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1.
Neurosurg Rev ; 46(1): 290, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37910275

RESUMO

Neurosurgical pathologies in pregnancy pose significant complications for the patient and fetus, and physiological stressors during anesthesia and surgery may lead to maternal and fetal complications. Awake craniotomy (AC) can preserve neurological functions while reducing exposure to anesthetic medications. We reviewed the literature investigating AC during pregnancy. PubMed, Scopus, and Web of Science databases were searched from the inception to February 7th, 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Studies in English investigating AC in pregnant patients were included in the final analysis. Nine studies composed of nine pregnant patients and ten fetuses (one twin-gestating patient) were included. Glioma was the most common pathology reported in six (66.7%) patients. The frontal lobe was the most involved region (4 cases, 44.4%), followed by the frontoparietal region (2 cases, 22.2%). The awake-awake-awake approach was the most common protocol in seven (77.8%) studies. The shortest operation time was two hours, whereas the longest one was eight hours and 29 min. The mean gestational age at diagnosis was 13.6 ± 6.5 (2-22) and 19.6 ± 6.9 (9-30) weeks at craniotomy. Seven (77.8%) studies employed intraoperative fetal heart rate monitoring. None of the AC procedures was converted to general anesthesia. Ten healthy babies were delivered from patients who underwent AC. In experienced hands, AC for resection of cranial lesions of eloquent areas in pregnant patients is safe and feasible and does not alter the pregnancy outcome.


Assuntos
Neoplasias Encefálicas , Glioma , Feminino , Humanos , Gravidez , Neoplasias Encefálicas/cirurgia , Vigília/fisiologia , Craniotomia/métodos , Glioma/cirurgia , Anestesia Geral
2.
BMC Geriatr ; 22(1): 222, 2022 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-35300602

RESUMO

BACKGROUND: Over the past two decades, prescription medication use for pain and depression increased dramatically. Most studies consider the early life course, despite a similar increase among those in later life. In this paper, we examine whether and how later life transitions may relate to changes in medication use. METHODS: We draw on data from the Health and Retirement Study and fixed-effects models to examine whether work, family, and civic transitions in later life are related to changes in the usage of prescription pain and depression medication. RESULTS: Results show that individuals had higher odds of regularly using prescription pain and depression medications in periods when out of the labor market. Higher odds of depression medication use were also associated with periods of widowhood, and lower odds of use when frequently volunteering. Such relations persist adjusting for reported levels of pain and depression. CONCLUSION: Our findings call attention to the importance of social ties and the presence of actors that may regulate health behaviors, as well as a change in social context, that may shape medication use in later life.


Assuntos
Depressão , Medicamentos sob Prescrição , Depressão/tratamento farmacológico , Depressão/epidemiologia , Humanos , Dor/tratamento farmacológico , Dor/epidemiologia , Medicamentos sob Prescrição/uso terapêutico , Prescrições , Aposentadoria
3.
Epilepsia ; 62(7): 1559-1568, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34060082

RESUMO

OBJECTIVE: Previous positron emission tomography (PET) studies using [11 C]ABP688 show reduced metabotropic glutamate receptor type 5 (mGluR5) allosteric binding site availability in the epileptogenic hippocampus of mesial temporal lobe epilepsy (MTLE) patients. However, the link between mGluR5 abnormalities and postsurgical outcomes remains unclear. Here, we test whether reduced PET [11 C]ABP688 binding in cornu ammonis (CA) sectors more vulnerable to glutamatergic excitotoxicity relates to surgical outcomes. METHODS: We obtained magnetic resonance imaging (MRI) and [11 C]ABP688-PET from 31 unilateral MTLE patients and 30 healthy controls. MRI hippocampal subfields were segmented using FreeSurfer. To respect the lower PET special resolution, MRI-derived anatomical subfields were combined into CA1-3, CA4/dentate gyrus, and Subiculum. Partial volume corrected [11 C]ABP688 nondisplaceable binding potential (BPND ) values were averaged across each subfield, and Z-scores were calculated. Subfield [11 C]ABP688-BPND was compared between seizure-free and non-seizure-free patients. In addition, we also assessed subfield volumes and [18 F]fluorodeoxyglucose (FDG) uptake in each clinical group. RESULTS: MTLE [11 C]ABP688-BPND was reduced in ipsilateral (epileptogenic) CA1-3 and CA4/dentate-gyrus (p < .001, 95% confidence interval [CI] = .29-.51) compared to controls, with no difference in Subiculum. [11 C]ABP688-BPND and subfield volumes were compared between seizure-free (Engel IA, n = 13) and non-seizure-free patients (Engel IC-III, n = 10). In ipsilateral CA1-3 only, [11 C]ABP688-BPND was lower in seizure-free patients than in non-seizure-free patients (p = .012, 95% CI = 1.46-11.0) independently of volume. A subset analysis of 12 patients with [11 C]ABP688-PET+[18 F]FDG-PET showed no between-group significant difference in [18 F]FDG uptake, whereas CA1-3 [11 C]ABP688-BPND remained significantly lower in the seven of 12 seizure-free patients (p = .03, 95% CI = -3.13 to -.21). SIGNIFICANCE: Reduced mGluR5 allosteric site availability in hippocampal CA1-3, measured in vivo by [11 C]ABP688-PET, is associated with postsurgery seizure freedom independent of atrophy or hypometabolism. Information derived from hippocampal CA1-3 [11 C]ABP688-PET is a promising imaging biomarker potentially impactful in surgical decisions for MRI-negative/PET-negative MTLE patients.


Assuntos
Epilepsia do Lobo Temporal/genética , Epilepsia do Lobo Temporal/cirurgia , Ácido Glutâmico/genética , Hipocampo/metabolismo , Procedimentos Neurocirúrgicos , Receptores de Ácido Caínico/genética , Adolescente , Adulto , Idoso , Região CA1 Hipocampal/metabolismo , Região CA3 Hipocampal , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Oximas , Tomografia por Emissão de Pósitrons , Piridinas , Compostos Radiofarmacêuticos , Receptores de Ácido Caínico/metabolismo , Resultado do Tratamento , Adulto Jovem
4.
Ann Neurol ; 85(2): 218-228, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30597619

RESUMO

OBJECTIVE: Surgical specimens from patients with mesial temporal lobe epilepsy (MTLE) show abnormalities in tissue concentrations of metabotropic glutamate receptor type 5 (mGluR5). To clarify whether these abnormalities are specific to the epileptogenic zone (EZ), we characterized in vivo whole-brain mGluR5 availability in MTLE patients using positron emission tomography (PET) and [11 C]ABP688, a radioligand that binds specifically to the mGluR5 allosteric site. METHODS: Thirty-one unilateral MTLE patients and 30 healthy controls underwent [11 C]ABP688 PET. We compared partial volume corrected [11 C]ABP688 nondisplaceable binding potentials (BPND ) between groups using region-of-interest and whole-brain voxelwise analyses. [18 F]Fluorodeoxyglucose (FDG) PET was acquired in 15 patients, for whom we calculated asymmetry indices of [11 C]ABP688 BPND and [18 F]FDG uptake to compare lateralization and localization differences. RESULTS: [11 C]ABP688 BPND was focally reduced in the epileptogenic hippocampal head and amygdala (p < 0.001). Patients with hippocampal atrophy showed more extensive abnormalities, including the ipsilateral temporal neocortex (p = 0.006). [11 C]ABP688 BPND showed interhemispheric differences of higher magnitude and discriminated the epileptogenic structures more accurately when compared to [18 F]FDG uptake, which showed more widespread hypometabolism. Among 23 of 25 operated patients with >1 year of follow-up, 13 were seizure-free (Engel Ia) and showed significantly lower [11 C]ABP688 BPND in the ipsilateral entorhinal cortex. INTERPRETATION: [11 C]ABP688 PET provides a focal biomarker for the EZ in MTLE with higher spatial accuracy compared to [18 F]FDG PET. Focally reduced mGluR5 availability in the EZ might reflect receptor internalization or conformational changes in response to excessive extracellular glutamate, supporting a potential role for mGluR5 as therapeutic target in human MTLE. Ann Neurol 2019; 1-11 ANN NEUROL 2019;85:218-228.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/metabolismo , Receptor de Glutamato Metabotrópico 5/metabolismo , Adolescente , Adulto , Idoso , Radioisótopos de Carbono/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oximas/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Piridinas/metabolismo , Adulto Jovem
5.
Sociol Q ; 56(3): 558-580, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26190868

RESUMO

Most existing research theorizes individual factors as predictors of perceived job insecurity. Incorporating contextual and organizational factors at an information technology organization where a merger was announced during data collection, we draw on status expectations and crossover theories to investigate whether managers' characteristics and insecurity shape their employees' job insecurity. We find having an Asian as opposed to a White manager is associated with lower job insecurity, while managers' own insecurity positively predicts employees' insecurity. Also contingent on the organizational climate, managers' own tenure buffers, and managers' perceived job insecurity magnifies insecurity of employees interviewed after a merger announcement, further specifying status expectations theory by considering context.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39041598

RESUMO

OBJECTIVES: This study examines how older adults' (65 years old plus) daily activities shifted in the years around the coronavirus disease (COVID) pandemic. METHODS: Using data from American Time Use Survey, this study compares activities across the pre-pandemic (2019 to March 2020), early-pandemic (May to December 2020), and pandemic-normal (2021) periods. RESULTS: In the first year of the pandemic, there was less time spent on average on leisure outside the home, traveling, and with nonhousehold members, and more time alone and at home, compared with before the pandemic. Moving beyond averages, sequence and cluster analyses find 5 similar typologies of days across the three periods, characterized by days predominated by (a) housework, (b) leisure at home, (c) TV, (d) a combination of leisure at home and outside with TV, and (e) paid work. Duration of time across various daily activities differed, however, even for the same clusters. For example, in days predominated by indoor leisure, adults spent 405 min in this activity before the pandemic, 432 min during the early-pandemic period, and 549 min during the pandemic-normal period. We also observed changes in the proportion of older adults in each cluster. Across the pre-pandemic and early-pandemic periods, the proportion of days predominated by leisure at home increased (9.9%-17.9%) whereas the proportion belonging to days predominated by housework decreased (45.7%-17.6%). DISCUSSION: COVID-19 shifted the daily life of older adults, and our findings are consistent with selection, optimization, and compensation theory, documenting that older adult adapted across the first 2 years of the pandemic.


Assuntos
Atividades Cotidianas , COVID-19 , Atividades de Lazer , Humanos , COVID-19/epidemiologia , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Estados Unidos/epidemiologia
7.
Neurology ; 103(3): e209528, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39008785

RESUMO

BACKGROUND AND OBJECTIVES: Neuroimaging studies in patients with temporal lobe epilepsy (TLE) show widespread brain network alterations beyond the mesiotemporal lobe. Despite the critical role of the cerebrovascular system in maintaining whole-brain structure and function, changes in cerebral blood flow (CBF) remain incompletely understood in the disease. Here, we studied whole-brain perfusion and vascular network alterations in TLE and assessed its associations with gray and white matter compromises and various clinical variables. METHODS: We included individuals with and without pharmaco-resistant TLE who underwent multimodal 3T MRI, including arterial spin labelling, structural, and diffusion-weighted imaging. Using surface-based MRI mapping, we generated individualized cortico-subcortical profiles of perfusion, morphology, and microstructure. Linear models compared regional CBF in patients with controls and related alterations to morphological and microstructural metrics. We further probed interregional vascular networks in TLE, using graph theoretical CBF covariance analysis. The effects of disease duration were explored to better understand the progressive changes in perfusion. We assessed the utility of perfusion in separating patients with TLE from controls using supervised machine learning. RESULTS: Compared with control participants (n = 38; mean ± SD age 34.8 ± 9.3 years; 20 females), patients with TLE (n = 24; mean ± SD age 35.8 ± 10.6 years; 12 females) showed widespread CBF reductions predominantly in fronto-temporal regions (Cohen d -0.69, 95% CI -1.21 to -0.16), consistent in a subgroup of patients who remained seizure-free after surgical resection of the seizure focus. Parallel structural profiling and network-based models showed that cerebral hypoperfusion may be partially constrained by gray and white matter changes (8.11% reduction in Cohen d) and topologically segregated from whole-brain perfusion networks (area under the curve -0.17, p < 0.05). Negative effects of progressive disease duration further targeted regional CBF profiles in patients (r = -0.54, 95% CI -0.77 to -0.16). Perfusion-derived classifiers discriminated patients from controls with high accuracy (71% [70%-82%]). Findings were robust when controlling for several methodological confounds. DISCUSSION: Our multimodal findings provide insights into vascular contributions to TLE pathophysiology affecting and extending beyond mesiotemporal structures and highlight their clinical potential in epilepsy diagnosis. As our work was cross-sectional and based on a single site, it motivates future longitudinal studies to confirm progressive effects, ideally in a multicentric setting.


Assuntos
Circulação Cerebrovascular , Epilepsia do Lobo Temporal , Substância Cinzenta , Substância Branca , Humanos , Epilepsia do Lobo Temporal/fisiopatologia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Masculino , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Substância Branca/irrigação sanguínea , Adulto , Circulação Cerebrovascular/fisiologia , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/irrigação sanguínea , Substância Cinzenta/patologia , Substância Cinzenta/fisiopatologia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Imagem de Difusão por Ressonância Magnética , Aprendizado de Máquina Supervisionado , Adulto Jovem , Epilepsia Resistente a Medicamentos/fisiopatologia , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/patologia
8.
Work Occup ; 40(2): 79-114, 2013 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-24039337

RESUMO

How are professionals responding to the time strains brought on by the stress of their higher status jobs? Qualitative data from professionals reveal (a) general acceptance of the emerging temporal organization of professional work, including rising time demands and blurred boundaries around work/ nonwork times and places, and (b) time work as strategic responses to work intensification, overloads, and boundarylessness. We detected four time-work strategies: prioritizing time, scaling back obligations, blocking out time, and time shifting of obligations. These strategies are often more work-friendly than family-friendly, but "blocking out time" and "time shifting" suggest promising avenues for work-time policy and practice.

9.
Gerontologist ; 63(2): 328-337, 2023 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-35452512

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this study is to contribute to the literature on variation in later-life outcomes by sexual identity. Drawing on the Iridescent Life Course framework, we examined differences in loneliness trajectories, and tested the roles of social connectedness and support, and socioeconomic and health statuses in explaining any observed disparities. RESEARCH DESIGN AND METHODS: Using growth models, we analyzed 19 years of data (2001-2019) from adults aged 50 years and older from the Household, Income and Labour Dynamics in Australia Survey (n = 5,500 individuals), where a question on sexual identity was asked twice in the study. RESULTS: One percent of our sample reported a change in their sexual identity, which we grouped with individuals who reported as bisexual. Our sample comprised of 45.3% heterosexual men, 52.2% heterosexual women, 0.6% gay men, 0.6% lesbian women, 0.6% bisexual-plus men, and 0.6% bisexual-plus women. We found bisexual-plus men were vulnerable to loneliness as they aged. This group had the highest levels of loneliness at age 50, and differences compared with heterosexual men persisted over time. Loneliness of bisexual-plus men increased steeply from age 70. Socioeconomic and health statuses did not explain the increased loneliness of older bisexual-plus men. Lower social support and connectedness partly accounted for these disparities. DISCUSSION AND IMPLICATIONS: Findings are discussed with regards to existing research and theories on social disadvantage and resilience over the life course. We expand knowledge on factors explaining loneliness and how it varies in women and men by sexual identity.


Assuntos
Homossexualidade Feminina , Minorias Sexuais e de Gênero , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Solidão , Bissexualidade , Comportamento Sexual
10.
Res Aging ; 45(2): 239-254, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35579594

RESUMO

Loneliness among older adults has been a topic of interest in recent years. We analyse four waves of data from the Australian Longitudinal Study on Women's Health. We estimate growth models to examine differences in loneliness trajectories from age 50 for women who identify as exclusively heterosexual, plurisexual (bisexual, mainly heterosexual, mainly lesbian) and exclusively lesbian. We find no significant differences in levels of loneliness across sexual identity groups at age 50. We find that while loneliness trajectories of exclusively heterosexual women trend down, levels of loneliness increase with age among plurisexual women. Adverse health events and relationship problems increase loneliness to a greater extent among plurisexual women compared to exclusively heterosexual and exclusively lesbian women. Our results suggest older lesbian women may have accumulated social or personal resources or developed coping mechanisms over the courses of their lives, while plurisexual women remain a vulnerable group.


Assuntos
Solidão , Minorias Sexuais e de Gênero , Feminino , Humanos , Idoso , Estudos Longitudinais , Austrália , Heterossexualidade , Bissexualidade
11.
J Appl Gerontol ; 42(4): 581-588, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36476078

RESUMO

We examine how changes in home care work, with greater emphasis on social support, have led to corresponding changes in the forms of labor performed by home care workers. Drawing on interviews with fifty older adults, we find in addition to physical and emotional labor, workers may be increasingly expected to engage in a form of labor we term "social labor," in which they actively manage the boundary between the professional services they provide and the personal relationships that may develop. We find examples of such expectations include (1) following the lead of clients who set out terms of the relationship and degree of sociality, (2) managing the potential dual role of "support worker" and "friend," and (3) meeting social needs of clients vulnerable to isolation. As Government acknowledges the value of social support and companionship, greater attention is needed to this aspect of care work, with implications for workers and clients.


Assuntos
Cuidadores , Serviços de Assistência Domiciliar , Humanos , Idoso , Cuidadores/psicologia , Amigos , Apoio Social , Emoções
12.
J Gerontol B Psychol Sci Soc Sci ; 78(4): 730-735, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36691876

RESUMO

OBJECTIVES: Both loneliness and the use of psychotropic drugs are common in later life. Although loneliness has been found to be associated with psychotropic drug use, most studies have been cross-sectional, and we know less about their longitudinal associations. METHODS: Drawing on five waves of data from the Health and Retirement Study and two statistical approaches (fixed-effects and cross-lagged panel models), we examine longitudinal associations between loneliness and the use of prescription pain and depression/anxiety medications. RESULTS: Across 57,654 observations among 20,589 respondents, 22.8% reported regular use of pain prescription medications, 17.8% regular use of depression/anxiety prescription medication, and 15.6% feeling lonely in the past week. Loneliness and the use of depression/anxiety medications were associated according to both modeling approaches, net of covariates. In years when a respondent reported feeling lonely, the odds of regular use of depression/anxiety medications were 1.42 times higher (p < .001) than in years when they did not feel lonely. Regarding reciprocation, odds of regular depression/anxiety medication use in a given wave range from 1.3 to 1.5 times higher if loneliness was reported in the prior wave. Likewise, the odds of reporting loneliness in a given wave range from 1.5 to 1.8 times higher if regular depression/anxiety medication was reported in the prior wave. DISCUSSION: Prior loneliness predicts contemporaneous regular use of depression/anxiety prescription medications. Although this confirms the directional association found in prior studies, we found prior use of depression/anxiety medications is also associated with increased odds of loneliness, suggesting further research is needed to understand mechanisms that explain their associations and potential interventions.


Assuntos
Depressão , Solidão , Humanos , Depressão/tratamento farmacológico , Depressão/epidemiologia , Estudos Transversais , Prescrições , Dor , Estudos Longitudinais
13.
J Aging Stud ; 64: 101097, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36868610

RESUMO

This paper examines the relationship between characteristics of older adults' networks and loneliness. Drawing on a mixed-methods study with primary data from 165 surveys and a subset of 50 in-depth interviews from the broader sample, we examine whether and how strong and weak ties in an individual's network provide different forms of support in buffering loneliness. Regression models demonstrate that a higher frequency of contacts with strong ties, rather than the number of strong ties, is associated with lower levels of loneliness. In contrast, a greater number of weak ties is related to lower levels of loneliness. Our qualitative interview data shows that strong ties are susceptible to relationship loss, geographic distances, or relationship conflict. A greater number of weak ties, on the other hand, increases the likelihood of support and engagement when needed, reciprocity of relationships, and access to new social groups and networks. Previous research has focused on the complementary forms of support provided by strong and weak ties. Our study shows the different forms of support provided by strong and weak ties, underscoring the importance of a diverse social network for reducing loneliness. Our study also highlights the role of network changes in later life and social tie availability as important factors that contribute to understanding how social ties operate to combat loneliness.


Assuntos
Confiabilidade dos Dados , Solidão , Humanos , Idoso , Grupo Social
14.
J Gerontol B Psychol Sci Soc Sci ; 77(11): 2113-2125, 2022 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34888639

RESUMO

OBJECTIVES: Loneliness is an important concern for older adults. Studies have linked demographic characteristics with loneliness, showing that it varies by ethnic and migrant statuses in countries in Europe and North America. Characteristics of the physical environment in which older adults are embedded have also received some attention, though prior studies have not fully investigated whether older adults from different ethnic-migrant backgrounds may report variation in loneliness because of characteristics of, or satisfaction with, their neighborhoods, which may shape their social interactions. METHODS: Drawing on up to 4 waves of data from the Household, Income, and Labour Dynamics in Australia Surveys and random-effects models, I examine whether loneliness differs across ethnic/migrant groups in the Australian context. Furthermore, I examine whether neighborhood characteristics (its conditions and sociality) and satisfaction with the neighborhood (with its safety, with the neighborhood itself, and with "feeling part of the local community") may be mediators for the association between ethnic-migrant status and loneliness. RESULTS: Findings show migrants from non-English-speaking countries report higher levels of loneliness, as compared with native-born, non-Indigenous Australians. More favorable neighborhood characteristics and higher levels of satisfaction with different aspects of the neighborhood are consistently associated with lower levels of loneliness. Neighborhood sociality and satisfaction with aspects of the neighborhood partially mediated the association between ethnicity status and loneliness for migrants from non-English-speaking countries. DISCUSSION: This study showed loneliness differs across older Australians of different ethnic and migrant backgrounds. It also showed how loneliness differences are explained by different mechanisms.


Assuntos
Migrantes , Humanos , Idoso , Etnicidade , Satisfação Pessoal , Solidão , Características da Vizinhança , Austrália , Características de Residência
15.
J Appl Gerontol ; 41(11): 2382-2391, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35801368

RESUMO

Objective: To examine characteristics of the built environment and investigate associations with loneliness among older adults. Methods: Drawing on geocoded data from the Household, Income and Labour Dynamics in Australia Survey and measures of neighborhood features retrieved from multiple publicly available sources, we conducted principal component and regression analyses to examine the associations between characteristics of the built environment and loneliness among older adults in South East Queensland, Australia. Results: Older adults living in compact neighborhoods with higher population and housing density, smaller land parcels, and more access to green space reported lower levels of loneliness. Compact and mixed land-use neighborhoods may increase people's exposure to and social interactions with surrounding people and the environment. Conclusion: The built environment provides the context for social interactions. Our study and findings inform research and suggest the development of interventions surrounding the built environment that could potentially help tackle loneliness in older adults.


Assuntos
Solidão , Características de Residência , Idoso , Ambiente Construído , Planejamento Ambiental , Humanos , Queensland , Inquéritos e Questionários
16.
Eur J Health Econ ; 23(3): 511-535, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34529152

RESUMO

Social support is increasingly acknowledged as an important resource for promoting well-being. We test whether social support changes around retirement. We also examine whether social support moderates dynamics in mental well-being around retirement and consider both own and spouse's retirement drawing on a unique longitudinal, couple-level data set from Australia. We observe descriptively no effect of own or spouse's retirement on social support. However, those with high social support do experience a small but statistically significant improvement in mental well-being post retirement. Using pension eligibility as an instrument, we find that own retirement causally improves mental well-being for women and by a similar degree for those with low/high social support. We also estimate responses to life satisfaction and find evidence that spill-over benefits from spousal retirement are larger for individuals with low social support.


Assuntos
Pensões , Aposentadoria , Austrália , Feminino , Humanos , Saúde Mental , Apoio Social
17.
Adv Life Course Res ; 51: 100446, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-36652309

RESUMO

Young motherhood is often framed as detrimental to the life chances of young women with research showing negative impacts on education and labor market outcomes. At the same time, qualitative research reports narratives of motherhood as a transformative experience, providing motivation for a fresh start and moving young women away from previously unstable life pathways. These scenarios appear contradictory, however outcomes might vary for different groups of women depending on their pre-birth trajectories. We investigate the effects of early parenthood using the Household, Income and Labour Dynamics in Australia (HILDA) survey. We employ a sequence based approach to compare labor market- and educational precarity of young mothers and non-parenting peers. We employ a novel sequence matching technique creating a comparison group of non-parenting young women, based on similarities in early labor market trajectories. We find that young mothers have higher levels of precarity in their pre-birth trajectories. Moreover, our results show that becoming a young mother is connected to an average increase in labor market and educational precarity post birth, which supports the hypothesis of cumulative disadvantage. However, only mothers with the least precarious trajectories prior to birth experience this development, whereas young women already on highly precarious paths see a decrease in precarity over time. Although our results do not support cumulative disadvantage for the most disadvantaged women, neither does it support the idea of parenthood as a transformative event. Our results point to the importance of understanding heterogeneity in the outcomes of young mothers.


Assuntos
Características da Família , Mães , Gravidez , Feminino , Humanos , Escolaridade , Emprego , Parto
18.
J Clin Neurosci ; 98: 254-260, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35247707

RESUMO

BACKGROUND: Cerebral venous sinus thrombosis (CSVT) is a rare condition, causing 0.5% of all strokes only, several mechanisms might be involved in forming the thrombosis, including closed head injury. METHODS: Systematic review was done by using the following databases: PubMed, Google Scholar, Microsoft Academic, Clinical Trials, Cochrane Library, and Web of Science. RESULTS: 25 articles met our criteria out of 152 articles, average and standard deviation of the age was 38.2 ± 16.8 years with an age range of 18-82. The majority of cases presented with loss of consciousness or decreased GCS (41%), followed by headache (26%), scalp abrasions/lacerations (21%), paralysis (18%), visual disturbance (18%), nystagmus (15%), and agitation (15%). The most commonly used diagnostic method was angiography. Thrombosis was the most frequently reported radiological finding among all the cases (26/34, 76%). Comparisons of outcomes between patients who underwent surgical intervention and those who did not undergo surgery revealed a significant difference in outcome favoring non-surgical treatment (p < 0.005, odds ratio (OR) 0.04, (95% CI) 0.003 - 0.30). CONCLUSION: Non-surgical outcomes were better than the surgical outcomes. However, no significant difference was seen comparing anti-coagulation versus conservative management (supportive without anticoagulation), single versus multi-sinuses (≥2 sinuses) involvement, and between any of the sinuses involved.


Assuntos
Traumatismos Cranianos Fechados , Trombose dos Seios Intracranianos , Adulto , Cavidades Cranianas , Traumatismos Cranianos Fechados/complicações , Cefaleia/etiologia , Humanos , Pessoa de Meia-Idade , Trombose dos Seios Intracranianos/complicações , Trombose dos Seios Intracranianos/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
19.
Diagnostics (Basel) ; 13(1)2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36611398

RESUMO

This study aimed to assess the accuracy of diagnosis of vertical furcation subclass in molars using periapical radiographs (PAs) and clinical chartings compared against cone-beam computer tomography (CBCT) as the gold standard. The protocol involved examiners with different levels of experience. This retrospective radiographic study retrieved 40 molar teeth with full periodontal chartings, PAs, and CBCT records. Fifteen examiners with different levels of experience evaluated the PAs and periodontal chartings to assess the vertical depth of furcation and, thus, the vertical subclassification. CBCT was used as the gold standard for comparison. The accuracy of vertical furcal depth measured was assessed together with the accuracy of vertical subclassification assignment. The reliability of the conventional diagnostic modality among the examiners was also evaluated. A linear mixed model adjusted for the CBCT vertical furcal depth measurement was constructed to determine if tooth position, horizontal furcation distribution, and examiner experience level affect the bias in the vertical depth of furcation measurement. The reliability of the conventional periodontal diagnostic method in measuring vertical furcal depth was found to be fair, while vertical subclass assignment was moderate. Significantly better reliability during subclass assignment was found with mandibular molars (p < 0.001) and in maxillary molars with isolated buccal class II furcation. Within the study's limitations, conventional periodontal diagnostics based on periapical radiographs and clinical periodontal chartings appear to be in poor to fair agreement with CBCT (gold standard) when measuring the vertical depth of furcation. Examiners with the least experience were more prone to bias when estimating the vertical furcal depth.

20.
J Aging Health ; 33(9): 751-763, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33882727

RESUMO

Objective: To contextualize experiences of activities during the day and investigate whether the contour of the day is correlated with well-being during activities. Methods: Drawing on American Time Use Surveys, we employ sequence and cluster analyses to create distinct typologies of daily life patterns, and bivariate analyses to describe whether well-being across activities varies by these typologies. Results: We identified four typologies characterized by different primary activity of the day: leisure (22.7%), TV (22.4%), housework (47.5%), and work (7.5%). Individuals in the work and leisure clusters tend to report more positive well-being and individuals in the housework and TV clusters tend to report more negative well-being in experiences of activities during the day. We also found that well-being experiences in the same activity differed across individuals in the different typologies. Conclusion: Understanding the daily life patterns of older adults may be important, given its correlation with well-being during activities.


Assuntos
Atividades de Lazer , Idoso , Humanos , Inquéritos e Questionários , Estados Unidos
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