RESUMO
OBJECTIVE: The objective of this study was to quantify changes over time in waist circumference (WC) relative to BMI by sex in the Americas (United States, Mexico, Chile, and Peru) and England. METHODS: Data from adults aged 25 to 64 years between 1997 and 2020 were analyzed, and US data were stratified by race and ethnicity groups. Sex-specific BMI and WC means and obesity and abdominal obesity prevalence were compared between the first and last surveys. Using data from all survey years, secular changes across the BMI and WC distributions were estimated, applying quantile regression models. BMI was added as a predictor of WC to estimate secular changes in WC relative to BMI. Interaction terms were included in all models to evaluate differences by sex. RESULTS: BMI and WC (except for Peru) showed larger secular increases at the upper-tails of the distributions in both sexes. Increases at the 50th and 75th WC percentiles relative to BMI were more pronounced in women than in men, with larger increases in US non-Hispanic White individuals and in England. In men, increases in WC independent of BMI were most evident in Mexico. CONCLUSIONS: Disease risk associated with visceral fat is potentially underestimated by national surveillance efforts that quantify only secular changes in BMI.
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Índice de Massa Corporal , Obesidade Abdominal , Circunferência da Cintura , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Obesidade Abdominal/epidemiologia , Inglaterra/epidemiologia , México/epidemiologia , Prevalência , Fatores Sexuais , Peru/epidemiologia , Obesidade/epidemiologiaRESUMO
OBJECTIVE: Does loneliness predict premature death? Much prior research suggests so, but this evidence draws primarily on populations from individualistic societies, such as North America and Western Europe. Here, we aimed to extend this evidence by testing a hypothesis that loneliness would predict greater mortality risk in collectivistic societies, where social interdependence is normatively sanctioned. METHOD: Using a harmonized dataset from two individualistic (England and the United States) and two collectivistic (Korea and Mexico) countries (combined N = 41,869), we tested whether cultural contexts moderate the extent to which loneliness predicts 10-year all-cause mortality. RESULTS: After adjustment of demographic variables and health behaviors, loneliness was associated with increased 10-year mortality in all four countries, with hazard ratios (HRs) of 1.13 in England, 1.21 in the United States and Mexico, and 1.51 in Korea. When health conditions were additionally controlled, this association became negligible in two individualistic countries, with HRs of 0.98 for both England and the United States. In contrast, the HR remained highly significant in Korea (HR = 1.27). Curiously, the mortality risk of loneliness in Mexico (HR = 1.03), another collectivistic country, was no different from the risks in England and the United States. CONCLUSIONS: When people feel that they are chronically isolated from social networks, this perception can be fatal in Korea, but it is less so in the other three countries. Discussion focuses on other cultural factors, besides the cultural dimension of individualism-collectivism, that may account for the current finding. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Comparação Transcultural , Solidão , Humanos , Solidão/psicologia , Masculino , Feminino , Estados Unidos , Pessoa de Meia-Idade , México , Adulto , Idoso , República da Coreia , Inglaterra , Mortalidade/tendências , Cultura , Fatores de RiscoRESUMO
INTRODUCTION: Previous research has shown that personality traits and gaming motives are important predictors for explaining regular and disordered gaming. However, the mediating role of gaming motives in the relation between personality traits and video game outcomes (e.g., time spent gaming or disordered gaming) has been scarcely studied and limited cross-national studies have addressed this issue. The present study aimed to examine the direct and indirect effects of the Big Five personality traits on weekly gaming and disordered gaming via gaming motives across seven countries. METHOD: 3540 college student gamers (59.5% women) from the U.S., Canada, Spain, Argentina, Uruguay, South Africa and England completed the online survey. Structural equation modeling was conducted to test models. Multigroup models were employed to test model invariance across countries. RESULTS: Significant, albeit weak, relations were found between personality traits and gaming outcomes, and were mediated mostly by coping motives in predicting disordered gaming, and by social interaction and recreation (to a lesser extent) motives in predicting weekly gaming. Some minor, yet significant, differences across countries appeared and are discussed in detail. DISCUSSION: The present findings indicate that the differential interrelations between personality traits, gaming motives, and video gaming outcomes may be generalized in college students across countries.
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Motivação , Personalidade , Estudantes , Jogos de Vídeo , Humanos , Feminino , Masculino , Estudantes/psicologia , Adulto Jovem , Jogos de Vídeo/psicologia , Canadá , Estados Unidos , Universidades , Adolescente , Espanha , África do Sul , Uruguai , Inglaterra , Argentina , Adulto , Comparação Transcultural , Transtorno de Adição à Internet/psicologia , Transtorno de Adição à Internet/epidemiologia , Adaptação PsicológicaRESUMO
OBJECTIVE: To assess the bidirectional association between chronic pain and depressive symptoms among middle-aged and older adults from two prospective cohort studies. METHODS: We used prospective data (12y of follow-up) from the English Longitudinal Study of Ageing (n = 9149, 5018 women, 65.0 ± 10.2y) and the Health and Retirement Study (n = 16,883, 9810 women, 66.9 ± 10.3y), including data from seven waves of each cohort between 2006 and 2018/2019. Depressive symptoms were assessed using the Centre of Epidemiological Studies Depression scale, while chronic pain was estimated using questions about the frequency of being troubled with pain. We used random-intercept cross-lagged panel models to assess the bidirectional association between pain and depressive symptoms, adjusting for potential confounders. RESULTS: There was a cross-lagged effect of chronic pain on depressive symptoms (ELSA: ß: 0.038; 95%CI: 0.011-0.066. Standardized coefficient (B): 0.021. SHARE: ß: 0.044; 95%CI: 0.023-0.065. B: 0.023-0.024) as well as depressive symptoms on pain (ELSA: ß: 0.010; 95%CI: 0.002-0.018. B: 0.017-0.019. SHARE: 0.011; 95%CI: 0.005-0.017. B: 0.020-0.021). Moreover, there were auto-regressive effects of both chronic pain (ELSA: ß: 0.149; 95%CI: 0.128-0.171. SHARE: ß: 0.129; 95%CI: 0.112-0.145) and depressive symptoms (ELSA: ß: 0.149; 95%CI: 0.130-0.168. SHARE: ß: 0.169; 95%CI: 0.154-0.184). CONCLUSION: We identified a modest bidirectional association between depressive symptoms and chronic pain, using two large prospective ageing cohorts.
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Dor Crônica , Depressão , Humanos , Feminino , Dor Crônica/epidemiologia , Masculino , Depressão/epidemiologia , Pessoa de Meia-Idade , Idoso , Estudos Longitudinais , Estudos Prospectivos , Inglaterra/epidemiologia , Envelhecimento , Idoso de 80 Anos ou maisRESUMO
AIM: Although diabetes is a risk factor for walking speed decline in older adults, it remains unclear how glycaemic control [assessed by glycated haemoglobin (HbA1c)] might affect the long-term trajectories of walking speed. We investigated whether the glycaemic control status accelerates the walking speed decline and whether this decline differs depending on previous mobility conditions. MATERIALS AND METHODS: In total, 3202 individuals aged ≥60 years from the English Longitudinal Study of Ageing (ELSA) were classified at baseline and after 4 and 8 years of follow-up according to glycaemic control status as 'without diabetes' (no self-reported diabetes and HbA1c <6.5%), 'good glycaemic control' (self-reported diabetes and HbA1c ≥6.5% and <7.0%) and 'poor glycaemic control' (PGC) (self-reported diabetes and HbA1c ≥7.0%). The generalized linear mixed models verified the walking speed trajectories in m/s. A second analysis was performed, including only participants without slowness at baseline (>0.8 m/s). RESULTS: Compared with the status 'without diabetes', the annual walking speed decline was -0.015 m/s for PGC and -0.011 m/s for good glycaemic control, totalling -0.160 and -0.130 m/s, respectively, over 8 years. Among those without slowness at baseline, only PGC had a significant walking speed decline, corresponding to -0.014 m/s per year and -0.222 m/s over 8 years. CONCLUSIONS: Poor glycaemic control is a discriminator of walking speed decline in older adults, regardless of previous mobility conditions. It may serve as an early screening tool for those at risk of decreased functional performance later in life.
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Envelhecimento , Hemoglobinas Glicadas , Controle Glicêmico , Velocidade de Caminhada , Humanos , Idoso , Masculino , Feminino , Estudos Longitudinais , Velocidade de Caminhada/fisiologia , Pessoa de Meia-Idade , Inglaterra/epidemiologia , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Envelhecimento/fisiologia , Fatores de Risco , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Glicemia/metabolismo , Glicemia/análise , Idoso de 80 Anos ou mais , Caminhada/fisiologia , Limitação da MobilidadeRESUMO
In response to escalating cases of serogroup W (MenW) invasive meningococcal disease (IMD), multiple countries introduced quadrivalent conjugate MenACWY vaccines into their national immunization programs (NIPs). Here, we summarize the real-world impact and vaccine effectiveness (VE) data of MenACWY-TT from Chile, England, the Netherlands, and Australia. Incidence rate reductions (IRRs) and VE from baseline to post-NIP period were extracted from publications or calculated. After the administration of a single dose of MenACWY-TT, substantial IRRs of MenCWY were observed across the countries in vaccine-eligible age groups (83%-85%) and via indirect protection in non-vaccine-eligible age groups (45%-53%). The impact of MenACWY-TT was primarily driven by MenW IRRs, as seen in vaccine-eligible age groups (65%-92%) and non-vaccine-eligible age groups (41%-57%). VE against MenW was reported in vaccine-eligible toddlers (92%) in the Netherlands and in vaccine-eligible adolescents/young adults (94%) in England. These real-world data support the implementation and continued use of MenACWY-TT in NIPs.
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Infecções Meningocócicas , Adolescente , Adulto Jovem , Humanos , Austrália/epidemiologia , Inglaterra , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/prevenção & controle , Países Baixos/epidemiologia , Vacinas CombinadasRESUMO
This article describes a seventeenth-century English woman writer's interests in medical care and the reasons that led her to publish texts on this topic. Hannah Woolley offered guidance on a wide variety of topics in the domestic sphere, including recipes for health and beauty. Here we investigate the principles that governed the preparation of these recipes, Woolley's intentions in writing on this topic, and the way in which academic medicine was translated and practiced by women routinely during this period. Defining these issues will help shed light on the scenario in which literate female healers worked and the nature of their relationships with learned physicians.
O artigo retrata os interesses de uma escritora inglesa do século XVII sobre cuidados médicos, e as razões que a levaram a publicar textos sobre essa matéria. Hannah Woolley tecia orientações sobre diversos assuntos do âmbito doméstico, entre os quais receitas para preservar a beleza e a saúde. O artigo investiga os princípios que regiam o preparo dessas receitas, as intenções de Woolley ao escrever sobre o tema, e a maneira como a medicina acadêmica era traduzida e praticada por mulheres no cotidiano da época. O delineamento dessas questões ajudará a elucidar o cenário de atuação das curadoras letradas e a natureza das relações que teceram com os médicos eruditos.
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Médicos , Humanos , Feminino , InglaterraRESUMO
OBJECTIVES: This study aimed to estimate five harmonized healthy aging indicators covering functional ability and intrinsic capacity among older women and men from Brazil and England and evaluate their association with loneliness. STUDY DESIGN: This was a cross-sectional study. METHODS: We used two nationally representative samples of men and women aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) wave 2 (2019-2021; n = 6929) and the English Longitudinal Study of Aging wave 9 (2018-2019; n = 5902). Healthy aging included five separate indicators (getting dressed, taking medication, managing money, cognitive function, and handgrip strength). Loneliness was measured by the 3-item University of California Loneliness Scale. Logistic regression models stratified by sex and country were performed. RESULTS: Overall, age-adjusted healthy aging indicators were worse in Brazil compared with England for both men and women. Considering functional ability, loneliness was negatively associated with all indicators (ranging from odds ratio [OR] = 0.26, [95% confidence interval (CI) 0.13-0.52] in English men regarding the ability to take medication to OR = 0.49 [95% CI 0.27-0.89] in Brazilian women regarding the ability to manage money). Considering intrinsic capacity, loneliness was negatively associated with a higher cognitive function (OR = 0.72; 95% CI 0.55-0.95 in English women) and a higher handgrip strength (OR = 0.61; 95% CI 0.45-0.83 in Brazilian women). Lonely women demonstrated lower odds of a higher number of healthy aging indicators than men in both countries. CONCLUSIONS: Country-specific social environments should be targeted by public policies to decrease loneliness and promote healthy aging later in life.
Assuntos
Envelhecimento Saudável , Solidão , Humanos , Masculino , Feminino , Idoso , Solidão/psicologia , Estudos Longitudinais , Brasil , Estudos Transversais , Força da Mão , Caracteres Sexuais , InglaterraRESUMO
Pay-for-performance (P4P) has been widely applied in OECD countries to improve the quality of both primary and secondary care, and is increasingly being implemented in low- and middle-income countries. In 2011, Brazil introduced one of the largest P4P schemes in the world, the National Programme for Improving Primary Care Access and Quality (PMAQ). We critically assess the design of PMAQ, drawing on a comparison with England's quality and outcome framework which, like PMAQ, was implemented at scale relatively rapidly within a nationalised health system. A key feature of PMAQ was that payment was based on the performance of primary care teams but rewards were given to municipalities, who had autonomy in how the funds could be used. This meant the incentives felt by family health teams were contingent on municipality decisions on whether to pass the funds on as bonuses and the basis upon which they allocated the funds between and within teams. Compared with England's P4P scheme, performance measurement under PMAQ focused more on structural rather than process quality of care, relied on many more indicators, and was less regular. While PMAQ represented an important new funding stream for primary health care, our review suggests that theoretical incentives generated were unclear and could have been better structured to direct health providers towards improvements in quality of care.
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Qualidade da Assistência à Saúde , Reembolso de Incentivo , Humanos , Brasil , Atenção Primária à Saúde , InglaterraRESUMO
ABSTRACT: Humanity is sporadically subjected to leaders with deviant behavior, ego problems, or psychiatric disorders, potentially leading to social instability. Bipolar disorder is not common in all populations, but, coincidentally, studies suggest that it affected two sovereigns that were contemporaries, King George III of England, who died 201 years ago, and Queen Maria I of Portugal, who died 205 years ago. They lived during a time when Europe was in turmoil with the French Revolution and Napoleonic Wars, which also coincided with the rise of psychiatry. Both monarchs were forced to have prince regents rule in their place, due to their emotional decline, and they shared the same medical consultant, Francis Willis.
Assuntos
Transtorno Bipolar , Pessoas Famosas , Psiquiatria , Humanos , Portugal , InglaterraAssuntos
Política , Opinião Pública , Vacina Antivariólica , Vacinas , Brasil , História do Século XIX , InglaterraRESUMO
Resumo O artigo retrata os interesses de uma escritora inglesa do século XVII sobre cuidados médicos, e as razões que a levaram a publicar textos sobre essa matéria. Hannah Woolley tecia orientações sobre diversos assuntos do âmbito doméstico, entre os quais receitas para preservar a beleza e a saúde. O artigo investiga os princípios que regiam o preparo dessas receitas, as intenções de Woolley ao escrever sobre o tema, e a maneira como a medicina acadêmica era traduzida e praticada por mulheres no cotidiano da época. O delineamento dessas questões ajudará a elucidar o cenário de atuação das curadoras letradas e a natureza das relações que teceram com os médicos eruditos.
Abstract This article describes a seventeenth-century English woman writer's interests in medical care and the reasons that led her to publish texts on this topic. Hannah Woolley offered guidance on a wide variety of topics in the domestic sphere, including recipes for health and beauty. Here we investigate the principles that governed the preparation of these recipes, Woolley's intentions in writing on this topic, and the way in which academic medicine was translated and practiced by women routinely during this period. Defining these issues will help shed light on the scenario in which literate female healers worked and the nature of their relationships with learned physicians.
Assuntos
Mulheres , Cuidados Médicos , Prescrições , História do Século XVII , InglaterraRESUMO
Citation rates can be used as an indicator of the influence and relevance of scientific papers. The present study analyzed the 100 most-cited articles related to erosive tooth wear (ETW). The top 100 most-cited papers focusing on ETW topics were collected from the Web of Science database on November 11, 2020. The following bibliometric data were extracted from papers: title, authorship, institutions, countries, number of citations, year of publication, journal title, study design, topic, and keywords. Scopus and Google Scholar were searched to compare the number of citations. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations of the 100 most-cited papers ranged from 71 to 330 (average: 97.44). The papers were published between 1949 and 2015. Caries Research (28%) and The Journal of Dentistry (16%) presented the majority of papers. Laboratorial (44%) and observational studies (33%) were the most common study designs. The most studied topics were epidemiology (31%) and the erosive potential of substances (drinks, foods, or medicines) (22%). The countries with the highest number of most-cited papers were England (32%), Germany (18%), and Switzerland (10%). The University of Bern was the institution with the most papers (10%). Lussi A was the author with the highest number of papers in the top 100 (14%). The most common keyword was "dental erosion" with 64 occurrences. The top 100 most-cited papers related to ETW were composed mainly of laboratorial and observational studies focusing on epidemiology and the erosive potential of substances.
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Bibliometria , Desgaste dos Dentes , Inglaterra , Alemanha , Humanos , Projetos de PesquisaRESUMO
BACKGROUND: Systems thinking is integral to working effectively within complex systems, such as those which drive the current population levels of overweight and obesity. It is increasingly recognised that a systems approach - which corrals public, private, voluntary and community sector organisations to make their actions and efforts coherent - is necessary to address the complex drivers of obesity. Identifying, implementing and evaluating actions within complex adaptive systems is challenging, and may differ from previous approaches used in public health. METHODS: Within this conceptual article, we present the Action Scales Model (ASM). The ASM is a simple tool to help policymakers, practitioners and evaluators to conceptualise, identify and appraise actions within complex adaptive systems. We developed this model using our collective expertise and experience in working with local government authority stakeholders on the Public Health England Whole Systems Obesity programme. It aligns with, and expands upon, previous models such as the Intervention Level Framework, the Iceberg Model and Donella Meadows' 12 places to intervene within a system. RESULTS: The ASM describes four levels (synonymous with leverage points) to intervene within a system, with deeper levels providing greater potential for changing how the system functions. Levels include events, structures, goals and beliefs. We also present how the ASM can be used to support practice and policy, and finish by highlighting its utility as an evaluative aid. DISCUSSION: This practical tool was designed to support those working at the front line of systems change efforts, and while we use the population prevalence of obesity as an outcome of a complex adaptive system, the ASM and the associated principles can be applied to other issues. We hope that the ASM encourages people to think differently about the systems that they work within and to identify new and potentially more impactful opportunities to leverage change.
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Organizações , Saúde Pública , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , InglaterraAssuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Transmissão de Doença Infecciosa/prevenção & controle , SARS-CoV-2 , COVID-19/transmissão , Vacina BNT162 , ChAdOx1 nCoV-19 , Estudos Retrospectivos , Carga Viral , Inglaterra , Estudos Observacionais como Assunto , Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , COVID-19/virologiaRESUMO
Decisions need to be made about which services or technologies should be prioritized for provision in the NHS in England .The analysis focuses specifically on the National Institute for Health and Care Excellence (NICE), and on how they appraise expensive medicines. This analysis takes a sociological perspective on decision-making in relation to uncertainty and how uncertainties are managed, drawing on evidence from a scoping study and an ethnographic study. Uncertainties were central to these rationing decisions. Three types of layers of uncertainty -epistemic, procedural and interpersonal - were shown to be salient. Another form of uncertainty was associated with the complexity of the science and that included the level of technicality of the information provided. The analysis highlighted the salience of uncertainties associated with interpersonal relations and the relations between the committees and the drug industry, clinical and patient experts. A key element in these relationships was trust. Decision makers adopted a mixture of formal and informal, collective and individual strategies in making decisions and a need to exercise pragmatism within a more formal institutional framework. The paper concludes by considering more recent policy developments in relation to appraising expensive medicines.
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Indústria Farmacêutica , Formulação de Políticas , Antropologia Cultural , Análise Custo-Benefício , Tomada de Decisões , Inglaterra , Humanos , IncertezaRESUMO
The world's largest ammonite, Parapuzosia (P.) seppenradensis (Landois, 1895), fascinated the world ever since the discovery, in 1895, of a specimen of 1.74 metres (m) diameter near Seppenrade in Westfalia, Germany, but subsequent findings of the taxon are exceedingly rare and its systematic position remains enigmatic. Here we revise the historical specimens and document abundant new material from England and Mexico. Our study comprises 154 specimens of large (< 1 m diameter) to giant (> 1m diameter) Parapuzosia from the Santonian and lower Campanian, mostly with stratigraphic information. High-resolution integrated stratigraphy allows for precise cross-Atlantic correlation of the occurrences. Our specimens were analysed regarding morphometry, growth stages and stratigraphic occurrence wherever possible. Our analysis provides insight into the ontogeny of Parapuzosia (P.) seppenradensis and into the evolution of this species from its potential ancestor P. (P.) leptophylla Sharpe, 1857. The latter grew to shell diameters of about 1 m and was restricted to Europe in the early Santonian, but it reached the Gulf of Mexico during the late Santonian. P. (P.) seppenradensis first appears in the uppermost Santonian- earliest Campanian on both sides of the Atlantic. Initially, it also reached diameters of about 1 m, but gradual evolutionary increase in size is seen in the middle early Campanian to diameters of 1.5 to 1.8 m. P. (P.) seppenradensis is characterized by five ontogenetic growth stages and by size dimorphism. We therefore here include the many historic species names used in the past to describe the morphological and size variability of the taxon. The concentration of adult shells in small geographic areas and scarcity of Parapuzosia in nearby coeval outcrop regions may point to a monocyclic, possibly even semelparous reproduction strategy in this giant cephalopod. Its gigantism exceeds a general trend of size increase in late Cretaceous cephalopods. Whether the coeval increase in size of mosasaurs, the top predators in Cretaceous seas, caused ecological pressure on Parapuzosia towards larger diameters remains unclear.