Estudos Transversais , Exposição Ambiental/estatística & dados numéricos , Feminino , Fluorenos , Humanos , Estilo de Vida , Modelos Lineares , Pulmão/metabolismo , Masculino , Naftóis , Fenantrenos
5.
RECIIS (Online) ; 13(4): 935-951, out.-dez. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1047680

RESUMO

Este artigo é resultado do trabalho de pesquisa sobre a produção das campanhas antitabagistas de governo e sobre a forma com que foram apropriados pela população. Nosso objetivo foi avaliar como essas campanhas foram pensadas em relação aos princípios de comunicação e saúde pressupostos pelo Sistema Único de Saúde. A expectativa foi problematizar a questão numa perspectiva interdisciplinar. Analisamos documentos a partir dos preceitos teóricos e metodológicos da Semiologia dos Discursos Sociais. Concluiu-se que foram criadas campanhas alarmistas, pautadas na imputação do medo e na vigília moral, que acabaram por se distanciar da ideia de uma comunicação em saúde pública dialógica, informativa e participativa.


This article is the result of a research on the use of the concept of aversion in the production of government anti-smoking campaigns and how they were appropriated by the population. Our objective was to evaluate how these campaigns were conceived in relation to the principles of communication and health presupposed by the Unified Health System. The expectation was to problematize the issue from an interdisciplinary perspective. We analyze documents from the theoretical and methodological precepts of Semiology of Social Discourses. It was concluded that alarmist campaigns were created, based on the imputation of fear and on moral vigilance, which eventually distanced these actions from the principles of communication in dialogic, informative and participatory public health.


Este artículo es el resultado del trabajo de investigación sobre la utilización del concepto de aversión en la producción de las campañas antitabaco de gobierno y sobre la forma en que fueron apropiados por la población. Nuestro objetivo fue evaluar cómo estas campañas fueron pensadas en relación a los principios de comunicación y salud presupuestados por el Sistema Único de Salud. La expectativa fue problematizar la cuestión desde una perspectiva interdisciplinaria. Analizamos documentos a partir de los preceptos teóricos y metodológicos de la Semiología de los Discursos Sociales. Se concluyó que se crearon campañas alarmistas, pautadas en la imputación del miedo y en la vigilia moral, que acabaron por distanciarse de la idea de una comunicación en salud pública dialógica, informativa y participativa.


Assuntos
Humanos , Tabagismo , Meios de Comunicação , Publicidade como Assunto , Promoção da Saúde , Estilo de Vida , Propaganda , Política Pública , Sistema Único de Saúde , Saúde , Comercialização de Produtos Derivados do Tabaco , Fumar Cigarros , Prevenção do Hábito de Fumar/história , Neoplasias
6.
Medicine (Baltimore) ; 98(50): e18323, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852122

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. PCOS has a significant negative impact on the health-related quality of life (HRQoL) and psychological function of women, of which there are reports of high levels of depression in women with PCOS compared to those without PCOS. However, the evidence surrounding the effects of exercise and/or dietary intervention participation on the HRQoL of women with PCOS is limited. Therefore, our objective is to examine the effects of lifestyle interventions (definition include exercise-only, diet-only, exercise + diet and behavioral or combined) on health-related quality of life or general quality of life in women with PCOS. METHODS: We will conduct an update of systematic review and we will follow the recommendations and guidelines of the Cochrane handbook for systematic reviews and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P). We will search the studies in the following databases: MEDLINE. PubMed, PsychINFO, Embase, SportDiscus, Web of Science, Cochrane Database (via Cochrane library), Cochrane Controlled Register of Trials (CENTRAL), and Google Scholar (advance). Manual search of the reference list of identified works, without language and year restrictions. The process of study selection and data extraction will be performed independently by 2 reviewers, with a third reviewer being responsible for the final decision in case of disagreement between the first two. We will use Egger funnel chart to evaluate possible publication biases, in addition, when possible we will perform a subgroup/meta-regression analysis. The strength of the evidence will be assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). PROTOCOL REGISTRY: PROSPERO number: CRD42019124176.


Assuntos
Estilo de Vida , Síndrome do Ovário Policístico/terapia , Qualidade de Vida , Adolescente , Adulto , Dieta/métodos , Exercício , Feminino , Humanos , Resistência à Insulina , Metanálise como Assunto , Síndrome do Ovário Policístico/psicologia , Projetos de Pesquisa , Revisão Sistemática como Assunto , Adulto Jovem
7.
JAMA ; 322(24): 2444-2445, 2019 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-31860038
8.
Medicine (Baltimore) ; 98(51): e18315, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860982

RESUMO

The incidence of breast cancer among Japanese women is substantially increasing. This study evaluated the effects of reproductive and lifestyle factors with respect to breast cancer overall and separately among pre- and postmenopausal women using data from the Three-Prefecture Cohort Study of Japan.A total of 33,410 women aged 40 to 79 years completed a self-administered questionnaire, which included items about menstrual and reproductive history and other lifestyle factors. The follow-up period was from 1984 to 1992 in Miyagi and 1985 to 2000 in Aichi Prefectures. We used Cox proportional hazards regression models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors.After 9.8 mean years of follow-up, 287 cases of breast cancer were recorded. In the overall analysis, later menarche (≥16 years) and parity were significantly associated with a decreased risk of breast cancer, with HRs of 0.69 (95% CI 0.48-0.99) and 0.72 (95% CI 0.52-0.99), respectively. Further, there was a significant decline in the risk of breast cancer with increasing number of birth among parous women (P for trend = .010). On the contrary, a family history of breast cancer in the mother was significantly associated with an increased risk of breast cancer (HR 3.22, 95% CI 1.52-6.84). Analyses based on menopausal status at baseline indicated that height (≥160 cm) and weight (≥65 kg) were significantly associated with an increased risk of postmenopausal breast cancer, with HRs of 1.34 (95% CI 0.72-2.50) and 3.13 (95% CI 1.75-5.60), respectively. Risk associated with BMI significantly differs by menopausal status.Our findings suggest the important role of reproductive factors in the development of breast cancer in Japanese women; however, body mass index (BMI) may have different effects on breast cancer in Japanese women compared with western women.


Assuntos
Neoplasias da Mama/etiologia , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Estudos de Coortes , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Anamnese , Menarca , Pessoa de Meia-Idade , Paridade , Fatores de Risco , Inquéritos e Questionários
9.
Zhonghua Gan Zang Bing Za Zhi ; 27(10): 748-753, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31734987

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in China. To provide evidence-based and updated practical recommendations for clinician, this expert recommendations have updated the diagnosis and treatment of NAFLD in five aspects as follows: (1) the framework of NAFLD treatment centre or clinic; (2) screening and evaluation: who should be screened, initial evaluation items, non-invasive assessment of steatohepatitis and advanced fibrosis, when to obtain a liver biopsy in patients with NAFLD, and other metabolic disorders and cardiovascular risk assessment; (3) managements of patient with NAFLD: lifestyle intervention (dietary, exercise and weight loss), drug treating metabolic co-morbidities such as hyperlipidemia, type 2 diabetes mellitus and hypertension, and steatohepatitis and fibrosis; (4) management of special populations with NAFLD: children, pregnant or lactating women, patients co-existence with alcoholic liver disease, chronic HBV and/or HCV infection, and autoimmune disorders; (5) monitoring and follow-up. This consensus aims to modify the optimizing management process and guide physicians make correct and reasonable decisions in the diagnosis and treatment for patients with NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/terapia , Biópsia , Criança , China , Comorbidade , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Hiperlipidemias , Hipertensão , Lactação , Estilo de Vida , Guias de Prática Clínica como Assunto
10.
Nihon Yakurigaku Zasshi ; 154(5): 270-274, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31735757

RESUMO

In the 18th century, Edward Jenner proposed the vaccine for smallpox as a first vaccine therapy based on the legend that a vaccinia prevents the infection with smallpox. Recently, the therapeutic target of vaccine will expand from infectious diseases to various diseases, such as amyloid ß or tau vaccine for Alzheimer's disease. We are now going to develop a therapeutic vaccine to lifestyle-related diseases (i.e. high blood pressure), and aim to realize a novel therapy which will be injected once or twice per year from a daily medication. For this purpose, the appropriate choice of an antigen, carrier and adjuvants should be required to activate hormonal immunity by the vaccine, leading to efficient antibody production without toxicity, because the therapeutic target of our vaccine is an endogenous protein (i.e. hormone). The clinical advantage of this therapeutic vaccine is to improve the medical adherence and drug management because the multiple drug users are increased in particular old patients, so called polypharmacy. If the vaccine will take place of a part of medicine in future, it may give us a novel therapeutic option with several social benefits.


Assuntos
Hipertensão/terapia , Estilo de Vida , Vacinas/uso terapêutico , Humanos
11.
Nurs Res ; 68(6): 453-463, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693551

RESUMO

BACKGROUND: Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES: The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS: A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS: Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION: These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.


Assuntos
Estresse Psicológico/epidemiologia , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
12.
Nurs Res ; 68(6): 494-500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693556

RESUMO

BACKGROUND: Recognizing the effects of acculturation on quality of life and emotional health, especially during pregnancy, we developed an intervention that would target these factors in order to improve maternal well-being during the prenatal period and potentially improve infant outcomes, particularly preterm birth for Mexican-American women (Latinas). OBJECTIVE: The purpose of these pilot studies was to test the acceptability, feasibility, and preliminary efficacy of the mastery lifestyle intervention (MLI) to decrease depressive and anxiety symptoms and improve coping as implemented in prenatal clinics with culturally homogenous groups of Latinas. METHODS: The MLI was tested in three small pilot studies (n = 15), one in El Paso, Texas (an urban area), and two in Bastrop, Texas (a rural area outside Austin), for acceptability and feasibility. A pretest/posttest, quasi-experimental design was used with pregnant self-identified Mexican-American Latinas at 14-20 weeks' gestation. Measures of anxiety, depressive symptoms, and positive and negative coping were used. RESULTS: Feasibility was a success in terms of implementation of the MLI in an active prenatal clinic setting and the use of electronic tablets for data collection and entry of data into REDcap. Satisfaction was high, with the location of the MLI being at their primary OB/GYN clinic. Participants reported that six intervention sessions appear to be ideal as was the class length of 1.5 to 2 hours. On Cohen's d, there were medium to large effect size decreases in depressive and anxiety symptoms and small to medium effect size decreases in the use of negative coping strategies and small effect sizes for increases in positive coping strategies. DISCUSSION: Pilot testing of the MLI indicated that it was well accepted from the participants and feasible as a culturally tailored behavioral therapy administered in a group setting by nurse practitioners. Our initial pilot results also suggest preliminary efficacy as indicated by moderate to large Cohen's d effect sizes for depression and anxiety.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Estilo de Vida/etnologia , Americanos Mexicanos/psicologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal , Aculturação , Adaptação Psicológica , Adulto , Ansiedade/etnologia , Depressão/etnologia , Estudos de Viabilidade , Feminino , Humanos , Projetos Piloto , Gravidez , Complicações na Gravidez/etnologia , Qualidade de Vida , Texas
13.
Wei Sheng Yan Jiu ; 48(5): 757-764, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601316

RESUMO

OBJECTIVE: To elucidate the association between lifestyle and dietary factors and esophageal squamous cell carcinoma( ESCC) in three different sections of the esophagus. METHODS: From January 2010 to December 2016, a hospital-based case-control study was conducted, and a total of 550 patients with ESCC and gender and age( ±3 age) frequency-matched 550 cancer-free control subjects were recruited in this study. Odds ratios( ORs) and their corresponding 95% confidence intervals( CIs) were calculated by using unconditional binary or multinomial logistic regression. Multiple correspondence analysis( MCA) was applied to illustrate the influence of the risk factors on different sections of the esophagus. RESULTS: Tea drinking was associated with lower risk of upper( Ut) and lower thoracic( Lt) ESCC( OR = 0. 40, 95% CI 0. 22-0. 73; OR= 0. 50, 95% CI 0. 31-0. 81; for Ut and Lt, respectively), and lower intake of vegetables increased the risk of Ut and Lt ESCC( OR = 3. 93, 95% CI 1. 61-9. 61; OR =2. 68, 95% CI 1. 30-5. 53; for Ut and Lt, respectively). Intake of hot food, hard food and lower intake of fruits were associated with an elevated risk of the ESCC in all subsites( P<0. 05). The strength of association between drinking and ESCC was lower in middle thoracic( Mt) compared with the Lt ESCC( OR = 0. 58, 95% CI 0. 35-0. 98). Moreover, this reduction of association strength were also found in eating hot food( OR = 0. 45, 95%CI 0. 27-0. 76) and lower intake of vegetables( Ut OR = 0. 44, 95% CI 0. 20-0. 99). However, the association between lower intake of fruits and the Mt ESCC risk was stronger compared with Lt ESCC( OR = 1. 66, 95% CI 1. 08-2. 55). In additional, the association between lower intake of fruits and the Ut ESCC risk was stronger compared with Mt ESCC. Joint category plot of MCA also identified the heterogeneous associations between risk factors and different sections of the esophagus. CONCLUSION: Differences in risk factors of ESCC in different subsites, intake of hot food, hard food, and lower intake of vegetables were common risk factors for three subsites of ESCC.


Assuntos
Dieta/estatística & dados numéricos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Comportamento Alimentar , Humanos , Estilo de Vida , Fatores de Risco
14.
Adv Mind Body Med ; 33(3): 22-30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31605602

RESUMO

Background: A 38-year-old, female with a history of GAD, MDD, AN, and PTSD wanted to taper her multiple medications in preparation for pregnancy. Benzodiazepine medications, such as Klonopin and Restoril; antidepressants, such as Effexor; and anticonvulsant medications, such as Lamictal, can be habit-forming, and withdrawal symptoms can occur upon discontinuation of use. Polypharmacy can be implicated in poor clinical outcomes, and a strategic and supported medication taper may improve those outcomes. Summary: After the primary MD unsuccessfully attempted to taper off the patient's psychotropic medications without lifestyle interventions, she was stabilized on a minimal regimen by an outside reproductive psychiatrist throughout her pregnancy. A second tapering was implemented by the primary MD after the patient had given birth and had established changes to her lifestyle. These lifestyle interventions included dietary changes, use of detoxification protocols, contemplative practices, and strategic supplement support in the setting of a powerful mindset shift. The patient experienced remarkable symptom remission after strategic discontinuation of medications through the addition of the lifestyle interventions. She also was able to heal the root-cause drivers of her psychiatric diagnoses. Currently she is symptom-free and medication-free after nearly 21 years. Conclusions: This case demonstrates the effectiveness of lifestyle interventions and psychospiritual support to enable dramatic clinical change without withdrawal syndrome after cessation of medication. More important, the initial failed tapering underpins the notion that a diligent meditation practice may be necessary to heal root-cause drivers of psychiatric symptoms and withdrawal syndrome. The results may serve to inform practitioners assisting patients who wish to discontinue benzodiazepine and other psychotropic medications or patients who would like to try a nonpharmaceutical approach as a first-line therapy.


Assuntos
Antidepressivos/efeitos adversos , Estilo de Vida , Psicotrópicos/efeitos adversos , Síndrome de Abstinência a Substâncias , Adulto , Antidepressivos/uso terapêutico , Benzodiazepinas , Feminino , Humanos , Psicotrópicos/uso terapêutico , Síndrome de Abstinência a Substâncias/etiologia
15.
Medicine (Baltimore) ; 98(41): e17490, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593113

RESUMO

Lifestyle in preschool children is associated with the onset of childhood obesity. However, the effect of environmental factors in childcare facilities on lifestyle and obesity in preschool children is unknown. The aim of this study was to determine the effect of environmental factors in childcare facilities on the association between obesity and individual lifestyle in preschool children.Subjects included 2902 infants, aged 4 to 6 years old in Kitakyushu City, Japan. A stratified multilevel analysis was conducted with 2 strata: factors related to individual lifestyle and maternal factors as the individual level and factors related to the childcare facility as the environmental level. Two-level multilevel regression analysis was conducted with the presence or absence of obesity.The proportion of infants with obesity was 4.2%. The childhood obesity was significantly associated with the mastication, nutritional methods during infancy, absence of breakfast, presence of skipping meals due to overeating of snacks, usual play activity, screen time on weekdays, maternal body mass index, and maternal weight increase during pregnancy at the individual level. On the other hand, childhood obesity had a significantly negative association with the receiving snacks in facilities by using multilevel analysis.The present study revealed that establishing and maintaining environmental factors in childcare facilities may play important roles in the prevention of obesity from early childhood.


Assuntos
Creches , Meio Ambiente , Estilo de Vida , Obesidade Pediátrica/epidemiologia , Criança , Pré-Escolar , Exercício , Comportamento Alimentar , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Refeições , Análise Multinível , Análise Multivariada , Obesidade Pediátrica/etiologia , Fatores de Risco
16.
Rev Saude Publica ; 53: 88, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31596321

RESUMO

OBJECTIVE: To determine the distribution of sociodemographic, reproductive, clinical and lifestyle habits in the cohort of women diagnosed with cervical cancer, assisted at Inca between 2012 and 2014, according to the histological type. METHODS: Retrospective observational study of a hospital cohort of 1,004 women diagnosed with cervical cancer. Data were obtained from the Inca hospital cancer registry, physical and electronic records. RESULTS: The most frequent histological type was squamous cell carcinoma (83.9%). Approximately 70% of the women aged more than 40 years. The study includes non-white women (67.4%), with less than 8 years of education (51.9%), with onset of sexual activity up to 16 years of age (40.7%), who were pregnant before (95.5%), with more than one pregnancy (82.9%), and more than two children (52.7%); 45.8% of the women were smokers or former smokers. Cervical adenocarcinoma was positively associated with earlier staging (IA-IIA) (OR = 1.79; 95%CI 1.03-3.13), as well as women with ≥ 12 years of education (OR = 6.30; 95%CI 1.97-20,13), who had no children (OR = 3.81; 95%CI 1.20 - 12,08) or who had up to two children (OR = 1.74; 95%CI 1.05 - 2,87). CONCLUSIONS: The difference between histological types is highlighted, suggesting that women with cervical adenocarcinoma may represent a distinct clinical entity of cervical neoplasia, which may require different approaches from those used in squamous cell carcinoma.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adenocarcinoma/patologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual , Fatores Socioeconômicos , Neoplasias do Colo do Útero/patologia
17.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190016.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596387

RESUMO

OBJECTIVE: To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil. METHODS: This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used. RESULTS: The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 ‒ 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 ‒ 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 ‒ 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 ‒ 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 ‒ 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 ‒ 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 ‒ 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 ‒ 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 ‒ 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 ‒ 2.1), former smokers (OR = 1.4; 95%CI 1.3 ‒ 1.6) or current smokers (OR = 1.2; 95%CI 1.03 ‒ 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 ‒ 1.5). CONCLUSION: The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.


Assuntos
Autoavaliação Diagnóstica , Inquéritos Epidemiológicos/métodos , Cardiopatias/diagnóstico , Cardiopatias/epidemiologia , Autorrelato/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Valores de Referência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
18.
Rev Lat Am Enfermagem ; 27: e3177, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596412

RESUMO

OBJECTIVE: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students. METHOD: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed. RESULTS: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity. CONCLUSION: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.


Assuntos
Sobrepeso/psicologia , Estresse Psicológico/epidemiologia , Estudantes de Enfermagem/psicologia , Adulto , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade/psicologia , Sobrepeso/prevenção & controle , Circunferência da Cintura
19.
Medicine (Baltimore) ; 98(39): e17287, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574848

RESUMO

Evidence suggests that mental health is associated with multiple factors such as physical activity, sedentary behavior, and physical function in older adults. The present study used latent profile analysis to identify classes of older adults based on their health profile among a representative sample of Korean older adults with hypertension. Differences in mental health between these classes were also examined.Seven hundred and sixty seven participants (mean age = 70.23, SD = 6.08; men 45.6%) were included in the analysis.There were 3 latent classes (class 1: a physically inactive lifestyle with low physical function and body perception; class 2: a physically moderate lifestyle with moderate physical function and low body perception; class 3: a physically active lifestyle with high physical function and body perception). According to class comparisons, older adults in class 3 had significantly lower anxiety/depression levels than classes 1 and 2. Older adults in class 3 had significantly lower stress levels than class 1.It is possible that among older adults, having a positive attitude of one's body shape may also be important for improving anxiety/depression along with having a physically active lifestyle and maintaining physical function.


Assuntos
Imagem Corporal/psicologia , Força da Mão , Hipertensão/psicologia , Postura Sentada , Caminhada , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Estudos Transversais , Depressão/psicologia , Exercício/psicologia , Feminino , Humanos , Hipertensão/fisiopatologia , Análise de Classes Latentes , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Percepção , República da Coreia , Estresse Psicológico/psicologia
20.
Medicine (Baltimore) ; 98(40): e17218, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577712

RESUMO

Health examination is an important method for early detection of people with different risk of stroke. This study estimates the risk of stroke and identify risk factors for people who underwent health examinations at the Health Examination Center at West China Hospital, Sichuan University from July 2014 to February 2018.A total of 31,464 people were recruited in this study and divided into 3 groups (low risk, moderate risk, and high risk) according to risk of stroke. We explored possible factors associated with the risk of stroke by using multivariable stepwise logistic regression analysis.Among the participants, 17,959 were at low risk, 11,825 were at moderate risk, and 1680 were at high risk. Age, smoking, alcohol consumption, body mass index, uric acid, diastolic pressure, systolic pressure, triglycerides, low-density lipoprotein cholesterol, glucose, and brachial-ankle pulse wave velocity (baPWV) were independent significant risk factors for stroke, whereas high-density lipoprotein cholesterol was an independent protective factor for stroke. Interestingly, with increasing age, the percentage of people at moderate or high risk of stroke was increased. The percentages of people at moderate and high risk of stroke were also increased with respect to the stages of baPWV.This study showed that >40% of the participants were at moderate or high risk of stroke, especially the older participants. Several factors were related to the risk of stroke, especially baPWV. Some preventive action may be adopted early, and more attention can be paid to the health examination population.


Assuntos
Exame Físico/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Índice Tornozelo-Braço , Pressão Sanguínea , Índice de Massa Corporal , China/epidemiologia , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos
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