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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46925

RESUMO

O curso conta com uma diversidade de conteúdos e professores de diferentes trajetórias e campos do conhecimento, contribuindo para a construção de uma formação interdisciplinar pelos direitos das pessoas com deficiência. Embora os módulos do curso apresentem uma sequência didática, de modo a facilitar a compreensão do conteúdo, cada um deles possui uma estrutura independente, o que possibilita que o aluno conduza o seu processo de aprendizagem de forma individual e como for mais conveniente. O curso é autoinstrucional e a navegação é sequencial e, ao final de cada módulo, o aluno terá a oportunidade de realizar alguns exercícios visando contribuir para uma maior assimilação do conteúdo. Será ainda disponibilizada uma avaliação final para certificação.


Assuntos
Educação Continuada , Educação a Distância , Pessoas com Deficiência , Pessoal de Saúde , Relações Médico-Paciente , Serviços de Saúde
2.
Ned Tijdschr Tandheelkd ; 126(12): 647-652, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840675

RESUMO

The Netherlands, like other Western countries, shows an obvious demography of aging, which is associated with many challenges. People age differently, after all. Some remain vital until very old age, while others become frail and disabled much earlier in life. Because of the indicated demographic trend, morbidity is expected to increase and with it, the number of older people needing care. 'Aging in place' has become a central phenomenon in healthcare policies. This means that older people should be empowered to lead a meaningful life in their own living environment as long as possible, even when they are frail and care dependent. Therefore, in the future, most care for older people will actually occur at home. This article aims to present a meaningful care model for the older people. Starting from the 'definition discussion' about frailty and a revaluation of the concept of' resilience, a basis will be provided for a sustainable, proactive and personalised elderly care, close to the living environment of older people, in which dentists and other oral health professionals play an important role as well.


Assuntos
Pessoas com Deficiência , Idoso Fragilizado , Idoso , Idoso de 80 Anos ou mais , Odontólogos , Pessoal de Saúde , Humanos , Países Baixos
3.
Orv Hetil ; 160(52): 2061-2066, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31868007

RESUMO

Introduction: During kayaking, the whole body works in a perfect harmony. While the trunk is doing a rotation, flexion-extension helps to the upper limb to create a special cyclic paddle. The purpose of this study was to gain a better understanding of the physical disabled (later disabled) person's kayaking motions and to probe whether there were any significant differences between disabled and non-disabled kayakers with special focus on the use of footrest. We hypothesised significantly different ranges of motion and muscle activity in lower limbs but no significant differences in those of the upper limbs. Aim: Our goal was to know more about the abled and disbled kayaking and compare the athlete's kayaking movements. Method: Thirteen (n = 13) elite disabled athletes (age range: 18-40 years, height range: 164-194 cm, body mass range:74-93 kg), eleven (n = 11) elite non-disabled athletes (age range: 18-40 years, height range:172-197 cm, body mass range: 72-96 kg) and nine (n = 9) athletes whose movements were artificially limited to imitate disabled conditions("imitation disabled" group) (age range: 18-40 years, height range: 172-197 cm, body mass range: 72-96 kg) were measured. Weba sport kayak ergometer, surface electromyography (EMG), and a 3-dimensional Vicon (MX T40) camera system were used to record the data, and a combined Matlab and MS Excel system was used to analyse the results. Results: In line with our basic assumption, range of motion of the upper limbs was not significantly different between disabled athletes and non-disabled athletes (p ≥ 0.05). However, muscle activities were significantly different in the disabled group compared to the non-disabled group (p ≤ 0.05). In the disabled group the knee joint and trunk motions and muscle activities were also significantly different compared to those in the non-disabled group (p ≤ 0.05). The differences in performance force applied to both footrests and force were significant (p ≤ 0.05). Discussion: The assumption that shoulder and elbow ranges of motion were not significantly different in disabled athletes compared to non-disabled athletes was proven. However, muscle activities were significantly different in the disabled group. In the disabled group, knee and trunk motions and muscle activities were also significantly different compared to the non-disabled group. Significant differences were found in performance, force and footrest use. Our results proved our assumption that motions and muscle activities of disabled and non-disabled athletes were significantly different. Orv Hetil. 2019; 160(52): 2061-2066.


Assuntos
Pessoas com Deficiência , Esportes para Pessoas com Deficiência , Tronco , Esportes Aquáticos/fisiologia , Adolescente , Adulto , Atletas , Fenômenos Biomecânicos , Humanos , Joelho , Força Muscular , Amplitude de Movimento Articular , Adulto Jovem
4.
J Surg Oncol ; 120(8): 1497-1504, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31705571

RESUMO

BACKGROUND AND OBJECTIVES: Few reports have investigated patient experiences following total en bloc sacrectomy. The aims of this study were to obtain a deeper understanding of patients' personal experiences, needs, and satisfaction with the treatment to reveal areas in which perioperative and long-term patient care can be improved. METHODS: A qualitative design was applied to examine patient experiences and supportive care needs. Patients treated between 2007 and 2017 were identified from our institutional database. RESULTS: A total of 28 survivors were interviewed (13 females, age 13-75 years). Eight themes were identified: the effect of surgery on patients' (a) daily lives, (b) social activities, (c) work or school activities, (d) and family lives; (e) acceptance of ostomy surgery; (f) need for guidance regarding long-term rehabilitation; (g) satisfaction with the medical services provided in the hospital; and (h) satisfaction with the treatment outcomes. CONCLUSION: Total en bloc sacrectomy can yield satisfactory oncological outcomes; however, the procedure is a life-changing event for patients and their families. Physicians must provide long-term support and guidance after surgery to enable patients to fully understand and cope with the changes in their lives.


Assuntos
Neoplasias Ósseas/terapia , Sobreviventes de Câncer/psicologia , Pessoas com Deficiência/psicologia , Qualidade de Vida , Sacro/cirurgia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Estomia/psicologia , Satisfação do Paciente , Adulto Jovem
5.
Isr Med Assoc J ; 21(11): 752-755, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31713365

RESUMO

BACKGROUND: In non-ambulatory patients with cerebral palsy, the presence of scoliosis has a major impact on health and quality of life. The aim of this review is to raise awareness of caregivers from various professions to the extent of the problem, to explain the natural history of neuromuscular scoliosis and its pathophysiology, and to describe up-to-date optional conservative and surgical treatments.


Assuntos
Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Escoliose/complicações , Escoliose/fisiopatologia , Pessoas com Deficiência , Humanos , Limitação da Mobilidade , Qualidade de Vida
6.
Pan Afr Med J ; 33: 302, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692863

RESUMO

Introduction: People with disabilities have been identified as a key risk population for HIV. The aim of this study was to investigate HIV status, knowledge, attitudes, behaviours and its correlates in persons with and without disabilities in South Africa. Methods: Cross-sectional data of 26404 participants 15 years and older from the "2012 South African national HIV prevalence, incidence and behaviour survey" were analysed. Results: 1348(5.3%) had a disability. Persons with a disability were older (median age 52 years, IQR=24; versus 36 years, IQR=29), more often men, had a lower education and lower income and more likely living in a rural area than persons without disability. The prevalence of HIV infection was 16.7% in persons with disability, 23.0% in persons with visual/hearing or speech disability, 31.6% in persons with hearing disability and 16.2% in persons without disability. Antiretroviral (ARV) exposure in the HIV positive population was 41.3% among persons with disability and 30% in persons without disability. In multivariable logistic regression analysis, persons with disability had a lower odds to know an HIV testing site (Odds Ratio=OR: 0.46, Confidence Interval=CI: 0.22, 0.98) and a higher odds to have had two or more sexual partners in the past 12 months (OR 2.74, CI: 1.44, 5.21), had casual or transactional sex (OR: 6.25, CI: 2.57, 15.21) and psychological distress (OR: 2.10, CI: 1.50, 2.95) than persons without disability. In multivariable logistic regression analysis in both groups (with and without disability), psychological distress (OR: 2.90, CI: 1.53, 5.47, and OR: 1.90, CI: 1.20, 3.01, respectively) and high HIV stigma (OR: 0.31, CI: 0.25, 0.67, and OR: 0.57, CI: 0.34, 0.96, respectively) were associated with increased prevalence of HIV infection. Conclusion: The study found a high prevalence of HIV infection in persons with disabilities, in particular in those with hearing impairment. In some areas, persons with disability showed lower knowledge and higher risk behaviours than persons without disabilities. There is a need to strengthen HIV information and communication strategies geared towards targeting people with all types of disabilities.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
7.
Pan Afr Med J ; 33: 299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692876

RESUMO

Introduction: Persons with disabilities have the same sexual and reproductive health (SRH) needs as the abled people but they often face barriers to SRH information and services which are necessary for healthy and safe relationships, protection from HIV and other sexually transmitted infections (STIs). This study sought to access the SRH services among adolescents with disabilities in four Special Needs Schools in Ghana. Methods: The study adopted a cross-sectional study design with a quantitative approach to data collection between the months of January to March, 2018. A structured and pretested questionnaire was used to collect data from adolescents with disabilities from selected schools in Ghana. Both descriptive and inferential statistics were performed using chi-square test and multivariate logistic regression. Results: Majority of participants had hearing disability (52.1%). The average age at menarche among females was 13 years whiles the age at which puberty was attained among boys was 14 years. School teachers were the major source of information on SRH for the respondents (63.7%) followed by parents (12.2%). A majority (67.1%) of respondents had good knowledge of SRH. Factors which were significantly associated with knowledge level were age (p=0.026), religion (p=0.034), sources of information (p<0.001), guardians (p=0.049). Conclusion: The majority of participants had good knowledge of SRH, although their knowledge of contraceptive and access were poor. Only condoms were mostly known. There is the need for increased awareness on the availability of other contraceptives methods and the removal of barriers to contraceptive methods.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva , Saúde Sexual , Adolescente , Anticoncepção/métodos , Estudos Transversais , Feminino , Gana , Acesso aos Serviços de Saúde , Humanos , Masculino , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
8.
Zhonghua Shao Shang Za Zhi ; 35(11): 804-810, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775469

RESUMO

Objective: To explore the development trajectories of quality of life and acceptance of disability of burn patients in the rehabilitation treatment stage and the influencing factors. Methods: Totally 207 burn patients, including 157 males and 50 females, aged (40±13) years, who were in the rehabilitation treatment stage were selected by convenient sampling method from October 2016 to July 2017 in the Department of Burns of Fujian Medical University Union Hospital for this longitudinal study. At discharge and 1, 3, and 6 months after discharge, the patient's quality of life and acceptance of disability were scored using the Burn Specific Health Scale-Brief and Chinese Version of Acceptance of Disability Scale-Revised respectively. Taking the intercept, the slope, and the curve slope as latent variables, the latent second growth curve model was constructed for the quality of life and the acceptance of disability. The robust maximum likelihood estimation (MLR) method was used to estimate the mean, the variance, and the covariance, so as to analyze the discharge level, the growth rate, the acceleration, and the correlation among them. Taking the acceptance of disability, the gender, the cause of burn, the severity of burn, the existence of complications, the payment way, and the education level as covariates, the latent second growth curve model was constructed for the quality of life. The MLR method was used to estimate the influence of covariates on the discharge level, the growth rate, and the acceleration of the quality of life. Results: At discharge and 1, 3, and 6 months after discharge, the quality of life scores of patients were (102±36), (111±36), (118±37), and (122±37) points respectively, and the acceptance of disability scores were (73±17), (75±17), (77±17), and (78±18) points respectively. The estimated mean intercept of the quality of life and the acceptance of disability were 101.680 and 72.993 respectively at discharge, both of which showed a curve increasing trend in 1, 3, and 6 months after discharge (estimated mean slope=11.024, 3.086, t=15.376, 7.476, P<0.01), and the increasing rate (acceleration) gradually slowed down (estimated mean curve slope=-1.393, -0.426, t=-13.339, -4.776, P<0.01). There were significant individual differences in the discharge level and the acceleration of quality of life of patients (estimated intercept variance=1 174.527, t=9.332; estimated curve slope variance=2.379, t=6.402; P<0.01). There were significant individual differences in the discharge level, the growth rate, and the acceleration of patients' acceptance of disability (estimated intercept variance=267.017, t=9.262; estimated slope variance=32.264, t=2.356; estimated curve slope variance=0.882, t=2.939; P<0.05 or P<0.01). There was no significant correlation among the discharge level, the growth rate, and the acceleration of the quality of life and those of the acceptance of disability of patients (estimated intercept and slope=37.273, -1.457, t=0.859, -0.131; estimated intercept and curve slope=-6.712, -0.573, t=-1.089, -0.248; estimated slope and curve slope=-5.494, -5.988, t=-0.930, -2.512; P>0.05). Among the time-constant covariates, only the severity of burn and the presence of complications had a significant impact on the quality of life of patients at discharge (estimated intercept=-10.721, 5.522, t=-6.229, 1.977, P<0.05 or P<0.01). At discharge and 1, 3, and 6 months after discharge, the level of acceptance of disability had a positive impact on the quality of life of patients (standardized regression coefficient=0.616, 0.669, 0.681, 0.678, t=18.874, 21.660, 22.824, 22.123, P<0.01). Conclusions: The initial levels of quality of life and acceptance of disability of burn patients in the rehabilitation treatment stage are relatively low, both with a curve increasing trend over time, and the increasing rate gradually slows down. Patients with complications and serious burns have poor quality of life at discharge, while the acceptance of disability has a positive impact on the quality of life.


Assuntos
Queimaduras/psicologia , Queimaduras/reabilitação , Qualidade de Vida , Adaptação Psicológica , Adulto , Queimaduras/fisiopatologia , Pessoas com Deficiência/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
9.
Wiad Lek ; 72(9 cz 1): 1633-1640, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31586975

RESUMO

OBJECTIVE: Introduction: Autonomy is a valuable asset in the lives of societies and individuals. It means self - reliance and independence in deciding about yourself. It is the right to follow the norms of your own conscience in life. Maintaining autonomy involves with respect for personal rights. At present loneliness is a problem that concerns people regardless of their age, education, profession, financial situation or social status. Therefore it is compared to epidemics. Health state is considered to be an import ant factor in the etiology of loneliness and loneliness is designated as a determinant of human physical and mental condition. The aim: Characteristics of psychological mechanisms accompanying the experience of loneliness by people with mobility disabilities. PATIENTS AND METHODS: Material and methods: The studiem group included 80 people with physical disability. They had rehabilitation treatment In the hospital ward. In the study psychological tests were applied. RESULTS: Results: The least and the most lonely persons differ due to the personality structure. Differences between groups are also found in socio-demographic factors. CONCLUSION: Conclusions: Personality traits that facilitate autonomous behavior protect against the difficult experience of loneliness.


Assuntos
Pessoas com Deficiência/psicologia , Solidão , Autonomia Pessoal , Personalidade , Humanos
11.
Ideggyogy Sz ; 72(9-10): 317-323, 2019 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-31625698

RESUMO

Gait disturbance is a major symptom in patients with multiple sclerosis. The Expanded Disability Status Scale (EDSS) was first used in clinical trials of multiple sclerosis for the assessment of disability, however it has become more and more widely used in clinical practice as well. Nowadays its use is essential in application of the new diagnostic criteria, the new clinical form classification and in monitoring the efficacy of therapies. EDSS is based on a standardised neurological examination, but focuses on those symptoms that are frequent in multiple sclerosis. Based on the examination it assesses seven functional systems: visual, brainstem, pyramidal, cerebellar, sensory, bowel-bladder and cerebral functions. EDSS scores can be determined based on the scores given in the functional systems and on testing the walking distance. In newer versions the "Ambulation score" has been added. This chapter clarifies the scores based on the maximal walking distance and the need for a walking aid to walk this distance. The Neurostatus/EDSS training method improves the reproducibility of the standardised neurological examination that forms the basis of the EDSS scoring. Of the tests assessing walking, the Timed-25 Foot Walk Test and the self-administered 12-Item Multiple Sclerosis Walking Scale are suitable for routine evaluation of walking performance. An increase of more than 20% in the Timed-25 Foot Walk may be considered a significant change in gait.


Assuntos
Pessoas com Deficiência , Marcha , Esclerose Múltipla/diagnóstico , Caminhada/fisiologia , Avaliação da Deficiência , Marcha/fisiologia , Humanos , Esclerose Múltipla/complicações , Reprodutibilidade dos Testes
12.
J Investig Clin Dent ; 10(4): e12474, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31612641

RESUMO

AIM: To validate the Thai version of the Health Literacy in Dentistry scale (HeLD-Th) among Thai adults with physical disabilities. METHODS: The original Health Literacy in Dentistry (HeLD) was translated into Thai (HeLD-Th). The final version of the HeLD-Th was evaluated through a cross-sectional study of 160 participants in Thailand. Interview questionnaires and oral examination were performed. The reliability and validity of the HeLD-Th were determined. RESULTS: The internal consistency was acceptable, with an overall Cronbach's alpha of 0.76. The face and content validity were confirmed. Sufficient construct validity was revealed by exploratory factor analysis. The convergent validity (P ≤ .013) and discriminant validity (P = .017) were estimated. The concurrent validity and predictive validity were confirmed by significantly higher HeLD-Th scores (P < .001). Multiple linear regression analyses indicated that approximately 60% of the variation in the HeLD-Th scores was explained by the final model. CONCLUSION: The HeLD-Th has sufficient psychometric properties to assess the oral health literacy of Thai adults with mild to moderate disabilities. There are some limitations of the study due to the small sample size, and the results are specific to Thai adults with disabilities. Future studies using the HeLD-Th scale are recommended.


Assuntos
Pessoas com Deficiência , Alfabetização em Saúde , Adulto , Estudos Transversais , Odontologia , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tailândia
13.
Mymensingh Med J ; 28(4): 762-766, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599238

RESUMO

Stroke is one of the leading cause of disability worldwide. Motor function deficits due to stroke contribute to overall low quality of life. The objective was of this study is to observe functional motor outcome after stroke with low dose Levodopa therapy. This prospective follow up study was carried out in the Department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2014 to June 2016 to see the effect of low dose of Levodopa (110mg) on motor outcome after stoke disability. Motor deficit was measured by Medical Research Council (MRC) grading and Rivermead Mobility Index (RMI) score. Two groups were selected by simple random method, consisted of both ischemic and hemorrhagic stroke. All the patients of both the groups were suffering from at least some post stroke motor disability and attended full course of physiotherapy. The group (L) received 110mg Levodopa with physiotherapy. On the other hand (NL) group received only physiotherapy. They were all followed up for four times within two months of time and were assessed for recovery of motor function. Mean age was 59.03±11.56 years in Levodopa (L) group and 57.10±12.41 years in the Non Levodopa (NL) group; Males were predominant in both groups. Ninety three (77.50%) cases had ischemic stroke and 27(22.50%) cases had hemorrhagic stroke. Most common risk factors were hypertension and smoking. No known risk factor was detected in 8 (6.67%) patients. Single or multiple risk factors were confirmed in 112 patients (93.33%). MRC score was significantly higher both in affected upper and lower limb in Levodopa group comparing non Levodopa group at 4th visit. RMI score was also significantly higher in Levodopa group comparing non Levodopa group at 4th visit. The Levodopa (L) group showed better recovery pattern than Non Levodopa (NL) group. It can be concluded that motor recovery was better with administration of a single low dose of Levodopa in combination with physiotherapy. Motor outcome was significantly higher in levodopa group than non-levodopa group.


Assuntos
Pessoas com Deficiência , Dopaminérgicos/uso terapêutico , Levodopa/uso terapêutico , Transtornos Motores/tratamento farmacológico , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Bangladesh , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida
14.
JAMA ; 322(13): 1283-1293, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573636

RESUMO

Importance: General anesthesia during thrombectomy for acute ischemic stroke has been associated with poor neurological outcome in nonrandomized studies. Three single-center randomized trials reported no significantly different or improved outcomes for patients who received general anesthesia compared with procedural sedation. Objective: To detect differences in functional outcome at 3 months between patients who received general anesthesia vs procedural sedation during thrombectomy for anterior circulation acute ischemic stroke. Data Source: MEDLINE search for English-language articles published from January 1, 1980, to July 31, 2019. Study Selection: Randomized clinical trials of adults with a National Institutes of Health Stroke Scale score of at least 10 and anterior circulation acute ischemic stroke assigned to receive general anesthesia or procedural sedation during thrombectomy. Data Extraction and Synthesis: Individual patient data were obtained from 3 single-center, randomized, parallel-group, open-label treatment trials with blinded end point evaluation that met inclusion criteria and were analyzed using fixed-effects meta-analysis. Main Outcomes and Measures: Degree of disability, measured via the modified Rankin Scale (mRS) score (range 0-6; lower scores indicate less disability), analyzed with the common odds ratio (cOR) to detect the ordinal shift in the distribution of disability over the range of mRS scores. Results: A total of 368 patients (mean [SD] age, 71.5 [12.9] years; 163 [44.3%] women; median [interquartile range] National Institutes of Health Stroke Scale score, 17 [14-21]) were included in the analysis, including 183 (49.7%) who received general anesthesia and 185 (50.3%) who received procedural sedation. The mean 3-month mRS score was 2.8 (95% CI, 2.5-3.1) in the general anesthesia group vs 3.2 (95% CI, 3.0-3.5) in the procedural sedation group (difference, 0.43 [95% CI, 0.03-0.83]; cOR, 1.58 [95% CI, 1.09-2.29]; P = .02). Among prespecified adverse events, only hypotension (decline in systolic blood pressure of more than 20% from baseline) (80.8% vs 53.1%; OR, 4.26 [95% CI, 2.55-7.09]; P < .001) and blood pressure variability (systolic blood pressure >180 mm Hg or <120 mm Hg) (79.7 vs 62.3%; OR, 2.42 [95% CI, 1.49-3.93]; P < .001) were significantly more common in the general anesthesia group. Conclusions and Relevance: Among patients with acute ischemic stroke involving the anterior circulation undergoing thrombectomy, the use of protocol-based general anesthesia, compared with procedural sedation, was significantly associated with less disability at 3 months. These findings should be interpreted tentatively, given that the individual trials examined were single-center trials and disability was the primary outcome in only 1 trial.


Assuntos
Anestesia Geral/efeitos adversos , Sedação Consciente/efeitos adversos , Pessoas com Deficiência/estatística & dados numéricos , Acidente Vascular Cerebral/cirurgia , Trombectomia , Idoso , Isquemia Encefálica/cirurgia , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
16.
Sante Publique ; Vol. 31(3): 417-426, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640329

RESUMO

INTRODUCTION: The French social system offers many kinds of allowances and support (in work, everyday life and social life fields) to persons with disabilities. People with severe mental disorders are often considered as having less access than other disabled persons to the various forms of compensation offered by the national solidarity system. Purpose of research : Our objective was to study, for people with diverse kinds of mental disorders, those who are frequent users of support devoted to disability. METHODS: By proceeding to an ascending hierarchical classification from the data of the Disability and Health National survey of 2008-2009 and by studying the characteristics of these groups with regards to the available resources of the disability field we wished to clarify the determinants of recourse. RESULTS: Two groups who very frequently have both various kinds of mental disorders (including mental retardation) and physical disorders have a very high rate of using solidarity support linked to disability. A third group, whose recourse to the field of the disability system is less high without being negligible includes people with different medical and social profiles, having signs of social difficulties and physical troubles which may precede or follow their mental problems instead of belonging to a same complex pattern. CONCLUSIONS: This self-reported data survey inevitably comprises approximate data as regards to diagnoses and impairments, but no other survey brings such diversified information and it usefully highlights that people with mental disorders should not be considered has having only mental disorders as long as they use the French disability system.


Assuntos
Pessoas com Deficiência/psicologia , Transtornos Mentais/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricos , França/epidemiologia , Inquéritos Epidemiológicos , Humanos
17.
Ig Sanita Pubbl ; 75(3): 189-199, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31645061

RESUMO

In a sluggish economy, cost containment is a central issue for the national health service, and health authorities are increasingly requiring proof of the economic and clinical value of health interventions. In this context, the integration and/or evolution of techniques to measure the economic sustain- ability of new technologies is essential. The disability-adjusted life year (DALY) and quality-adjusted life year (QALY) are two measures used in the assessment of health interventions, which, although based on the same theoretical concept, differ in a number of important aspects. DALY can overcome the limit of using arbitrary economic threshold values since it is a benchmark directly comparable with the GDP per capita, an unbiased measure of sustainability. Indeed, in 2002 the World Health Organization (WHO) suggested that interventions costing less than 3 times the per-capita GDP per DALY averted could be considered cost effective. The Expected Value of Information and an estimate of the contribution to GDP (social costs due to presenteeism and absenteeism), along with Health Technology Assessment-based disinvestment decisions and the generation of a comprehensive health dataset (to be analysed using artificial intelligence) should be implemented. These procedures may improve the effectiveness of health governance and lead to better quality of healthcare services.


Assuntos
Pessoas com Deficiência , Custos de Cuidados de Saúde , Anos de Vida Ajustados por Qualidade de Vida , Análise Custo-Benefício , Humanos , Organização Mundial da Saúde
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1203-1205, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658517

RESUMO

With accelerating and rapid ageing in China, there is an urgent need to collect reliable, valid and cross-nationally comparable data on health in the elderly to provide basis for richer and empirical analysis on the changing health over one's life course and compression of morbidity. To meet the demands of this growing special population, planning and preparing on related social protection mechanisms (health and pension systems) should also based on evidence-based decision-making process. Based on long-term follow-up, large scale cohort study is indispensible for the etiology of common chronic diseases and disabling conditions. This study aims to introduce the background, project objectives, contents, baseline characteristics, strength and weakness as well as prospect, related to the Study on global AGEing and adult health in China.


Assuntos
Envelhecimento , Doença Crônica , Pessoas com Deficiência , Saúde Pública , Adulto , Idoso , China , Estudos de Coortes , Humanos
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1084-1088, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594150

RESUMO

Objective: To analyze the disease burden of pancreatic cancer in China in 1990 and 2017. Methods: Province-specific data in China from the Global Burden of Disease Study (GBD) 2017 were used to describe the change of death status, disease burden of pancreatic cancer in Chinese population by specific province and age groups, including incidence, mortality, disability-adjusted life years (DALY), years of life lost (YLL) due to premature mortality and years lived with disability (YLD) in 1990 and 2017. Meanwhile the incidence, mortality, DALY rate, YLL rate, YLD rate were standardized by the GBD global standard population in 2017. Results: In 2017, the new cases of pancreatic cancer, incidence and age-standardized incidence accounted for 83.6 thousand, 5.92/100 000 and 4.37/100 000 in China, with an increase of 230.94%, 180.45% and 49.88% compared with 1990, respectively. The total number of deaths, mortality and age-standardized mortality appeared as 85.1 thousand, 6.02/100 000, 4.48/100 000, with an increase of 236.08%, 184.80% and 47.51% respectively. The incidence and mortality of pancreatic cancer increased with age and accelerated from the age of 55 to 59 both in 1990 and 2017. The highest incidence and mortality showed in 85-89 years old in 2017 and in 90-94 years old in 1990. The standardized DALY rate of pancreatic cancer increased from 71.00/100 000 in 1990 to 94.32/100 000 in 2017, increased by 32.84%. The standardized YLL rate increased from 70.39/100 000 to 93.42/100 000, increased by 32.72%. The standardized YLD rate increased from 0.62/100 000 to 0.90/100 000, increased by 45.80%. In terms of age distribution, DALY rate, YLL rate and YLD rate of pancreatic cancer basically showed an increasing trend with age in 1990 and 2017. In 2017, Jiangsu (7.61/100 000), Shanghai (7.52/100 000) and Liaoning (6.84/100 000) ranked the top three provinces in terms of standardized mortality. Compared with 1990, Henan (104.28%), Sichuan (94.02%) and Hebei (90.39%) saw the fastest increase in standardized mortality. Conclusions: The incidence, mortality and disease burden of pancreatic cancer in China increased significantly from 1990 to 2017. Prevention and control measures should be strengthened to reduce the disease burden of pancreatic cancer.


Assuntos
Neoplasias Pancreáticas/epidemiologia , Idoso de 80 Anos ou mais , China/epidemiologia , Pessoas com Deficiência , Carga Global da Doença , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Padrões de Referência
20.
Codas ; 31(5): e20180102, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31664367

RESUMO

PURPOSE: verify the perception of Care Network users for People with Disabilities in Minas Gerais regarding the quality of care. METHODS: This is an observational, descriptive and cross-sectional study of 871 informants, users and caregivers of Care Network for People with Disabilities in Minas Gerais. Interviews were carried out based on three instruments, the User Interview Roadmap and Brazil's Economic Classification Criteria for sociodemographic, clinical and care characterization, as well as the Quality of Care Scale to assess the quality of care for the interviewees. RESULTS: the majority of users were male, single, unworked and had income of a minimum wage. A higher proportion of elementary school is incomplete, white in color, with household income greater than one and up to two minimum wages. The average age of 98.9% of the users was 28.6 years, of which 50.0% was up to 14 years. The majority reported having a type of disability with no associated comorbidity. Regarding the quality of care referred to, at least a quarter of the interviewees evaluated negatively the Access, Social Needs and Received Information axes. CONCLUSION: It will be necessary to improve the waiting time to receive care and also the services offer where the user resides, to facilitate access to consultations, to contribute intersectorally in leisure and social activities and to improve communication with users to increase the quality of care.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adolescente , Adulto , Brasil , Cuidadores , Estudos Transversais , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Características de Residência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
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