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1.
Z Geburtshilfe Neonatol ; 223(6): 373-394, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31801169

RESUMO

AIMS: This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. METHODS: The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). RECOMMENDATIONS: Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.


Assuntos
Ruptura Prematura de Membranas Fetais , Trabalho de Parto Prematuro/prevenção & controle , Guias de Prática Clínica como Assunto , Nascimento Prematuro , Sociedades Médicas , Prevenção Terciária , Incompetência do Colo do Útero , Áustria , Feminino , Ruptura Prematura de Membranas Fetais/prevenção & controle , Ruptura Prematura de Membranas Fetais/terapia , Humanos , Recém-Nascido , Obstetrícia , Gravidez , Nascimento Prematuro/prevenção & controle , Nascimento Prematuro/terapia , Sistema de Registros
2.
Presse Med ; 48(10): 1051-1058, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31473024

RESUMO

Subjects suffering from post-traumatic stress disorder present sleeping disorders like a chronic insomnia, traumatic nightmares, but also less expected, sleep breathing disorders. Sleep problems are a factor of development and maintenance of PTSD, but also a factor of resistance to treatment. After a therapy focused on PTSD, they represent frequent residual symptoms. It is necessary to couple, with the usual management of PTSD, targeted approaches for sleep problems. These targeted approaches allow an improvement of the nocturnal properties but also diurnal specific symptoms of PTSD. Stakes around primary, secondary and tertiary prevention of PTSD emerge around these sleep disorders.


Assuntos
Síndrome das Pernas Inquietas/etiologia , Síndromes da Apneia do Sono/etiologia , Transtornos do Sono-Vigília/etiologia , Transtornos de Estresse Pós-Traumáticos/complicações , Sonhos , Humanos , Síndrome das Pernas Inquietas/terapia , Prevenção Secundária , Síndromes da Apneia do Sono/terapia , Transtornos do Sono-Vigília/terapia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/terapia , Prevenção Terciária
3.
Rev Chil Pediatr ; 90(2): 139-144, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31095229

RESUMO

Hemolytic uremic syndrome (HUS) associated with intestinal infection by Shiga toxin-producing bacteria, which mainly affects children, can cause severe acute morbidity, chronic sequelae in seve ral organs, and premature death in some of them. Given its zoonotic nature, adequate measures of agricultural management and proper hygiene of what we consume are essential to prevent infection. Once the HUS is triggered, medical management is currently mainly supportive. In recent years, va rious therapeutic strategies have been developed to prevent this disease from occurring or, at least, to mitigate its morbidity and mortality consequences. This article describes specific actions at different levels of prevention of this pathology.


Assuntos
Síndrome Hemolítico-Urêmica/prevenção & controle , Toxinas Shiga/efeitos adversos , Síndrome Hemolítico-Urêmica/diagnóstico , Síndrome Hemolítico-Urêmica/etiologia , Síndrome Hemolítico-Urêmica/terapia , Humanos , Prevenção Primária/métodos , Prevenção Secundária/métodos , Prevenção Terciária/métodos
4.
Bull Cancer ; 106(4): 304-315, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30777301

RESUMO

INTRODUCTION: Increasing physical activity among cancer patients is one of the priority recommendations in tertiary prevention; the level of physical activity is one of the determining factors in reducing the risk of relapse and mortality. However, many barriers to initiation and maintenance of regular physical activity have been identified. A program combining bi-weekly adapted physical activity sessions, mindfulness-based meditation and socio-aesthetic care was put together in 2015, in a Cancer Center, in order to facilitate adherence and sustainable attendance. METHODS: Data on patient participation of program components, patient satisfaction, and psycho-corporal changes, collected in ecological conditions between 2015 and 2017 from 144 participants, were retrospectively analyzed to provide a first assessment. RESULTS: Nearly 60% of the patients were in treatment, 17% were metastatic. The average participation time was 9 months, with an average of one physical activity session per week. Changes were observed, both quantitatively and qualitatively, in terms of emotional state, sleep and body image. The overall satisfaction rate was 96%. DISCUSSION: The conclusions of the study support the continuation of the program. The methodological limitations of this pilot format may be overtaken in future research, which will allow further in-depth investigations into the effects of combined approaches on sustainable physical activity.


Assuntos
Imagem Corporal , Exercício , Meditação , Atenção Plena , Neoplasias/prevenção & controle , Neoplasias/psicologia , Avaliação de Programas e Projetos de Saúde , Prevenção Terciária/métodos , Adulto , Idoso , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Plena/estatística & dados numéricos , Recidiva Local de Neoplasia/prevenção & controle , Recidiva Local de Neoplasia/psicologia , Satisfação do Paciente/estatística & dados numéricos , Projetos Piloto , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
5.
Eur Urol Focus ; 5(1): 42-45, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30262198

RESUMO

Penile cancer remains an aggressive disease with poor prognosis in advanced stages. Another specific problem of any rare disease is that the population is not aware of prevention strategies and higher chances for curation by early diagnosis. In penile carcinogenesis, two major pathways are known. Besides a non-human papilloma virus (HPV)-related pathway (mainly caused by phimosis and chronic inflammation), up to 50% of penile carcinomas are HPV-related (HPV high-risk types). Prophylactic HPV vaccination has proven its efficacy against cervical cancer; its B-cell-mediated immunity against HPV capsid proteins provides probably lifelong protection against specific HPV subtypes covered by the vaccine. Therefore, a consequent HPV vaccination program for children of both sexes might dramatically reduce the incidence of not only cervical cancer but also partially prevent penile cancer. However, for the treatment of already existing intracellular HPV infections, an antigen-specific T-cell immunity is necessary. Appropriate therapeutic HPV vaccines are under investigation. This article gives an overview about different levels of prevention of the HPV-related penile cancer.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias Penianas/virologia , Ensaios Clínicos como Assunto , Humanos , Masculino , Vacinação em Massa , Papillomaviridae/efeitos dos fármacos , Infecções por Papillomavirus/tratamento farmacológico , Vacinas contra Papillomavirus/farmacologia , Neoplasias Penianas/tratamento farmacológico , Neoplasias Penianas/prevenção & controle , Prevenção Primária , Prevenção Secundária , Prevenção Terciária
6.
Am J Orthopsychiatry ; 89(2): 248-257, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30382726

RESUMO

This article examines the feasibility of a complex intervention designed to facilitate the transition of youth out of homelessness. It is intended to contribute to efforts to build out the youth homelessness intervention literature, which is underdeveloped relative to descriptive characterizations of risk. The 6-month intervention examined here, referred to as the Housing Outreach Program-Collaboration (HOP-C), is comprised of transitional outreach-based case management, individual and group mental health supports, and peer support. The intervention was delivered through a multiagency, interdisciplinary collaboration. Feasibility was assessed using a mixed methods design that included prepost intervention metrics and the study site was a large Canadian urban center. A total of 31 youth participated in the study with 28 completing the intervention. Overall, implementation and youth engagement was successful though patterns and intensity of engagement were quite variable. While prepost, self-report metrics improved modestly, substantial gains were observed in employment, education, and mental health service connectedness. Qualitative themes focused on the benefits of a flexible, multicomponent approach, close attention to seamless delivery and common factors, and supporting youth in the balance of isolation versus independence. These findings suggested that this tertiary prevention approach is feasible and warrants further investigation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Administração de Caso , Jovens em Situação de Rua/psicologia , Grupo Associado , Apoio Social , Prevenção Terciária/métodos , Adolescente , Adulto , Canadá , Estudos de Viabilidade , Feminino , Jovens em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , População Urbana , Adulto Jovem
7.
J Formos Med Assoc ; 118(8): 1239-1246, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30581103

RESUMO

BACKGROUND: Secondary prevention of hepatocellular carcinoma (HCC) among patients with chronic hepatitis C (CHC) who achieve sustained virologic response (SVR) with interferon-based therapy has been proved effective. However, tertiary prevention with PegIFN/RBV therapy of HCC recurrence seems limited effect in CHC-HCC patients post curative therapies. This study aims to investigate the timing and impact of PegIFN/RBV treatment on prevention of HCC recurrence in patients after RFA treatment. METHODS: From 2013 to 2016, a total of 137 CHC-HCC patients from a 508 patient based cohort receiving complete RFA treatment in Chang Gung Memorial Hospital, Linkou Medical Center were retrospectively recruited. Pre-RFA patient demographics were analyzed by cox regression analysis for prediction on tumor recurrence. Statistics analysis was performed with SPSS V.20 (IBM, USA). RESULTS: The mean age of the 137 patients were 69.6 year-old and 71.5% of patients were cirrhotic. After propensity score matching, one hundred and two patients were enrolled into the analysis. Fifty-one patients (50%) received PegIFN/RBV therapy and twenty-seven patients (52.9%) achieved SVR. Patients who could achieve SVR had lower tumor recurrence rate than non-SVR and untreated groups (29.6% vs. 66.7% vs. 49.0%, P = 0.030). The effect is more prominent in those achieve SVR prior to compared with after RFA despite not reach statistically significant (26.1% vs. 50.0%, P = 0.334). CONCLUSION: Timely treatment with SVR achievement has the lowest tumor recurrence rate in CHC-HCC patients. Secondary prevention might be even more important than tertiary prevention in CHC patients, especially regarding prevention of post RFA HCC recurrence.


Assuntos
Antivirais/uso terapêutico , Carcinoma Hepatocelular/virologia , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Neoplasias Hepáticas/virologia , Ribavirina/uso terapêutico , Idoso , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/mortalidade , Quimioterapia Combinada , Feminino , Hepatite C Crônica/complicações , Humanos , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Polietilenoglicóis , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Prevenção Secundária , Resposta Viral Sustentada , Taiwan , Prevenção Terciária , Carga Viral , Viremia/tratamento farmacológico
8.
Contact Dermatitis ; 80(1): 35-44, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30506828

RESUMO

BACKGROUND: Allergic contact dermatitis (ACD) is one of the most common occupational skin diseases (OSDs). Its prevalence and the causative allergens differ between occupations. OBJECTIVES: To evaluate the prevalence of ACD and the pattern of patch test results of patients taking part in a tertiary individual prevention programme (TIP) for OSD in Germany. PATIENTS AND METHODS: In a retrospective cohort study, the data of 3411 TIP patients patch tested between 2007 and 2016 were analysed. RESULTS: In 2687 (78.8%) patients, work-related skin disease was diagnosed, mostly hand dermatitis. The highest proportion of face dermatitis was seen in painters (8.1%). ACD was most common in painters (56.8%), hairdressers (45.8%), construction workers (31.5%), gardeners/florists (26.7%), and metalworkers (26.5%). On average, hairdressers had the youngest age (31.4 ± 12.6 years, P < 0.0001) and the shortest time in the profession prior to the TIP (mean 13.7 years). The pattern of patch test reactivity showed occupation-specific differences related to work exposures. CONCLUSIONS: Identification of occupational groups at risk for ACD and relevant allergens may help in the development and implementation of targeted prevention strategies. Our data suggest that there should be a particular focus on hairdressers and painters.


Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Ocupacional/epidemiologia , Dermatoses Faciais/epidemiologia , Dermatoses da Mão/epidemiologia , Adulto , Indústria da Beleza , Estudos de Coortes , Indústria da Construção , Feminino , Jardinagem , Alemanha/epidemiologia , Humanos , Masculino , Metalurgia , Pessoa de Meia-Idade , Pinturas , Testes do Emplastro , Prevalência , Estudos Retrospectivos , Prevenção Terciária , Adulto Jovem
9.
BMC Cancer ; 18(1): 1210, 2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30514262

RESUMO

BACKGROUND: Epidemiological studies and cardiovascular prevention trials have shown that low-dose aspirin can reduce colorectal cancer (CRC) incidence and mortality, including inhibition of distant metastases. Metformin has also been associated with decreased colon adenoma recurrence in clinical trials and lower CRC incidence and mortality in epidemiological studies in diabetics. While both drugs have been tested as single agents, their combination has not been tested in cancer prevention trials. METHODS/DESIGN: This is a randomized, placebo-controlled, double-blind, 2 × 2 biomarker trial of aspirin and metformin to test the activity of either agent alone and the potential synergism of their combination on a set of surrogate biomarkers of colorectal carcinogenesis. After surgery, 160 patients with stage I-III CRC are randomly assigned in a four-arm trial to either aspirin (100 mg day), metformin (850 mg bis in die), their combination, or placebo for one year. The primary endpoint biomarker is the change of IHC expression of nuclear factor kappa-B (NFκB) in the unaffected mucosa of proximal and distal colon obtained by multiple biopsies in two paired colonoscopies one year apart. Additional biomarkers will include: 1) the measurement of circulating IL-6, CRP and VEGF; 2) the IHC expression of tissue pS6K, p53, beta-catenin, PI3K; 3) the associations of genetic markers with treatment response as assessed by next generation sequencing of primary tumors; 4) the genomic profile of candidate genes, pathways, and overall genomic patterns in tissue biopsies by genome wide gene expression arrays; and 5) the evaluation of adenoma occurrence at 1 year. DISCUSSION: A favorable biomarker modulation by aspirin and metformin may provide important clues for a subsequent phase III adjuvant trial aimed at preventing second primary cancer, delaying recurrence and improving prognosis in patients with CRC. TRIAL REGISTRATION: EudraCT Number: 2015-004824-77; ClinicalTrial.gov Identifier: NCT03047837 . Registered on February 1, 2017.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Aspirina/administração & dosagem , Biomarcadores Tumorais/metabolismo , Neoplasias Colorretais/metabolismo , Metformina/administração & dosagem , Prevenção Terciária/métodos , Anti-Inflamatórios não Esteroides/administração & dosagem , Neoplasias Colorretais/prevenção & controle , Neoplasias Colorretais/cirurgia , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Seguimentos , Humanos , Hipoglicemiantes/administração & dosagem , Prevenção Terciária/tendências
10.
Br J Cancer ; 119(7): 785-792, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30287914

RESUMO

Colorectal cancer (CRC) is both one of the most common and one of the most preventable cancers globally, with powerful but strongly missed potential for primary, secondary and tertiary prevention. CRC incidence has traditionally been the highest in affluent Western countries, but it is now increasing rapidly with economic development in many other parts of the world. CRC shares several main risk factors, such as smoking, excessive alcohol consumption, physical inactivity and being overweight, with other common diseases; therefore, primary prevention efforts to reduce these risk factors are expected to have multiple beneficial effects that extend beyond CRC prevention, and should have high public health impact. A sizeable reduction in the incidence and mortality of CRC can also be achieved by offering effective screening tests, such as faecal immunochemical tests, flexible sigmoidoscopy and colonoscopy, in organised screening programmes which have been implemented in an increasing number of countries. Countries with early and high uptake rates of effective screening have exhibited major declines in CRC incidence and mortality, in contrast to most other countries. Finally, increasing evidence shows that the prognosis and quality of life of CRC patients can be substantially improved by tertiary prevention measures, such as the administration of low-dose aspirin and the promotion of physical activity.


Assuntos
Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Epidemias/prevenção & controle , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Estilo de Vida Saudável , Humanos , Incidência , Prevenção Primária , Prognóstico , Medição de Risco , Prevenção Secundária , Prevenção Terciária
12.
Pharmacoeconomics ; 36(8): 929-939, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29679316

RESUMO

BACKGROUND: Men who have sex with men require special attention for human papillomavirus vaccination given elevated infection risks and the development of, in particular, anal cancer. OBJECTIVE: Our purpose was to review the cost effectiveness of human papillomavirus vaccination for both currently vaccine-eligible and non-eligible individuals, particularly the men-who-have-sex-with-men population, and synthesize the available evidence. METHODS: We systematically searched for published articles in two main databases (PubMed and EMBASE). Screening and data extraction were performed by two independent reviewers. The risk of bias was assessed using a validated instrument (Bias in Economic Evaluation, ECOBIAS). Methodological aspects, study results, and sensitivity analyses were extracted and synthesized to generate a consistent overview of the cost effectiveness of human papillomavirus vaccination in the men-who-have-sex-with-men population. RESULTS: From 770 identified articles, four met the inclusion criteria. Across the studies, human papillomavirus vaccination showed incremental cost-effectiveness ratios ranging from dominant to US$96,146 and US$14,000 to US$18,200 for tertiary prevention and primary prevention, respectively. The incremental cost-effectiveness ratio seemed most sensitive to vaccine efficacy, vaccine costs, and the incidence of anal cancer in the selected target populations. CONCLUSION: This review presents the human papillomavirus vaccine, both as a primary and adjuvant (tertiary) vaccination, as a potentially cost-effective strategy for preventing mainly-but not limited to only-anal cancer in men-who-have-sex-with-men populations.


Assuntos
Análise Custo-Benefício/estatística & dados numéricos , Vacinas contra Papillomavirus/economia , Prevenção Primária/economia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Prevenção Terciária/economia , Humanos
13.
Clin Ter ; 169(2): e62-e66, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29595867

RESUMO

Lip and palate cleft represent one of the most frequently occurring congenital deformity, which includes dental anomalies, such as variation in tooth number and position. In case of hypodontia implant-prosthetic rehabilitation offers significant advantages in terms of function, aesthetics and quality of life and bone graft is usually needed. Secondary bone grafting, generally performed in the mixed dentition phase (years 8-11) seems to be the most successful method to allow for rehabilitation. It's often necessary to perform a tertiary bone grafting in adult age in order to achieve better bone quantity and quality before implant placement. Aim of this retrospective study was to evaluate the aesthetic perception that patients had of themselves comparing dental implants placed in tertiary grafted alveolar cleft sites with a previous secondary grafting to only secondary grafting. Between 2009 and 2012, fourteen alveolar cleft were treated with implant rehabilitation and eleven of them received tertiary bone grafting six months prior to implant placement. All patients were questioned to give a score from 1 to 10 their aesthetic satisfaction of their smile before and after implant rehabilitation and during pre-surgery provisional rehabilitation. At the end of their prosthesis rehabilitation patients who received tertiary bone grafting resulted more satisfied than those who had secondary bone grafting only (9.5 vs 8).


Assuntos
Transplante Ósseo/métodos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Implantes Dentários/psicologia , Estética/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Adolescente , Feminino , Humanos , Masculino , Estudos Retrospectivos , Prevenção Secundária/métodos , Prevenção Terciária/métodos , Adulto Jovem
14.
Endocr Res ; 43(2): 124-140, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29319359

RESUMO

INTRODUCTION: Secondary and tertiary preventions are concerned with the recognition of the disease process in a very early stage and delay in progression to complete disease and minimization of complications and the impact of illness. METHODS: All articles related to secondary and tertiary prevention of thyroid diseases were reviewed. Using related key words, articles published between 2001 and 2015 were evaluated, categorized, and analyzed. RESULTS: In secondary prevention, congenital hypothyroidism and subclinical hypo and hyperthyroidism are equally important. Routine screening of patients with multinodular goiter by either ultrasonography or calcitonin is a controversial issue, while calcitonin assessments in medullary cancer and RET in family members are recommended. Screening of thyroid disease in pregnancy is limited to those with risk factors. Views regarding the importance of thyroid autoimmunity in secondary prevention are also presented. In tertiary prevention, prescribing excessive doses of levothyroxine, in the elderly in particular and appropriate care of all patients to avoid progression and complications are the key issues. CONCLUSION: Optimization of management of thyroid diseases requires timely screening, prevention of progression to more sever disease, optimal medical care, and avoidance of iatrogenic conditions.


Assuntos
Progressão da Doença , Prevenção Secundária , Prevenção Terciária , Doenças da Glândula Tireoide , Humanos , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/tratamento farmacológico , Doenças da Glândula Tireoide/prevenção & controle
15.
Heart ; 104(11): 882-887, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29191806

RESUMO

Atrial fibrillation (AF), which is the most diagnosed arrhythmia, is becoming a significant issue for health policy-makers. In particular, more and more attention is being devoted to AF prevention. Indeed, several studies recently published point out how targeted interventions could be useful in reducing the risk of AF occurrence (or recurrence). In this review, we briefly summarised the role of the major risk factors associated with the incidence of AF, as well as the effectiveness of interventions aimed at controlling these risk factors. Several general risk factors, such as alcohol consumption, physical activity, smoking habit, as well as specific cardiovascular risk factors as diabetes mellitus, hypertension and obesity have a relevant impact in determining the occurrence of AF, along with a strong clinical evidence of a dose-effect response mechanism for most of the factors examined. Specific interventions aimed at controlling risk factors have been showed to clearly reduce the risk of AF in several cohorts. Even more importantly, integrated programmes aimed at controlling for multiple risk factors would be more efficient in terms of reducing risk of AF, in particular whena stricter control is observed. AF prevention requires a series of initiatives focused on the many risk factors that we reviewed, as well as a more integrated approach, which should involve many stakeholders at different levels. In this light and also considering the constantly changing epidemiology, AF prevention may constitute a future 'win-win' strategy for all the stakeholders.


Assuntos
Fibrilação Atrial/prevenção & controle , Humanos , Prevenção Primária , Fatores de Risco , Comportamento de Redução do Risco , Prevenção Secundária , Prevenção Terciária
17.
Rev. gerenc. políticas salud ; 16(33): 60-77, jul.-dic. 2017. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-901720

RESUMO

Resumen Estudio descriptivo que permitió caracterizar los programas y las actividades de promoción de la salud y prevención de la enfermedad en cuatro instituciones de salud de alta complejidad de Medellín. Por medio de un estudio descriptivo de serie de casos, se aplicaron dos instrumentos semiestructurados tipo encuesta donde se recolectó información sobre: estructura y funcionamiento, enfoque, públicos beneficiarios, metodologías y equipos de trabajo. Se encontró que las cuatro instituciones desarrollan actividades de este tipo, con un enfoque hacia la prevención terciaria congruente con su nivel de complejidad; están orientadas esencialmente al paciente y a las familias, y, a veces, a la comunidad; los empleados también se benefician desde salud ocupacional; son desarrolladas por profesionales de diferentes disciplinas; su funcionamiento depende generalmente de las direcciones científicas; no se identifica un área en particular que las gestione articuladamente. Se considera importante que las instituciones se declaren a favor de modelos de atención en salud integrales donde se trabaje de manera articulada las actividades de promoción y prevención con la atención clínica.


Abstract This is a descriptive study that allowed for the characterization of the health promotion and disease prevention programs and activities in four high-complexity health institutions in Medellín. By means of a descriptive study of a series of cases, two semi-structured survey instruments were applied through which information was collected on: structure and functioning, approach, beneficiary communities, methodologies, and work teams. We found that all four institutions develop activities of this type, with a focus on tertiary prevention consistent with their level of complexity; they are essentially oriented to the patient and their families, and, sometimes, to the community; employees also benefit from occupational health; the activities are developed by professionals from different disciplines; their operation depends in general terms on scientific management; and no particular area was identified to manage the activities articulately. We considered important that the institutions manifest to be in favor of integral health care models where the promotion and prevention activities are coordinated with clinical care.


Resumo Estudo descritivo que permitiu caracterizar os programas e atividades de promoção da saúde e prevenção de doença em quatro instituições de saúde de alta complexidade de Medellín. Por meio de estudo descritivo de série de casos, aplicaram-se dois instrumentos semiestruturados tipo inquérito onde foi coletada informação sobre: estrutura e funcionamento, enfoque, públicos beneficiários, metodologias e equipes de trabalho. Verificou-se que as quatro instituições desenvolvem atividades deste tipo, com enfoque para a prevenção terciária congruente com o seu nível de complexidade; são orientadas essencialmente ao paciente e as famílias, e, às vezes, à comunidade; os empregados também são beneficiados desde saúde ocupacional; são desenvolvidas por profissionais de diferentes disciplinas; o seu funcionamento depende geralmente das direções científicas; não se identifica uma área em particular que as gere articuladamente. Considera-se importante as instituições se declararem em favor de modelos de atenção em saúde integrais onde se trabalharem de maneira articulada as atividades de promoção e prevenção com a atenção clínica.


Assuntos
Prevenção Primária , Serviços Hospitalares , Prevenção de Doenças , Prevenção Secundária , Prevenção Terciária , Promoção da Saúde/organização & administração
19.
Rev. nefrol. diál. traspl ; 37(3): 157-162, sept. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-1006501

RESUMO

INTRODUCCIÓN: La actividad física se ha convertido en los últimos años en una herramienta terapéutica y mecanismo protector en el adulto mayor para disminuir el riesgo cardiovascular en usuarios con diversos tipos de diálisis que se encuentran en su fase paliativa. OBJETIVO: El presente trabajo buscó determinar la evaluación de ingreso a un programa de actividad física terapéutica por medio de la aplicación del Cuestionario PARQ & YOU en un grupo de participantes adultos mayores con diversos tipos de hemodiálisis, y su relación con los factores de riesgo cardiovascular. MATERIAL Y MÉTODOS: Se utilizó una prueba chi cuadrado de Pearson con el fin de determinar la posible asociación de las variables en relación a los antecedentes médicos y el disconfort, frente a la práctica de actividad física versus el resultado del PAR-Q & YOU. Se realizó una regresión logística binaria con las variables que en el análisis mediante prueba chi cuadrado. CONCLUSIONES: En la regresión logística se evidenció que los antecedentes cardiovasculares tienen 10.44 más veces influencia sobre la pertinencia de la aplicación del PAR-Q & YOU, como un instrumento básico para el ingreso a programas de actividad física en la rehabilitación renal desde la fisioterapia


INTRODUCTION: During the last few years, physical activity has become a therapeutic tool and a protective mechanism for the elderly; it reduces cardiovascular risk in patients undergoing different types of dialysis and receiving palliative care. OBJECTIVE: The aim of this study was to establish the inclusion criteria for a therapeutic physical activity program through the use of the PAR-Q & YOU Questionnaire with elderly patients treated with different types of hemodialysis, and to relate it with cardiovascular risk factors. METHODS:Pearson's chi-squared test was used to determine the possible association among variables, considering the medical history and discomfort caused by physical activity against the results of PAR-Q & YOU. Binary logistic regression was used with the variables in the chi-squared test. CONCLUSIONS: Through logistic regression, we found that cardiovascular history was 10.44 times more significant to establish the relevance of the PAR-Q & YOU as a basic assessment instrument for the inclusion in a physical activity program which is part of a physiotherapy-led renal rehabilitation


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Exercício , Diálise Renal , Manipulações Musculoesqueléticas , Prevenção Terciária
20.
BMJ Open ; 7(8): e015520, 2017 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-28801401

RESUMO

OBJECTIVES: Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. METHODS: We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. RESULTS: Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. CONCLUSIONS: Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process.


Assuntos
Grupos Étnicos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Prevenção Terciária , Estudos Transversais , Emigrantes e Imigrantes , Feminino , Alemanha , Grécia , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Portugal , Retorno ao Trabalho , Turquia , Revisão da Utilização de Recursos de Saúde
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