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1.
PLoS One ; 16(6): e0252427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086706

RESUMO

INTRODUCTION: COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. METHODS: This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. RESULTS: Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. CONCLUSIONS: Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries.


Assuntos
COVID-19/epidemiologia , Cognição , Comportamentos Relacionados com a Saúde , SARS-CoV-2 , Fumantes , Abandono do Hábito de Fumar , Inquéritos e Questionários , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adolescente , Adulto , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar Tabaco/psicologia , Vaping/psicologia
2.
Medicine (Baltimore) ; 100(22): e26163, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087875

RESUMO

ABSTRACT: The premise of this study is that spoken word recognition and object knowledge are impaired in semantic variant primary progressive aphasia (PPA) (svPPA) and are spared in logopenic variant (lvPPA) and nonfluent agrammatic primary progressive aphasia (nfaPPA) at disease onset. Over time, however, there may be heterogeneity in these abilities in lvPPA and nfaPPA. We hypothesized that individuals with svPPA would demonstrate poorer performance on baseline spoken word recognition and object knowledge than those with lvPPA and nfaPPA) as documented in the literature, but that rates of decline over time on spoken word recognition and object knowledge would be similar in all 3 PPA variants because these become less distinguishable with disease progression.The aim of this study was to investigate longitudinal patterns of decline in spoken word recognition and object knowledge across PPA variants.Ninety-five individuals with PPA completed the Semantic Word Picture Matching and Semantic Associates tests at baseline to establish expected performance in these areas. Thirty-five individuals completed follow-up testing.The distributions of trichotomized mean rates of decline in object knowledge were similar for lvPPA and svPPA (P = .05). There were weak negative correlations between symptom duration and baseline scores on Semantic Word Picture Matching (r[37] = -0.399, P = .01), and baseline scores on Semantic Associates (r[37] = -0.394, P = .01) in lvPPA.Degradation of spoken word recognition and object knowledge occurs over time in lvPPA. Further investigation of the receptive language deficits in PPA is warranted to characterize language changes that lessen the distinctions between PPA variants with disease progression.


Assuntos
Afasia Primária Progressiva/patologia , Vocabulário , Fatores Etários , Idoso , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores Sexuais , Fatores de Tempo
3.
Nat Commun ; 12(1): 3452, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103532

RESUMO

Progressive apraxia of speech is a neurodegenerative syndrome affecting spoken communication. Molecular pathology, biochemistry, genetics, and longitudinal imaging were investigated in 32 autopsy-confirmed patients with progressive apraxia of speech who were followed over 10 years. Corticobasal degeneration and progressive supranuclear palsy (4R-tauopathies) were the most common underlying pathologies. Perceptually distinct speech characteristics, combined with age-at-onset, predicted specific 4R-tauopathy; phonetic subtype and younger age predicted corticobasal degeneration, and prosodic subtype and older age predicted progressive supranuclear palsy. Phonetic and prosodic subtypes showed differing relationships within the cortico-striato-pallido-nigro-luysial network. Biochemical analysis revealed no distinct differences in aggregated 4R-tau while tau H1 haplotype frequency (69%) was lower compared to 1000+ autopsy-confirmed 4R-tauopathies. Corticobasal degeneration patients had faster rates of decline, greater cortical degeneration, and shorter illness duration than progressive supranuclear palsy. These findings help define the pathobiology of progressive apraxia of speech and may have consequences for development of 4R-tau targeting treatment.


Assuntos
Apraxias/diagnóstico por imagem , Apraxias/genética , Progressão da Doença , Neuroimagem , Fala , Idoso , Idoso de 80 Anos ou mais , Anisotropia , Apraxias/complicações , Apraxias/patologia , Disfunção Cognitiva/complicações , Imagem de Tensor de Difusão , Feminino , Fluordesoxiglucose F18/química , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Neurobiologia , Neurônios/metabolismo , Neurônios/patologia , Patologia Molecular , Tomografia por Emissão de Pósitrons , Proteínas tau/metabolismo
4.
J Pak Med Assoc ; 71(6): 1605-1607, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111081

RESUMO

OBJECTIVE: To determine the frequency of allergic fungal sinusitis among patients with nasal polyps, and to compare Lund-Mackay scores of patients with and without allergic fungal sinusitis. METHODS: The cross-sectional longitudinal study was conducted at a tertiary healthcare centre in Karachi, Pakistan, from December 2016 to November 2018, and comprised patients with sinonasal polyposis undergoing surgery. The patients were categorised as having allergic fungal sinusitis when histopathology showed allergic mucin with fungal hyphae and culture was positive for fungal growth. Lund-Mackay scoring of each patient was noted and mean scores of allergic fungal sinusitis and non-allergic fungal sinusitis patients were compared. Data was analysed using SPSS 25. RESULTS: Of the 114 patients, 61(53.5%) were males. The overall mean age was 37.3±15.3 years. Of the total, 27(23.7%) patients had allergic fungal sinusitis. There was a significant relationship between asthma and allergic fungal sinusitis (p=0.03). The mean Lund-Mackay score was significantly higher for allergic fungal sinusitis patients (p<0.01). Recurrence was seen in 11(9.6%) cases. CONCLUSIONS: About one-fourth of patients with nasal polyps had allergic fungal sinusitis, and such patients showed significantly high mean Lund-Mackay score.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Adulto , Doença Crônica , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Pólipos Nasais/epidemiologia , Recidiva Local de Neoplasia , Paquistão/epidemiologia , Prevalência , Sinusite/complicações , Sinusite/epidemiologia , Adulto Jovem
5.
J Pak Med Assoc ; 71(6): 1618-1622, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111084

RESUMO

OBJECTIVE: To estimate the burden of antenatal and postpartum depression, and to explore possible predictors of perinatal depression. METHODS: The longitudinal study was conducted at the Department of Obstetrics and Gynaecology, Shifa International Hospital and its Community Healthcare centre in Islamabad, Pakistan, from October 2018 to May 2019, and comprised women in their third trimester of pregnancy. Socioeconomic and obstetrical history was recorded on a proforma, and the Edinburgh Postnatal Depression Scale was used for screening of depression. Data was analysed using SPSS version 23. RESULTS: Of the 200 women, 71(35.5%) were primigravida and 129(64.5%) were multigravida. The overall mean age was 27.1±5.08 years. Further, 64(32%) women belonged to the low-income group, 99(49.5%) middle-income and 37(18.5%) to upper-income group. Women in postnatal period had higher depression scores than women in antenatal period (p<0.05). Antenatal depression increased the risk of postpartum depression (p<0.05). In women having unplanned pregnancies, or being multigravida, or belonging to middle and lower socioeconomic classes, the chances of perinatal depression were higher (p<0.05). CONCLUSIONS: Antenatal depression was strongly associated with postpartum depression, indicating that the former was a significant predictor of the latter. Social class and parity were also found to be directly linked with perinatal depression.


Assuntos
Depressão Pós-Parto , Complicações na Gravidez , Adulto , Depressão/epidemiologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Paquistão/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
6.
BMC Health Serv Res ; 21(1): 572, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112164

RESUMO

BACKGROUND: Understanding the differential utilization of healthcare services is essential to address the public health challenges. Through the migration process, refugees move from one set of health risk factors to another and can face multiple healthcare challenges along their journey. Yet how these changing risk factors influence refugees' use of health care services is poorly understood. METHODS: A longitudinal survey assessing health care utilization of 353 adult Syrian refugees was conducted; first in a transit setting in Lebanon and after one year of resettlement in Norway. The main outcomes are the utilization of general practitioner services, emergency care, outpatient and/or specialist care and hospitalization during the previous 12 months. Associations between use of healthcare services and several sociodemographic, migration-related and health status variables at both time points were found using regression analysis. We also analyzed longitudinal changes in utilization rates using generalized estimating equations. RESULTS: The use of general practitioner and emergency care increased after resettlement while outpatient/specialist care markedly dropped, and hospitalization rates remained the same. Undocumented status and poor self-rated health (SRH) prior to resettlement were identified as predictors for use of health care after arrival. After resettlement, higher health literacy, higher education, higher social support and poor SRH and quality of life were significantly associated with use of healthcare services. CONCLUSIONS: Utilization of health services changes post migration to the destination country and are associated with migration-related and socio-demographic factors. Poor SRH is associated with use of services, both pre-arrival and post-resettlement. Our findings have implications for future resettlements, health care policies and service provision to newly arrived refugees with regard to both health needs as well as delivery of services.


Assuntos
Refugiados , Adulto , Acesso aos Serviços de Saúde , Humanos , Líbano/epidemiologia , Estudos Longitudinais , Noruega/epidemiologia , Estudos Prospectivos , Qualidade de Vida , Síria
7.
BMC Infect Dis ; 21(1): 536, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098889

RESUMO

BACKGROUND: At present, no agents are known to be effective at preventing COVID-19. Based on current knowledge of the pathogenesis of this disease, we suggest that SARS-CoV-2 infection might be attenuated by directly maintaining innate pulmonary redox, metabolic and dilation functions using well-tolerated medications that are known to serve these functions, specifically, a low-dose aerosolized combination of glutathione, inosine and potassium. METHODS: From June 1 to July 10, 2020, we conducted a pilot, prospective, open-label, single-arm, single-center study to evaluate the safety and efficacy of preexposure prophylaxis (PrEP) with aerosolized combination medication (ACM) on the incidence of SARS-CoV-2 positivity in 99 healthcare workers (HCWs) at a hospital designated for treating COVID-19 patients. We compared SARS-CoV-2 positivity in ACM users to retrospective data collected from 268 untreated HCWs at the same hospital. Eligible participants received an aerosolized combination of 21.3 mg/ml glutathione and 8.7 mg/ml inosine in 107 mM potassium solution for 14 days. The main outcome was the frequency of laboratory-confirmed SARS-CoV-2 cases, defined as individuals with positive genetic or immunological tests within 28 days of the study period. RESULTS: SARS-CoV-2 was detected in 2 ACM users (2, 95% CI: 0.3 to 7.1%), which was significantly less than the incidence in nonusers, at 24 (9, 95% CI: 5.8 to 13.0%; P = 0.02). During the PrEP period, solicited adverse events occurred in five participants; all were mild and transient reactions. CONCLUSIONS: Our findings might be used either to prevent SARS-CoV-2 infection or to support ongoing and new research into more effective treatments for COVID-19. TRIAL REGISTRATION: ISRCTN, ISRCTN34160010 . Registered 14 September 2020 - Retrospectively registered.


Assuntos
COVID-19/tratamento farmacológico , COVID-19/prevenção & controle , Pessoal de Saúde , Profilaxia Pré-Exposição , Adulto , Aerossóis/farmacologia , Feminino , Hospitais , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
8.
BMC Musculoskelet Disord ; 22(1): 522, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098929

RESUMO

BACKGROUND: Musculoskeletal pain (MSP) is recognized worldwide as a major cause of increased years lived with disability. In addition to known generic prognostic factors, illness perceptions (IPs) may have predictive value for poor recovery in MSP. We were interested in the added predictive value of baseline IPs, over and above the known generic prognostic factors, on clinical recovery from MSP. Also, it is hypothesized there may be overlap between IPs and domains covered by the Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety and somatization. The aim of this study is twofold; 1) to assess the added predictive value of IPs for poor recovery and 2) to assess differences in predictive value for poor recovery between the Brief Illness Perception Questionnaire - Dutch Language Version (Brief IPQ-DLV) and the 4DSQ. METHODS: An eligible sample of 251 patients with musculoskeletal pain attending outpatient physical therapy were included in a multi-center longitudinal cohort study. Pain intensity, physical functioning and Global Perceived Effect were the primary outcomes. Hierarchical logistic regression models were used to assess the added value of baseline IPs for predicting poor recovery. To investigate the performance of the models, the levels of calibration (Hosmer-Lemeshov test) and discrimination (Area under the Curve (AUC)) were assessed. RESULTS: Baseline 'Treatment Control' added little predictive value for poor recovery in pain intensity [Odds Ratio (OR) 0.80 (Confidence Interval (CI) 0.66-0.97), increase in AUC 2%] and global perceived effect [OR 0.78 (CI 0.65-0.93), increase in AUC 3%]. Baseline 'Timeline' added little predictive value for poor recovery in physical functioning [OR 1.16 (CI 1.03-1.30), increase in AUC 2%]. There was a non-significant difference between AUCs in predictive value for poor recovery between the Brief IPQ-DLV and the 4DSQ. CONCLUSIONS: Based on the findings of this explorative study, assessing baseline IPs, over and above the known generic prognostic factors, does not result in a substantial improvement in the prediction of poor recovery. Also, no recommendations can be given for preferring either the 4DSQ or the Brief IPQ-DLV to assess psychological factors.


Assuntos
Dor Musculoesquelética , Ansiedade , Humanos , Estudos Longitudinais , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/terapia , Percepção , Inquéritos e Questionários
9.
J Spec Oper Med ; 21(2): 112-114, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105134

RESUMO

This is the first of an ongoing series to provide a background into reading medical research literature for the SOF medic.


Assuntos
Pesquisa Biomédica , Militares , Humanos , Estudos Longitudinais
10.
Artigo em Inglês | MEDLINE | ID: mdl-34072431

RESUMO

The COVID-19 pandemic is known to increase older adults' vulnerability to adverse outcomes. Alongside increased physical frailty, anxiety symptoms associated with the risk of SARS-CoV-2 contagion appear to represent its most prominent 'sequelae'. The attentional and linguistic resources required for decoding virus-related information may also influence the perceived threat of contagion. However, the possible role of neuropsychogeriatric factors on the latter dimension has never been assessed in a longitudinal study on the older population. To fill this gap, 50 healthy cognitively preserved older adults underwent a neuropsychological and physical frailty assessment before the pandemic (T0). Subsequently, they agreed to be interviewed and re-assessed during the lockdown (T1) and immediately after it (T2) through a longitudinal one-year study. Perceived threat of SARS-CoV-2 at T2 was predicted both by baseline anxiety and frailty scores, and by decreased performance in information processing speed and language comprehension tests. While confirming the joint role of frailty and anxiety, a moderation/interaction model showed that each of them was sufficient, at its highest level, to support the maximum degree of perceived threat of contagion. The contribution of neuropsychological factors to perceived threat of SARS-CoV-2 highlights their importance of tailoring information campaigns addressed to older people.


Assuntos
COVID-19 , Envelhecimento Saudável , Idoso , Controle de Doenças Transmissíveis , Humanos , Estudos Longitudinais , Pandemias , SARS-CoV-2
11.
Artigo em Inglês | MEDLINE | ID: mdl-34072829

RESUMO

The global COVID-19 pandemic is creating challenges to manage staff ratios in clinical units. Nurse staffing level is an important indicator of the quality of care. This study aimed to identify any changes in the nurse staffing levels in the general wards of hospitals in Korea during the COVID-19 pandemic. The unit of analysis was the hospitals. This longitudinal study observed the quarterly change of the nurse staffing grades in 969 hospitals in 2020. The nurse staffing grades ranged from 1 to 7 according to the nurse-patient ratio measured by the number of patients (or beds) per nurse. The major dependent and independent variables were the change of nurse staffing grades and three quarterly observation points being compared with those during the 1st quarter (1Q) of 2020, respectively. A generalized linear model was used. Unexpectedly, the nurse staffing grades significantly improved (2Q: RR, 27.2%; 95% confidence interval (CI), 15.1-27.6; p < 0.001; 3Q: RR, 95% CI, 20.2%; 16.9-21.6; p < 0.001; 4Q: RR, 26.6%; 95% CI, 17.8-39.6; p < 0.001) quarterly, indicating that the nurse staffing levels increased. In the comparison of grades at 2Q, 3Q, and 4Q with those at 1Q, most figures improved in tertiary, general, and small hospitals (p < 0.05), except at 3Q and 4Q of general hospitals. In conclusion, the nurse staffing levels did not decrease, but nursing shortage might occur.


Assuntos
COVID-19 , Recursos Humanos de Enfermagem no Hospital , Hospitais , Humanos , Estudos Longitudinais , Pandemias , República da Coreia/epidemiologia , SARS-CoV-2 , Recursos Humanos
12.
Epidemiol Psychiatr Sci ; 30: e49, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34074355

RESUMO

AIMS: To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain; and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. METHODS: Data from a longitudinal adult population-based cohort from the provinces of Madrid and Barcelona were analysed (n = 1103). Structured face-to-face home-based interviews (pre-pandemic) and telephone interviews were performed. Both depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). A variety of validated instruments and sociodemographic variables including age, sex, educational level, occupational status, home quietness, screen time, resilience, loneliness, social support, physical activity, disability, economic situation and COVID-19-related information were also considered. Population prevalence estimates and multivariable logistic regressions were computed. RESULTS: Overall, prevalence rates of depression and suicidal ideation did not change significantly from before to after the COVID-19 outbreak. However, the rates of depression among individuals aged 50+ years showed a significant decrease compared to before the pandemic (from 8.48 to 6.41%; p = 0.01). Younger individuals (odds ratio (OR) = 0.97 per year older; 95% confidence interval (CI) = 0.95-0.99) and those feeling loneliness (OR = 1.96; 95% CI = 1.42-2.70) during the lockdown were at an increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.46; 95% CI = 0.32-0.66) and suicidal ideation (OR = 0.33; 95% CI = 0.16-0.68), whereas individuals perceiving social support were at a lower risk of developing suicidal thoughts (OR = 0.35; 95% CI = 0.18-0.69). CONCLUSIONS: Continuous reinforcement of mental health preventive and intervening measures during and in the aftermath of the crisis is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.


Assuntos
COVID-19 , Ideação Suicida , Adulto , Controle de Doenças Transmissíveis , Depressão/epidemiologia , Humanos , Estudos Longitudinais , Pandemias , Fatores de Risco , SARS-CoV-2 , Espanha/epidemiologia
13.
Nat Commun ; 12(1): 3294, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078892

RESUMO

Experimental manipulation of gut microbes in animal models alters fear behavior and relevant neurocircuitry. In humans, the first year of life is a key period for brain development, the emergence of fearfulness, and the establishment of the gut microbiome. Variation in the infant gut microbiome has previously been linked to cognitive development, but its relationship with fear behavior and neurocircuitry is unknown. In this pilot study of 34 infants, we find that 1-year gut microbiome composition (Weighted Unifrac; lower abundance of Bacteroides, increased abundance of Veillonella, Dialister, and Clostridiales) is significantly associated with increased fear behavior during a non-social fear paradigm. Infants with increased richness and reduced evenness of the 1-month microbiome also display increased non-social fear. This study indicates associations of the human infant gut microbiome with fear behavior and possible relationships with fear-related brain structures on the basis of a small cohort. As such, it represents an important step in understanding the role of the gut microbiome in the development of human fear behaviors, but requires further validation with a larger number of participants.


Assuntos
Bacteroides/genética , Clostridiales/genética , Medo/psicologia , Microbioma Gastrointestinal/genética , Veillonella/genética , Veillonellaceae/genética , Adulto , Bacteroides/classificação , Bacteroides/isolamento & purificação , Encéfalo/fisiologia , Aleitamento Materno , Clostridiales/classificação , Clostridiales/isolamento & purificação , Fezes/microbiologia , Feminino , Humanos , Lactente , Fórmulas Infantis , Estudos Longitudinais , Masculino , Projetos Piloto , RNA Ribossômico 16S/genética , Veillonella/classificação , Veillonella/isolamento & purificação , Veillonellaceae/classificação , Veillonellaceae/isolamento & purificação
14.
J Headache Pain ; 22(1): 49, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074243

RESUMO

BACKGROUND: Headache disorders are highly prevalent worldwide, but not well investigated in adolescents. Few studies have included representative nationwide samples. This study aimed to present the prevalence and burden of recurrent headache in Australian adolescents. METHODS: The prevalence of recurrent headache, headache characteristics (severity and frequency) and burden on health-related quality of life in Australian children aged 10-17 years were presented, using nationally representative data from the Longitudinal Study of Australian children (LSAC). The LSAC, commencing in 2004, collects data every 2 years from a sample of Australian children of two different age cohorts: B 'baby' cohort, aged 0-1 years and K 'kindergarten' cohort, aged 4-5 years at the commencement of the study. Face-to-face interviews and self-complete questionnaires have been conducted with the study child and parents of the study child (carer-reported data) at each data collection wave, with seven waves of data available at the time of the current study. Wave 7 of the LSAC was conducted in 2016, with B cohort children aged 12-13 years and K cohort children aged 16-17 years. For the current study, data were accessed for four out of seven waves of available data (Wave 4-7) and presented cross-sectionally for the two cohorts of Australian children, for the included age groups (10-11 years, 12-13 years, 14-15 years and 16-17 years). All available carer-reported questionnaire data pertaining to headache prevalence, severity and frequency, general health and health-related quality of life, for the two cohorts, were included in the study, and presented for male and female adolescents. Carer-reported general health status of the study child and health-related quality of life scores, using the parent proxy-report of the Paediatric Quality of Life Inventory™ 4.0, were compared for male and female adolescents with recurrent headache and compared with a healthy group. Finally, health-related quality of life scores were compared based on headache frequency and severity. RESULTS: The LSAC study initially recruited 10,090 Australian children (B cohort n = 5107, K cohort n = 4983), and 64.1% of the initial sample responded at wave 7. Attrition rates across the included waves ranged from 26.3% to 33.8% (wave 6 and 7) for the B cohort, and 16.3% to 38.0% (wave 4-7) for the K cohort. Recurrent headache was more common in females, increasing from 6.6% in 10-11 years old females to 13.2% in 16-17 years old females. The prevalence of headache in males ranged from 4.3% to 6.4% across the age groups. Health-related quality of life scores were lower for all functional domains in adolescents with recurrent headache, for both sexes. Headache frequency, but not severity, was significantly associated with lower health-related quality of life scores, in both males and females. CONCLUSIONS: Recurrent headache was common among Australian adolescents and increased in prevalence for females, across the age groups. Frequent recurrent headache is burdensome for both male and female adolescents. This study provides information regarding the prevalence and burden of recurrent headache in the adolescent population based on findings from the Longitudinal Study of Australian Children.


Assuntos
Cefaleia , Qualidade de Vida , Adolescente , Austrália/epidemiologia , Criança , Feminino , Cefaleia/epidemiologia , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Prevalência , Inquéritos e Questionários
15.
Arch Esp Urol ; 74(5): 494-502, 2021 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-34080569

RESUMO

OBJECTIVES: To analyse the outcomes of Robotic Sacrocolpopexy (RSC) on resolution of Lower urinary tract Symptoms (LUTS) associated to pelvic organ prolapses (POP) and to determine the risk factors for preoperative LUTS presence. MATERIAL AND METHODS: A longitudinal study was carried out on 51 females mean aged (± standard deviation) 66 ± 9 years, who underwent RSC. A preoperative evaluation was made on the degree and type of POP, and the presence of the LUTS stress urinary incontinence (SUI), urgency and voiding difficulty. An urodynamic study was also performed. The presence of LUTS was evaluated again six months after being operated on. The statistical test used were the Mcnermar test for dependent variables, the Fisher's exact test and the t Student's mean comparison test. The signification level was set at p < 0.05 bilaterally. RESULTS: A significate decrease of postoperative SUI and voiding difficult was observed. However, urgency did not significantly diminish. Transobturatice free-tension mesh ( TOT) implementation in patients with evident or occult (with POP reduction) urodynamic SUI significantly decreased the prevalence of symptomatic SUI. The only significate risk factor was the preoperative presence of urgency regarding its postoperative prevalence. CONCLUSIONS: Robotic sacrocolpopexy significantly improves postoperative voiding difficult. TOT implement in patients with positive POP reduction test is useful to prevent postoperative symptomatic SUI.


Assuntos
Sintomas do Trato Urinário Inferior , Prolapso de Órgão Pélvico , Procedimentos Cirúrgicos Robóticos , Incontinência Urinária por Estresse , Idoso , Feminino , Humanos , Estudos Longitudinais , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/cirurgia , Prevalência , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/cirurgia
16.
Nutrients ; 13(5)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064833

RESUMO

As a result of the coronavirus disease 2019 (COVID-19) pandemic-related restrictions, food systems have undergone unprecedented changes, with the potential to affect dietary behavior. We aimed to investigate workers' dietary changes resulting from the introduction of regulations to combat COVID-19 in a Japanese factory cafeteria. Objective data on daytime dietary intake were automatically collected from electronic purchase system records. The dataset included the weekly data of 890 men from 1 July 2019 to 30 September 2020. The cafeteria regulations came into effect on 10 April 2020; in this context, the purchase of dishes and estimated dietary intake were monitored. The number of cafeteria visits decreased slightly after the introduction of the regulations. The purchase of main and side dishes also decreased, but the purchase of grain dishes was less affected. When compared with summer 2019 (pre-pandemic, no regulations: 1 July to 29 September 2019), in summer 2020 (during the pandemic and with regulations: 29 June to 30 September 2020), the estimated mean grain, meat, fish, and total energy intake was stable; however, vegetable intake decreased by 11%. As the COVID-19 pandemic continues, workplace cafeteria regulations need to be monitored to avoid unfavorable dietary changes in employees.


Assuntos
COVID-19/epidemiologia , Comportamento do Consumidor , Registros de Dieta , Ingestão de Alimentos , Comportamento Alimentar , Pandemias , SARS-CoV-2 , Adulto , Feminino , Humanos , Japão/epidemiologia , Estudos Longitudinais , Masculino
17.
Nutrients ; 13(6)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34072977

RESUMO

The trace element copper (Cu) is part of our nutrition and essentially needed for several cuproenzymes that control redox status and support the immune system. In blood, the ferroxidase ceruloplasmin (CP) accounts for the majority of circulating Cu and serves as transport protein. Both Cu and CP behave as positive, whereas serum selenium (Se) and its transporter selenoprotein P (SELENOP) behave as negative acute phase reactants. In view that coronavirus disease (COVID-19) causes systemic inflammation, we hypothesized that biomarkers of Cu and Se status are regulated inversely, in relation to disease severity and mortality risk. Serum samples from COVID-19 patients were analysed for Cu by total reflection X-ray fluorescence and CP was quantified by a validated sandwich ELISA. The two Cu biomarkers correlated positively in serum from patients with COVID-19 (R = 0.42, p < 0.001). Surviving patients showed higher mean serum Cu and CP concentrations in comparison to non-survivors ([mean+/-SEM], Cu; 1475.9+/-22.7 vs. 1317.9+/-43.9 µg/L; p < 0.001, CP; 547.2.5 +/- 19.5 vs. 438.8+/-32.9 mg/L, p = 0.086). In contrast to expectations, total serum Cu and Se concentrations displayed a positive linear correlation in the patient samples analysed (R = 0.23, p = 0.003). Serum CP and SELENOP levels were not interrelated. Applying receiver operating characteristics (ROC) curve analysis, the combination of Cu and SELENOP with age outperformed other combinations of parameters for predicting risk of death, yielding an AUC of 95.0%. We conclude that the alterations in serum biomarkers of Cu and Se status in COVID-19 are not compatible with a simple acute phase response, and that serum Cu and SELENOP levels contribute to a good prediction of survival. Adjuvant supplementation in patients with diagnostically proven deficits in Cu or Se may positively influence disease course, as both increase in survivors and are of crucial importance for the immune response and antioxidative defence systems.


Assuntos
COVID-19/sangue , COVID-19/mortalidade , Cobre/sangue , SARS-CoV-2/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Intervalo Livre de Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Selênio/sangue , Selenoproteína P/sangue , Taxa de Sobrevida
18.
BMC Med Educ ; 21(1): 316, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088308

RESUMO

BACKGROUND: Empathy, which involves understanding another person's experiences and concerns, is an important component for developing physicians' overall competence. This longitudinal study was designed to test the hypothesis that medical students' empathy can be enhanced and sustained by Humanitude Care Methodology, which focuses on perception, emotion and speech. METHODS: This six-year longitudinal observational study examined 115 students who entered Okayama University Medical School in 2013. The study participants were exposed to two empathy-enhancing programs: (1) a communication skills training program (involving medical interviews) and (2) a Humanitude training program aimed at enhancing their empathy. They completed the Jefferson Scale of Empathy (JSE) seven times: when they entered medical school, before participation in the first program (medical interview), immediately after the first program, before the second program (Humanitude exercise), immediately after the second program, and in the 5th and 6th year (last year) of medical school. A total of 79 students (69% of the cohort) completed all seven test administrations of the JSE. RESULTS: The mean JSE scores improved significantly after participation in the medical interview program (p < 0.01) and the Humanitude training program (p = 0.001). However, neither program showed a sustained effect. CONCLUSIONS: The Humanitude training program as well as medical interview training program, had significant short-term positive effects for improving empathy among medical students. Additional reinforcements may be necessary for a long-term sustained effect.


Assuntos
Estudantes de Medicina , Empatia , Humanos , Japão , Estudos Longitudinais , Faculdades de Medicina
19.
BMC Musculoskelet Disord ; 22(1): 516, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090387

RESUMO

BACKGROUND: Knee osteoarthritis (KOA), chronic widespread pain (CWP) and overweight/obesity are public health problems that often coincide, and there is a multifactorial and unclear relationship between them. The study aimed to (1) investigate pain sensitivity, assessed by pressure pain thresholds (PPTs), among women and men with knee pain and (2) associations with, respectively, radiographic KOA (rKOA), CWP, and overweight/obesity. METHODS: Baseline data from an ongoing longitudinal study involving 280 individuals with knee pain in the 30-60 age group. Pain sensitivity was assessed by PPTs on eight different tender points using a pressure algometer. The participants' knees were x-rayed. Self-reported CWP and number of pain sites were assessed with a pain figure, and overweight/obesity was measured using body mass index (BMI), visceral fat area (VFA), and body fat percentage, assessed with a bioimpedance. Associations were analysed using regression analyses. RESULTS: Women reported lower PPTs than men (p < 0.001), but no PPTs differences were found between those with and without rKOA. Low PPTs was associated with female sex, more pain sites, CWP, and a higher VFA and body fat percentage. The tender points second rib and the knees were most affected. The prevalence of CWP was 38 %. CONCLUSIONS: The modifiable factors, increased VFA, and body fat could be associated with increased pain sensitivity among individuals with knee pain. Longitudinal studies are needed to further investigate the associations.


Assuntos
Osteoartrite do Joelho , Limiar da Dor , Estudos Transversais , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Estudos Longitudinais , Masculino , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/epidemiologia
20.
J Pak Med Assoc ; 71(6): 1556-1560, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111071

RESUMO

OBJECTIVE: To evaluate the sensitivity of the modified Brief Form of Bruininks Oseretsky Test in identifying motor differences secondary to malnutrition and poverty. METHODS: This longitudinal cohort study was conducted at Nowshero Feroze, Sindh from 2013 to 2014 and comprised data drawn from children who participated in a randomised controlled trial, that assessed responsive stimulation and nutrition interventions in the first two years of life. Outcome measures included motor development assessed using Brief Form of Bruininks Oseretsky Test, child anthropometry and household economic and demographic information. Data was analysed using SPSS 15 and STATA 12. RESULTS: Of the 1058 children, 570(53%) were boys. Moderate-severe stunting was reported in 171(16.12%) subjects, while moderate-severe underweight was reported in 117(11.1%). Also, 591(56%) subjects belonged to poor families, 343(32%) had illiterate mothers, and 392(37%) were food-insecure. Malnutrition, socio-economic status and maternal literacy were significantly associated with a 6-item motor composite of the Brief Form of Bruininks Oseretsky Test (p<0.05). CONCLUSIONS: The 6-item motor composite of the Brief Form of Bruininks Oseretsky Test was found to be a reliable tool to measure motor performance in Pakistani pre-school children.


Assuntos
Desnutrição , Destreza Motora , Criança , Feminino , Transtornos do Crescimento , Humanos , Estudos Longitudinais , Masculino , Paquistão , Ensaios Clínicos Controlados Aleatórios como Assunto
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