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1.
J Allied Health ; 50(2): e63-e66, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34061942

RESUMO

INTRODUCTION: The health status of adults with disabilities is recognized as a formal health disparity. Due to COVID-19, participation in wellness programs for this population has been restricted. To provide program participants with continued accessibility, one regional wellness program for adults with disabilities adopted a virtual format. The purpose of this research is to determine the effectiveness of a virtual wellness program for this population. METHODS: Study subjects consisted of adults with disabilities who participated in a regional virtual wellness program. A survey was developed and disseminated electronically to study participants through Qualtrics software. Part 1 of the survey included demographic information, while Part 2 surveyed participants' perceptions and satisfaction with the virtual program using a 5-point Likert scale. RESULTS: 10 out of 14 participants responded to the survey. Results indicated that the majority (80%) of participants utilized the program at least 1-2 times/week. All participants reported that, despite preferring in-person wellness classes, they were satisfied with the virtual format of the program. Positive responses were also reported for survey items related to self-perceived health and functional benefits from participation, degree of staff and peer support offered through virtual means, ease of technology use, and the degree of safety within the virtual environment. DISCUSSION: Given the health status of adults with disabilities during an ongoing global pandemic, continued restrictions limiting participation with in-person wellness programs is anticipated. Virtual formats may offer an advantageous solution to provide adults with disabilities with continued access to this essential programming. While the current study showed positive self-perceived health and functional benefits from participation, further research is needed to determine the effectiveness of this format through expanded and standardized objective outcome measures and to better understand factors that may impact participation.


Assuntos
COVID-19/epidemiologia , Pessoas com Deficiência/educação , Exercício Físico/fisiologia , Promoção da Saúde/organização & administração , Telemedicina/organização & administração , Adulto , Idoso , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente , SARS-CoV-2
2.
Health Qual Life Outcomes ; 19(1): 159, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059073

RESUMO

BACKGROUND: The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was developed to accurately assess the pain, urinary symptoms, and quality of life related to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This study aimed to evaluate the cross-cultural adaptations of the NIH-CPSI. METHOD: PubMed, Embase, CINAHL, and SciELO databases were searched from their established year to September 2020. Cross-cultural adaptations and the quality control of measurement properties of adaptations were conducted by two reviewers independently according to the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and the Quality Criteria for Psychometric Properties of Health Status Questionnaire. RESULTS: Area total of 21 papers with 16 adaptations, and six studies of the original version of the NIH-CPSI were enrolled in the systematic review. Back translation was the weakest process for the quality assessment of the cross-cultural adaptations of the NIH-CPSI. Internal consistency was analyzed for most of the adaptations, but none of them met the standard. Only 11 adaptations reported test reliability, then only the Arabic-Egyptian, Chinese-Mainland, Danish, Italian, Persian, and Turkish adaptations met the criterion. Most adaptations reported the interpretability, but only the Danish adaptation reported the agreement. The other measurement properties, including responsiveness, and floor as well as ceiling effects were not reported in any of the adaptations. CONCLUSIONS: The overall quality of the NIH-CPSI cross-cultural adaptations was not organized as expected. Only the Portuguese-Brazilian, Italian, and Spanish adaptations reached over half the process for the cross-cultural adaptation. Only the Turkish adaptations finished half of the measurement properties of cross-cultural adaptations.


Assuntos
Dor Crônica/psicologia , Comparação Transcultural , Prostatite/fisiopatologia , Prostatite/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Avaliação de Sintomas/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor Crônica/fisiopatologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , National Institutes of Health (U.S.) , Psicometria , Reprodutibilidade dos Testes , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Traduções , Estados Unidos
3.
Health Qual Life Outcomes ; 19(1): 157, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059079

RESUMO

BACKGROUND: The 12-item Short-Form Health Survey version 2 (SF-12v2), a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. No study to date has examined the measurement properties of the SF-12v2 in patients with lung cancer using Rasch analysis. The aim of this study was to extend the psychometric evaluations of the SF-12 within the lung cancer population to ensure its validity and reliability to assess the health status in this population. METHODS: Participants in the Victorian Lung Cancer Registry (VLCR) who completed the SF-12v2 between 2012 and 2016 were included in this study. The structural validity of the SF-12v2 was assessed using Rasch analysis. Overall fit to the Rasch measurement model was examined as well as five key measurement properties: uni-dimensionality, response thresholds, internal consistency, measurement invariance and targeting. RESULTS: A total of 342 participants completed the SF-12v2 three months following their lung cancer diagnosis. The SF-12 Physical Component Score (PCS-12) did not fit the overall Rasch measurement model (χ2 107.0; p < 0.001). Three items deviated significantly from the Rasch model (item fit residual beyond ± 2.5) with signs of dependency between item responses and disordered thresholds. Nevertheless, the PCS-12 was uni-dimensional with good internal consistency (person separation index [PSI] 0.83) and reasonable targeting. In contrast, the SF-12 Mental Component Score (MCS-12) had good overall model fit (χ2 35.1; p = 0.07), reasonable targeting and good internal consistency (PSI 0.81). CONCLUSIONS: Rasch analysis suggests that there is general support for the reliability of the SF-12v2 as a measure of physical and mental health in people with lung cancer. However, the appropriateness of some items (e.g. pain) in the PCS-12 is questionable and further refinement of the scale including changing the response options may be required to improve the ability of the SF-12v2 to more appropriately assess the health status of this population.


Assuntos
Nível de Saúde , Inquéritos Epidemiológicos/normas , Neoplasias Pulmonares/fisiopatologia , Psicometria/normas , Inquéritos e Questionários/normas , Avaliação de Sintomas/estatística & dados numéricos , Avaliação de Sintomas/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários/estatística & dados numéricos
4.
Soins ; 66(855): 14-18, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34103126

RESUMO

The condition of women has vastly improved over recent decades: respect of equality, better salary conditions and health status. Although women, like men, are living longer, certain differences in care are emerging. This survey studies the characteristics of women's cardiovascular health, especially in terms of treatment and follow-up.


Assuntos
Doenças Cardiovasculares , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Feminino , Seguimentos , Nível de Saúde , Humanos , Masculino , Saúde da Mulher
5.
J Frailty Aging ; 10(3): 259-271, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105711

RESUMO

The population of older adults over 60 years is growing faster than any other age group and will more than double between 2020 and 2050. This increase has led to clinical, public health, and policy interest in how to age "successfully". Before the Rowe and Kahn's model proposed thirty years ago, aging was seen as a process of losses associated with diseases and disability. However, since the emergence of this model, there has been a shift towards a more positive view, serving for promoting diverse medical or psychosocial models, and personal perspectives. Several technical terms of "success" (e.g. "successful aging", "healthy aging", "active aging", "aging well"…) coexist and compete for the meaning of the concept in the absence of a consensual definition. Our literature review article aims to study discrepancies and similarities between the main technical terms through quantitative or qualitative studies. A literature review using PubMed, SCOPUS, PsycINFO, Psycarticles, Psychology, and Behavioral Sciences Collection, Cochrane database, and clinicaltrials.gov databases was conducted. A total of 1057 articles were found and finally, 43 papers were selected for full extraction. We identified several components in these definitions, which reveal considerable inconsistency. The results particularly suggest that lay personals perspectives could bridge the gap between biomedical and psychosocial models in successful aging. In conclusion, an optimal definition would be a multidimensional one that could combine functional capacities, psychosocial abilities, environmental factors and subjective assessments of one's own criteria to discriminate older adults at potential risk of "unsuccessful" aging to healthy aging trajectories.


Assuntos
Envelhecimento Saudável , Idoso , Envelhecimento , Nível de Saúde , Humanos , Vida Independente , Pesquisa Qualitativa
6.
Wiad Lek ; 74(5): 1142-1176, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090280

RESUMO

OBJECTIVE: The aim: Is to investigate the influence of sport classes on the psychophysical health of Ukrainian Armed Forces' servicemen. PATIENTS AND METHODS: Materials and methods: The level of servicemen's health was estimated according to the professor Apanasenko's methodology based on the anthropometric and functional indicators. In the research there were 120 cadets aged 18 to 22 from Odesa Military Academy. Methods of research: analysis of scientific works, medical and biological methods, experiment, statistics analysis. RESULTS: Results: It was found out at the end of the experiment that the health level of the cadets who attended Crossfit classes is significantly higher than that of the cadets who studied according to the standard physical training program. The most profound effect was revealed on the functionality of the cardiovascular, respiratory and muscular systems, and the stabilization of body weight of cadets of experimental groups. CONCLUSION: Conclusions:The results of the research show sufficiently high effectiveness of the Crossfit classes for the purpose of improving cadets' psychophysical health during studying. High psychophysical health level formed during the Crossfit training increases longevity and resistance of the body to unfavourable factors of professional activity, reduces the risk of professional diseases and improves the efficiency of the official duties performance.


Assuntos
Militares , Esportes , Peso Corporal , Nível de Saúde , Humanos , Aptidão Física
7.
Orv Hetil ; 162(23): 911-923, 2021 06 06.
Artigo em Húngaro | MEDLINE | ID: mdl-34091435

RESUMO

Összefoglaló. Bevezetés: A lakosság idosödésével növekvo betegségteher egyéni és társadalmi szinten is fokozódó nyomást jelent. Célkituzés: Felmérni a hazai általános felnott lakosságnak a korlátozottsággal, a gondozási igényekkel és a munkavégzéssel kapcsolatos idoskori szubjektív várakozásait. Módszer: Online keresztmetszeti felmérést végeztünk. A korlátozottsággal kapcsolatos várakozásokat a hivatalos szakstatisztikákban alkalmazott globális tevékenységkorlátozottsági mutató (Global Activity Limitation Indicator, GALI) segítségével elsoként vizsgáltuk. A jelen és szubjektíve várt munkavégzést, gondozási igényt, gondozói tevékenységet, valamint a jelen egészségi állapotot és szociodemográfiai helyzetet vizsgáló kérdéseket is feltettünk. Statisztikai analízis: A mintában mért adatokat lokális polinom segítségével simítottuk, és a 60/70/80/90 éves korra adott szubjektív várakozásokkal hasonlítottuk össze. A szubjektív várakozásokat meghatározó tényezoket intervallumregresszióval becsültük. Eredmények: 1000 kitöltotol 914 érvényes választ kaptunk. Az átlagéletkor (± szórás) 51,2 (± 15,2) év, a minta 55,8%-a no volt. A férfiak között a fizetett munkát végzok (p<0,001), a nok között az informális gondozók aránya volt magasabb (p = 0,010). Az átlagos (± szórás) szubjektíve várható élettartam (81,0 ± 11,1 év) a minta statisztikailag várható élettartamánál (79,6 ± 3,7 év) 1,3 évvel volt hosszabb (p<0,001), azonban az átlagos, szubjektíve várható egészséges élettartam (64,6 ± 15,2 év) 5,3 évvel volt rövidebb a statisztikailag várható értéknél (70,0 ± 4,2 év; p<0,001). A szubjektíve várható egészséges élettartamot és gondozási igényt elsosorban a válaszadók jelenlegi egészségi állapota befolyásolta. Az életmód és a szubjektíve várható egészséges élettartam között noknél nem találtunk összefüggés, míg a túlzott gyakorisággal alkoholt fogyasztó vagy elhízott férfiak hosszabb egészséges élettartamra számítottak. A szubjektív várakozások meghatározó tényezoi jelentos nemi különbségeket mutattak. Következtetés: Az egészséggel, munkával és gondozással kapcsolatos szubjektív várakozások eltéroek a populációban mért valós adatoktól, és különböznek a nemek között. Orv Hetil. 2021; 162(23): 911-923. INTRODUCTION: The growing disease burden due to ageing populations poses a challenge on both individuals and societies. OBJECTIVE: To explore the general population's subjective expectations concerning disability, care needs and employment at older ages. METHOD: We conducted an online cross-sectional survey. We were the first to measure subjective health expectations using the Global Activity Limitation Indicator (GALI) of official health statistics. Respondents' actual status and subjective expectations concerning employment, care needs and informal caregiver status, self-perceived health and sociodemographic factors were queried. STATISTICAL ANALYSIS: We estimated sample characteristics by local polynomial smoothing and compared with subjective expectations at ages of 60/70/80/90 years. Determinants of subjective expectations were analyzed via interval regression. RESULTS: From 1000 subjects, 914 provided valid responses. Mean (± SD) age was 51.2 (± 15.2) years, and 55.8% of respondents were women. Paid employment was more frequent among men (p<0.001), while informal caregiver status among women (p = 0.010). Mean (± SD) subjective life expectancy (81.0 ± 11.1 years) was 1.3 years longer (p<0.001) than actuarial life-expectancy (79.6 ± 3.7 years), while mean subjective healthy life expectancy (sHLE) (64.6 ± 15.2 years) was 5.3 years shorter than actuarial healthy life expectancy (70.0 ± 4.2 years; p<0.001). sHLE and care needs were mainly determined by respondents' self-perceived health. Lifestyle risks were not associated with sHLE in women, while pervasive drinker or obese men expected longer healthy life span. Determinants of sHLE showed considerable gender differences. CONCLUSION: Subjective expectations concerning health, employment and care needs differ from actual values of the general population, with considerable gender differences. Orv Hetil. 2021; 162(23): 911-923.


Assuntos
Expectativa de Vida , Motivação , Adulto , Idoso , Envelhecimento , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade
8.
Recenti Prog Med ; 112(5): 347-359, 2021 05.
Artigo em Italiano | MEDLINE | ID: mdl-34003187

RESUMO

BACKGROUND: Schools' closure during covid-19 pandemic implemented almost all over the world, together with social distances measures and lockdown to reduce transmission, could have had negative impact on youths' health. AIM: Summarize the most relevant data from a literature systematic review on the impact on youths' physical health of the 2020 school closure and social distances measures implemented in response to covid-19 pandemic. METHODS: Authors of the original review searched on 11 international databases up to 1st September 2020 to retrieve cohort studies, cross sectional surveys, uncontrolled pre-post studies and modelling studies. Methodological quality has been assessed with validated checklists. RESULTS: Forty-two studies reporting the impact on physical health have been finally included. They have been conducted in 14 countries, most of which in Italy (30.9%) and UK (30.9%). The majority were cohort studies (40.5%) and the overall methodological quality, irrespective of study designs, was high for the 71.4% of the studies. Twenty-seven studies assessed the impact on health services utilization, whose results showed a relevant reduction of Emergency Departments accesses (64%-89.3%) and hospital admissions (31%-85%); however, an increase of acute cases was observed together with delayed admission. An important reduction of vaccine services utilization was also noted during the first period of lockdown. Domestic accidents and head trauma for suspected domestic violence increased. Health related behaviours worsened, with a relevant increase of screen time (mean of 2.9 hours to 5.1 hours), an important reduction of physical activity (up to 64%). Finally, sleep problems and increase of food consumption, particularly the unhealthy food were reported. CONCLUSIONS: Relevant negative effects of school closure and social distances measures have observed. All the studies have been conducted during the first wave of pandemic and assessed the short-term effect of closures implemented for relatively short periods. If school closure and rigid social distances measures imposition will extend for a long time, an even more pronounced negative effect can be expected. In the context of health policies, in addition to the potential benefits of school closures and social distancing measures on the containment of infection, the potential damage on the physical health of young people should be taken into account by implementing policies to safeguard their health.


Assuntos
/prevenção & controle , Acesso aos Serviços de Saúde , Nível de Saúde , Pandemias , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Ingestão de Alimentos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Exercício Físico , Humanos , Lactente , Quarentena , Instituições Acadêmicas , Comportamento Sedentário , Sono , Isolamento Social , Fatores de Tempo , Vacinação/estatística & dados numéricos , Adulto Jovem
9.
Recenti Prog Med ; 112(5): 51e-67e, 2021 05.
Artigo em Italiano | MEDLINE | ID: mdl-34003196

RESUMO

BACKGROUND: During the first semester 2020 almost all country implemented rigid measures of social distances, including schools closure, to limit the transmission of SARS-CoV-2 infection. Up to now, however, the efficacy of school closure to reduce the spread of the disease in the community still remain unclear and no much is known about the potential negative effects of such measures on physical health and psychological wellbeing of children and adolescents, mainly if protracted for long periods. OBJECTIVE: To summarize the most relevant data of a systematic review on the impact of the 2020 school closure and social distances measures implemented in response to covid-19 pandemic on youths physical health and psychological wellbeing. In the present paper we describe the review's methodology and the characteristics and methodological quality of the retrieved studies. METHODS: We searched on 11 international databases up to 1st September 2020 to retrieve cohort studies, cross sectional surveys, uncontrolled pre-post studies and modelling studies. Methodological quality of included studies has been assessed with validated checklists. RESULTS: Sixty-four studies have been included; 42 assessed the effect of social distances measure of physical health and 27 on psychological wellbeing. All the studies have been conducted during the first wave of pandemic and assessed the short-term effect of social distances measures implemented for relatively short periods. The 32.4% of the studies has been conducted in the UK, 20.3% in Italy, 12.5% in China, 10.9% in developing countries and 9.4% in the US. 37.5% of the studies were cohort studies, 40.6% cross sectional surveys, 19.7% uncontrolled studies and 1 was a modeling study. 59.6% of the studies has been rated as high quality. The most important weakness of the cross-sectional surveys and uncontrolled studies was the scarce representativeness of the sample while 96% of the cohort studies were judged as high quality. CONCLUSIONS: A large number of acceptable quality studies have been published during the first months of pandemic to assess the impact of school closure and social distances measures on physical health and psychological wellbeing of youths. This highlights the relevance of the topic and the need to assess carefully the balance between harms and benefits of such measures in terms of actual reduction of transmission and youths' psychological and physical harms. Further studies are needed on the long-term effect of social distances measures extended over long periods.


Assuntos
/prevenção & controle , Nível de Saúde , Saúde Mental , Adolescente , Criança , Pré-Escolar , Humanos , Pandemias , Quarentena , Instituições Acadêmicas
10.
Respir Res ; 22(1): 151, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006276

RESUMO

The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades. In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health. Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19).


Assuntos
/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Aromatizantes/efeitos adversos , Nível de Saúde , Vaping/efeitos adversos , Vaping/epidemiologia , /metabolismo , Aromatizantes/metabolismo , Humanos , Vaping/metabolismo
11.
Maturitas ; 148: 7-13, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024351

RESUMO

OBJECTIVES: . We used longitudinal cohort data to examine the effect of leisure activities and psychological wellbeing on the risk of cognitive impairment among Chinese older adults with hearing difficulty (HD). STUDY DESIGN: . This prospective cohort study included 10,341 cognitively normal individuals aged 65 years or more at baseline from the Chinese Longitudinal Healthy Longevity survey (from 2002 to 2011). MAIN OUTCOME MEASURES: . Hearing difficulty, leisure activities and psychological wellbeing were measured at baseline. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score of less than 18 points. RESULTS: . During a median follow-up of 5.6 years (59,869 person-years), 2,614 participants developed cognitive impairment. Cox proportional hazards models showed that the multi-adjusted hazard ratio (HR, 95% confidence interval) of cognitive impairment was 1.42 (1.28-1.58) for HD. Participants with a healthy lifestyle had a lower risk of cognitive impairment (HR = 0.77, 95% CI 0.69-0.85). Furthermore, participants with HD and a healthy lifestyle (HR = 1.67, 95% CI 1.27-2.18) had a lower HR of cognitive impairment than those with HD and an unhealthy lifestyle (HR = 1.86, 95% CI 1.61-2.14). A healthy lifestyle also delayed the onset of cognitive impairment by 0.50 years in people with HD. CONCLUSIONS: . HD was associated with an increased risk of cognitive impairment, but a healthy lifestyle may decrease the risk of cognitive impairment related to HD and delay the onset of cognitive impairment.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Disfunção Cognitiva/prevenção & controle , Perda Auditiva/complicações , Atividades de Lazer , Saúde Mental , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Feminino , Nível de Saúde , Humanos , Longevidade , Estudos Longitudinais , Masculino , Testes de Estado Mental e Demência , Estudos Prospectivos
12.
Clin Interv Aging ; 16: 697-706, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33948083

RESUMO

Objective: We examined the association between obesity and physical performance under different metabolic status. Methods: The sample included 1395 Chinese community-dwelling participants (mean age, 71.88 ± 5.87 years; 40.9% men). Being metabolically healthy was defined as having the presence of < 3 of 5 components of metabolic syndrome (MetS); obesity was defined as having a BMI > 28 kg/m2. Participants were divided into four groups based on BMI (non-obese/obese) and metabolic health (healthy/unhealthy). Physical performance was measured by grip strength, 4-m walking speed, and the timed up and go test (TUGT). Results: After multiple adjustments, compared with metabolically healthy non-obese group, the metabolically unhealthy obese group showed lower relative grip strength, lower 4-m walking speed, and higher TUGT (P all < 0.05), and only relative grip strength of the metabolically healthy obese group was significantly lower than that of metabolically healthy non-obese (P < 0.01). Relative grip strength was negatively associated with impaired fasting glucose (ß = -0.071), elevated triglycerides (ß = -0.062), abdominal obesity (ß = -0.230) and general obesity (ß = -0.225) (P all < 0.01). Walking speed and TUGT were only associated with general obesity, rather than other metabolic components. The associations of MetS with physical performance were mainly driven by abdominal obesity. Conclusion: Even in those who are metabolically healthy, obesity (especially general obesity) increases the risk of poor physical performance. Elderly people with general obesity and MetS, whether in combination or alone, have an increased risk of muscle dysfunction, and that combination produces a higher risk of impaired mobility.


Assuntos
Obesidade/fisiopatologia , Desempenho Físico Funcional , Idoso , Glicemia , Índice de Massa Corporal , China , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Vida Independente , Lipídeos/sangue , Masculino , Equilíbrio Postural/fisiologia , Estudos de Tempo e Movimento , Velocidade de Caminhada
13.
Clin Interv Aging ; 16: 789-798, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34007164

RESUMO

Objective: To evaluate how changes in oral health and chewing efficiency affect the changes in oral-health-related quality of life (OHRQoL) of nursing-home residents over six months. Methods: The study was conducted in nine nursing homes. Sociodemographic and general data were collected for all eligible individuals (n = 150). Of these, 114 participants (mean age 82.0 [± 9.5] years, 77.2% women) were available for the following tests at baseline and six months later: a comprehensive examination of dental and general health, a two-colour mixing-ability test (to assess chewing efficiency), the Geriatric Oral Health Assessment Index (GOHAI; to evaluate the OHRQoL), and the Mini Mental State Examination (MMSE; to diagnose the presence and severity of dementia). Univariate and multivariate linear regression models were compiled to analyse possible factors affecting OHRQoL. Results: For the final analysis, 108 participants were available. For the study cohort as a whole, a decrease in the number of functional occluding pairs (C: 0.195; p = 0.034) and an increase in dental-treatment needs (C: -1.968; p = 0.056) had the greatest negative effects on OHRQoL as expressed by the GOHAI score. For denture wearers, a deterioration of denture condition (C: -2.946; p = 0.003) was the most important predictor for a decline in OHRQoL. Conclusion: A short-term decline in oral health and function affects the OHRQoL of nursing-home residents. The most important dental variables in this regard are the number of functional occluding pairs and dental and denture-related treatment needs.


Assuntos
Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Mastigação/fisiologia , Casas de Saúde/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Feminino , Avaliação Geriátrica , Nível de Saúde , Humanos , Masculino , Fatores Socioeconômicos
14.
15.
Med Educ Online ; 26(1): 1917488, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33944707

RESUMO

Problem: The novel coronavirus SARS-CoV-2 disease (COVID-19) impacted medical learner well-being and serves as a unique opportunity to understand medical learner wellness. The authors designed a formal needs assessment to assess medical learners' perspectives regarding distress related to disrupted training environments. This Rapid Communication describes findings from a qualitative study which defined medical learner wellness and validated five wellness domains.Approach: We conducted follow-up telephone interviews to an online needs assessment survey to identify a learner definition for wellness and to validate five wellness domains, including social, mental, physical, intellectual, and occupational wellness. Using purposive and maximal variation sampling, 27 students were interviewed from July-August 2020. Thematic analysis was performed using a deductive thematic approach to qualitative analysis.Outcomes: Medical learners defined wellness as a general [holistic] sense of personal well-being - the opportunity to be and to do what they most need and value. Learners validated all five wellness domains for medical education. Learners acknowledged the need for an adoptable and adaptable holistic framework for wellness in medical education.Next steps: We recommend academic medical institutions consider learner wellness a key component of medical education to cultivate learners as a competent collective of self-reliant, scholarly experts. We encourage evaluation of wellness domains in diverse medical learner populations to identify feasible interventions potentially associated with improvements in medical learner wellness.


Assuntos
/epidemiologia , Educação Médica/organização & administração , Promoção da Saúde/organização & administração , Estudantes de Medicina/psicologia , Adulto , Comunicação , Currículo , Feminino , Nível de Saúde , Humanos , Entrevistas como Assunto , Aprendizagem , Masculino , Saúde Mental , Determinação de Necessidades de Cuidados de Saúde , Saúde do Trabalhador , Pandemias , Pesquisa Qualitativa
16.
BMJ Health Care Inform ; 28(1)2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33980502

RESUMO

OBJECTIVES: Prior research has reported an increased risk of fatality for patients with cancer, but most studies investigated the risk by comparing cancer to non-cancer patients among COVID-19 infections, where cancer might have contributed to the increased risk. This study is to understand COVID-19's imposed HR of fatality while controlling for covariates, such as age, sex, metastasis status and cancer type. METHODS: We conducted survival analyses of 4606 cancer patients with COVID-19 test results from 16 March to 11 October 2020 in UK Biobank and estimated the overall HR of fatality with and without COVID-19 infection. We also examined the HRs of 13 specific cancer types with at least 100 patients using a stratified analysis. RESULTS: COVID-19 resulted in an overall HR of 7.76 (95% CI 5.78 to 10.40, p<10-10) by following 4606 patients with cancer for 21 days after the tests. The HR varied among cancer type, with over a 10-fold increase in fatality rate (false discovery rate ≤0.02) for melanoma, haematological malignancies, uterine cancer and kidney cancer. Although COVID-19 imposed a higher risk for localised versus distant metastasis cancers, those of distant metastases yielded higher overall fatality rates due to their multiplicative effects. DISCUSSION: The results confirmed prior reports for the increased risk of fatality for patients with COVID-19 plus hematological malignancies and demonstrated similar findings of COVID-19 on melanoma, uterine, and kidney cancers. CONCLUSION: The results highlight the heightened risk that COVID-19 imposes on localised and haematological cancer patients and the necessity to vaccinate uninfected patients with cancer promptly, particularly for the cancer types most influenced by COVID-19. Results also suggest the importance of timely care for patients with localised cancer, whether they are infected by COVID-19 or not.


Assuntos
/mortalidade , Nível de Saúde , Neoplasias/mortalidade , Vigilância em Saúde Pública , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Neoplasias/patologia , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Adulto Jovem
17.
BMC Health Serv Res ; 21(1): 438, 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964906

RESUMO

BACKGROUND: Based on the "China Migrants Dynamic Survey-Special investigation on Floating Elderly in 8 megacities in 2015", the health status and the utilization of medical and health services in floating elderly were described and analyzed. OBJECTIVE: Scientific basis and critical suggestions are provided for improving the utilization level of medical and health services in the floating elderly and designing targeted health policies to improve their well-being. METHODS: The rank-sum test and Pearson χ2 test were used to compare the health status of floating elderly with different characteristics. Thereafter based on Andersen model, floating characteristics were added and binary logistic regression was used to explore the influencing factors of medical and health service utilization in the floating elderly. RESULTS: About 94.7% of the floating elderly were self-assessed as healthy/basically healthy. About 24.2% had hypertension or diabetes as diagnosed by the qualified doctors. About 7% suffered from diseases that required hospitalization. Only 28.6% of the floating elderly with hypertension or diabetes had visited a doctor for follow-up. In the case of minor ailments, only 48.7% decided to visit the clinics. Approximately 70.7% of the floating elderly had used in-patient services when they suffered from diseases requiring hospitalization. CONCLUSION: The floating elderly were observed to be generally in good health but a high prevalence of hypertension or diabetes was observed among them. The cultivation of health awareness was found to be of great significance contributing to the improvement of the overall health level among the floating elderly. The basic medical insurance coverage was low, and the medical and health services were found to be severely underutilized. Adequate social support can promote the health of the floating elderly and improve their utilization of medical and health services. The floating reasons, scope and years of the elderly significantly affected their health status and the utilization rate of the basic public health services.


Assuntos
Serviços de Saúde , Migrantes , Idoso , China/epidemiologia , Nível de Saúde , Hospitalização , Humanos
18.
BMC Public Health ; 21(1): 948, 2021 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-34011345

RESUMO

BACKGROUND: Elevated blood pressure is the leading risk factor for global mortality. While it is known that there exist differences between men and women with respect to socioeconomic status, self-reported health, and healthcare utilization, there are few published studies from Africa. This study therefore aims to characterize differences in self-reported health status, healthcare utilization, and costs between men and women with elevated blood pressure in Kenya. METHODS: Data from 1447 participants enrolled in the LARK Hypertension study in western Kenya were analyzed. Latent class analysis based on five dependent variables was performed to describe patterns of healthcare utilization and costs in the study population. Regression analysis was then performed to describe the relationship between different demographics and each outcome. RESULTS: Women in our study had higher rates of unemployment (28% vs 12%), were more likely to report lower monthly earnings (72% vs 51%), and had more outpatient visits (39% vs 28%) and pharmacy prescriptions (42% vs 30%). Women were also more likely to report lower quality-of-life and functional health status, including pain, mobility, self-care, and ability to perform usual activities. Three patterns of healthcare utilization were described: (1) individuals with low healthcare utilization, (2) individuals who utilized care and paid high out-of-pocket costs, and (3) individuals who utilized care but had lower out-of-pocket costs. Women and those with health insurance were more likely to be in the high-cost utilizer group. CONCLUSIONS: Men and women with elevated blood pressure in Kenya have different health care utilization behaviors, cost and economic burdens, and self-perceived health status. Awareness of these sex differences can help inform targeted interventions in these populations.


Assuntos
Hipertensão , Caracteres Sexuais , Pressão Sanguínea , Feminino , Custos de Cuidados de Saúde , Nível de Saúde , Humanos , Hipertensão/epidemiologia , Quênia/epidemiologia , Masculino , Aceitação pelo Paciente de Cuidados de Saúde
19.
Health Promot Pract ; 22(1_suppl): 141S-146S, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33942651

RESUMO

As the public health field deepens its focus on social and environmental determinants of health and, as that field expands its attention to finding allied interests in the community development field, a critical opportunity to better understand the power of arts and culture in pursuit of shared goals has emerged. This is an extraordinary time in which the confluence of public health, community development, and the arts can lead to transformational ways of working, resulting in changes in industry standards in all three fields and most importantly, more healthy, just, and equitable communities. Drawing from 30 years of work to better understand the roles of arts and cultural activity in historically marginalized communities, this article presents reasons for and ways in which these fields can and should be allied. Specifically, it calls attention to gaps in community development and planning that have resulted in the fields' lack of attention to historic and present harm in the form of often racialized dehumanization. It also draws attention to the role of the arts in the critical collective work of reframing community concerns and conditions, retooling or finding new more effective ways of working toward repair-the redress of historic and current harm experienced in low-income and historically marginalized communities. The essay lifts up the possibility of transformational work and also presents important barriers that must be overcome by stakeholders from all three fields.


Assuntos
Arte , Saúde Pública , Promoção da Saúde , Nível de Saúde , Humanos
20.
Front Public Health ; 9: 658830, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33959585

RESUMO

Objective: The economic support of elderly patients with chronic diseases may affect their health status. This study assessed the impact of economic support on the health status of elderly patients with chronic diseases in China and explored the relationship between regional economic differences and the impact of economic support on health status. Methods: This study used the data of 3,416 elderly patients with chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. Logit model and stepwise regression method were used to analyze and compare the influence of economic support on self-rated health, mental health, and activities of daily living (ADL) of elderly patients with chronic diseases. Sub-regional comparison was used for the research of regional differences in the impact of economic support on health. Results: we find that economic support has a positive effect on the health status of elderly patients with chronic diseases in China. Socioeconomic support has a positive effect on self-rated health and mental health of elderly patients with chronic diseases, and the effect on activities of daily living (ADL) is no longer significant after the gradual inclusion of control variables. Family economic support has no significant impact on the health dimensions of elderly patients with chronic diseases. With respect to regional differences, socioeconomic support can improve mental health in central China and improve self-rated health in western China, while it can improve overall health status in eastern China. The influence of family economic support on different health dimensions in different regions is still insignificant. Conclusions: The health status of elderly patients with chronic diseases is affected by socioeconomic support in China. In order to improve the health of elderly patients with chronic diseases, it is necessary to increase socioeconomic support. Meanwhile, it is also essential to pay attention to the differences in economic support between different regions and increase the socioeconomic support for elderly patients with chronic diseases in undeveloped regions so as to improve their health status.


Assuntos
Atividades Cotidianas , Aposentadoria , Idoso , China/epidemiologia , Doença Crônica , Nível de Saúde , Humanos , Estudos Longitudinais
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