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1.
Front Public Health ; 12: 1419824, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39086810

RESUMO

Introduction: The purpose of the present study was to investigate the impact of the FIT FIRST FOR ALL school-based physical activity program on health-related physical fitness in Faroese schoolchildren. The program aimed to add three weekly sessions of organized high-intensity physical activity to the standard weekly physical education sessions for all pupils across the entire school. Methods: A non-randomized controlled design was used to evaluate the effects of the program. Two schools participated, including one intervention school (INT; n =179) and one control school (CON; n =181), with pupils aged 7-16 years (grades 1-9). The FIT FIRST FOR ALL program consisted of three weekly 40-minute sessions of age-adjusted high-intensity physical activity over 10 weeks for the INT school, while the CON school continued their normal school program. Pre- and post-intervention assessments included cardiorespiratory fitness (Yo-Yo IR1C test), agility (Arrowhead Agility test), postural balance (Stork Stand), standing long jump performance, body composition, blood pressure, and resting heart rate. Results: A significant time × group effect (p < 0.001) was observed for cardiorespiratory fitness, which increased by 31% [23;39] in INT (p < 0.001) and remained unaltered in CON (7% [-2;16], p = 0.13). In addition, a time × group effect (p < 0.001) was observed for agility, which improved by 2.1% [1.0;3.2] in INT (p < 0.001) and regressed by 3.3% [2.3;4.4] in CON (p < 0.001). No significant between-group effects were found for standing long jump and balance. A time × group effect (p < 0.001) was observed for changes in total muscle mass, which increased by 1.4 kg [1.2;1.5] in INT (p < 0.001) and by 0.4 kg [0.3;0.6] in CON (p < 0.05). Furthermore, a time × group effect (p < 0.001) was observed for total fat percentage, which decreased by -2.3% [-2.8;-1.9] in INT (p < 0.001) and remained unchanged in CON (-0.3% [-0.7;0.1], p = 0.16). No significant time × group effects were found for blood pressure and resting heart rate. Discussion: The FIT FIRST FOR ALL program significantly improved cardiorespiratory fitness and agility, and it led to favorable changes in body composition in the intervention school. These findings suggest that the program is highly effective in enhancing physical fitness and health status across all investigated age groups when implemented at a school-wide level.


Assuntos
Composição Corporal , Aptidão Cardiorrespiratória , Exercício Físico , Humanos , Criança , Masculino , Feminino , Aptidão Cardiorrespiratória/fisiologia , Adolescente , Exercício Físico/fisiologia , Instituições Acadêmicas , Educação Física e Treinamento , Promoção da Saúde/métodos , Serviços de Saúde Escolar , Dinamarca , Avaliação de Programas e Projetos de Saúde , Aptidão Física/fisiologia , Frequência Cardíaca/fisiologia
2.
Clin Gerontol ; : 1-10, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38949203

RESUMO

OBJECTIVES: Health-related factors, such as health status, health anxiety, and health literacy, are established contributors to self-efficacy. However, the relationship between electronic health literacy and self-efficacy is less known. The present study examined the role of electronic health literacy in relation to self-efficacy among community-dwelling older adults. METHODS: Cross-sectional survey data were collected in the United States between September 2022 and March 2023. The survey dataset consisted of 191 responses from individuals in the United States who were ages 65 or older. It provided information about survey respondents' sociodemographic status, perceived health status, health anxiety, electronic health literacy, and self-efficacy. Hierarchical linear regression was conducted to analyze the data. RESULTS: Electronic health literacy was positively related to self-efficacy, and health anxiety was negatively related to self-efficacy, with sociodemographic status and perceived health status controlled. CONCLUSIONS: The results indicate that electronic health literacy can be a source of self-efficacy among community-dwelling older adults. CLINICAL IMPLICATIONS: Improving older adults' electronic health literacy may help them maintain self-efficacy, and the improvement should be made, especially in the domains of evaluating health information found on the internet and making decisions based on the information.

3.
Sci Rep ; 14(1): 15036, 2024 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951633

RESUMO

Overly restrictive clinical trial eligibility criteria can reduce generalizability, slow enrollment, and disproportionately exclude historically underrepresented populations. The eligibility criteria for 196 Alzheimer's Disease and Related Dementias (AD/ADRD) trials funded by the National Institute on Aging were analyzed to identify common criteria and their potential to disproportionately exclude participants by race/ethnicity. The trials were categorized by type (48 Phase I/II pharmacological, 7 Phase III/IV pharmacological, 128 non-pharmacological, 7 diagnostic, and 6 neuropsychiatric) and target population (51 AD/ADRD, 58 Mild Cognitive Impairment, 25 at-risk, and 62 cognitively normal). Eligibility criteria were coded into the following categories: Medical, Neurologic, Psychiatric, and Procedural. A literature search was conducted to describe the prevalence of disparities for eligibility criteria for African Americans/Black (AA/B), Hispanic/Latino (H/L), American Indian/Alaska Native (AI/AN) and Native Hawaiian/Pacific Islander (NH/PI) populations. The trials had a median of 15 criteria. The most frequent criterion were age cutoffs (87% of trials), specified neurologic (65%), and psychiatric disorders (61%). Underrepresented groups could be disproportionately excluded by 16 eligibility categories; 42% of trials specified English-speakers only in their criteria. Most trials (82%) contain poorly operationalized criteria (i.e., criteria not well defined that can have multiple interpretations/means of implementation) and criteria that may reduce racial/ethnic enrollment diversity.


Assuntos
Doença de Alzheimer , Ensaios Clínicos como Assunto , Seleção de Pacientes , Humanos , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/diagnóstico , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Definição da Elegibilidade , Etnicidade , National Institute on Aging (U.S.) , Estados Unidos/epidemiologia , Negro ou Afro-Americano , Hispânico ou Latino , Indígena Americano ou Nativo do Alasca , Havaiano Nativo ou Outro Ilhéu do Pacífico
4.
Nagoya J Med Sci ; 86(2): 262-279, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38962421

RESUMO

Despite encouraging multi-generational cohabitation, the population of Japanese people living alone has increased. However, little is known about the association between health and multigenerational cohabitation. This study examined the relationship between self-rated health and living arrangements among Japanese adults using data from the Japan Multi-Institutional Collaborative Cohort Study (2013-2017). The analysis employed multivariate logistic regression to examine the associations. Our results showed no association between living arrangements and self-rated health when stratified by gender. Living alone was found to be associated with poor self-rated health among women aged 65 and above. A similar association may exist among men in the same age group. Among women aged < 65 years, two-generation cohabitation was associated with a good self-rated health, similar to those living alone. Among men aged < 65 years, neither living alone nor two-generation cohabitation was significantly associated with good self-rated health. We found no association between three- or plus-generation cohabitation and self-rated health. Therefore, our findings indicate associations between multigenerational cohabitation and self-rated health, but they vary by gender and age. Invested stakeholders in the public health field should consider the potential impact of living arrangements on health based on gender and age.


Assuntos
Nível de Saúde , Humanos , Feminino , Masculino , Idoso , Japão , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Etários , Características de Residência , Estudos de Coortes , Autorrelato
5.
JMIR Res Protoc ; 13: e58440, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38954809

RESUMO

BACKGROUND: The aging population and increased disability prevalence in Spain have heightened the demand for long-term care. Informal caregiving, primarily performed by women, plays a crucial role in this scenario. This protocol outlines the CUIDAR-SE study, focusing on the gender-specific impact of informal caregiving on health and quality of life among caregivers in Andalusia and the Basque Country from 2013 to 2024. OBJECTIVE: This study aims to analyze the gender differences in health and quality of life indicators of informal caregivers residing in 2 Spanish autonomous communities (Granada, Andalusia, and Gipuzkoa; Basque Country) and their evolution over time, in relation to the characteristics of caregivers, the caregiving situation, and support received. METHODS: The CUIDAR-SE study uses a longitudinal, multicenter design across 3 phases, tracking health and quality of life indicators among informal caregivers. Using a questionnaire adapted to the Spanish context that uses validated scales and multilevel analysis, the research captures changes in caregivers' experiences amid societal crises, notably the 2008 economic crisis and the COVID-19 pandemic. A multistage randomized cluster sampling technique is used to minimize study design effects. RESULTS: Funding for the CUIDAR-SE study was in 3 phases starting in January 2013, 2017, and 2021, spanning a 10-year period. Data collection commenced in 2013 and continued annually, except for 2016 and 2020 due to financial and pandemic-related challenges. As of March 2024, a total of 1294 participants have been enrolled, with data collection ongoing for 2023. Initial data analysis focused on gender disparities in caregiver health, quality of life, burden, perceived needs, and received support, with results from phase I published. Currently, analysis is ongoing for phases II and III, as well as longitudinal analysis across all phases. CONCLUSIONS: This protocol aims to provide comprehensive insights into caregiving dynamics and caregivers' experiences over time, as well as understand the role of caregiving on gender inequality in health, considering regional variations. Despite limitations in participant recruitment, focusing on registered caregivers, the study offers a detailed exploration of the health impacts of caregiving in Spain. The incorporation of a gender perspective and the examination of diverse contextual factors enrich the study's depth, contributing significantly to the discourse on caregiving health complexities in Spain. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58440.


Assuntos
Cuidadores , Qualidade de Vida , Humanos , Cuidadores/psicologia , Qualidade de Vida/psicologia , Espanha/epidemiologia , Masculino , Feminino , Estudos Longitudinais , Fatores Sexuais , Pessoa de Meia-Idade , Idoso , Inquéritos e Questionários , COVID-19/epidemiologia , COVID-19/psicologia , Disparidades nos Níveis de Saúde , Adulto
6.
Aten Primaria ; 56(11): 103051, 2024 Jul 22.
Artigo em Espanhol | MEDLINE | ID: mdl-39043010

RESUMO

OBJECTIVE: To identify the structural and intermediate determinants associated with avoidable hospitalizations (AH) of patients with type2 diabetes mellitus (T2DM). DESIGN: Literature review based on narrative synthesis. DATA SOURCES: Databases: PubMed, Science Direct, and Latin American and Caribbean Literature in Health Sciences (LILACS). STUDY SELECTION: Documents were selected and analyzed under a critical literature review, considering inclusion and exclusion criteria. DATA EXTRACTION: Information extracted from each selected article was synthesized based on the countries' income levels and the social determinants of health framework. RESULTS: A total of 4,166 articles were relevant, 36 were selected for review. From this selection, 21 were publications conducted in high-income countries, 14 in upper-middle-income countries, and one in lower-middle-income countries. The review identified that the coverage of health services -mainly primary health care- and health insurance contribute to reducing the risk of AH for T2DM, while social inequalities tend to increase the risk. CONCLUSIONS: The AH due to T2DM are susceptible to reduction through policies that contribute to increasing effective access to health services (availability, insurance), since they express social inequality, occurring to a greater extent in socioeconomically vulnerable populations. This review also provides evidence of the need to expand research on this topic in middle and low-income countries.

7.
Adv Ther ; 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39046695

RESUMO

INTRODUCTION: Symptom status and treatment changes among patients with chronic obstructive pulmonary disease (COPD) using inhaler treatment in real-world clinical settings are not well understood, particularly according to class of treatment. We investigated the proportion of symptomatic patients among those with COPD using inhaler treatment, based on COPD Assessment Test (CAT) scores in clinical practice, and changes in inhaler treatments and symptoms at 1-year follow-up. METHODS: This was a retrospective analysis of data from a multicenter, prospective cohort study conducted at medical institutions with respiratory specialists in Japan. The primary endpoint was the proportion of patients with CAT scores ≥ 10 or < 10 in each inhaler treatment group at registration. RESULTS: Of 414 patients in the full analysis set, 76 (18.4%), 261 (63.0%), and 77 (18.6%) were using long-acting muscarinic antagonist (LAMA), LAMA + long-acting ß2-agonist (LABA), and inhaled corticosteroids (ICS) + LABA, respectively, at registration. The proportions of patients with CAT scores ≥ 10 or < 10 per inhaler treatment group at registration, respectively, were 32.9% and 67.1% in the LAMA group, 55.0% and 45.0% in the LAMA + LABA group, and 50.0% and 50.0% in the ICS + LABA group. Most patients (> 75%) in each inhaler treatment group showed no change in inhaler treatment at 1 year, regardless of their CAT score at registration. Approximately 70-80% of patients with CAT scores ≥ 10 at registration still had CAT scores ≥ 10 at 1 year; 10-30% of patients with CAT scores < 10 at registration had CAT scores ≥ 10 at 1 year. CONCLUSION: In real-world Japanese clinical practice, a considerable proportion of patients have persistent symptoms (CAT score ≥ 10) despite using mono or dual inhaler treatment; > 75% of symptomatic patients with COPD using inhaler treatment did not undergo treatment escalation at 1-year follow-up and remained symptomatic. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT05903989.

8.
Trop Med Infect Dis ; 9(7)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39058198

RESUMO

Generally, human rights documents are to be applied universally. However, certain groups are identified for special treatment due to vulnerabilities faced; these are often referred to as vulnerable groups or populations. While human rights literature and public health literature make a case for particular sensitivity regarding vulnerable populations living with HIV, there is perhaps a case to be made for people living with HIV to be recognised as a vulnerable group in and of itself. It is often other vulnerabilities, such as poverty, disability, or discrimination, that render persons living with HIV legally vulnerable. But what happens if these other vulnerabilities are not present? Persons living with HIV could benefit from being recognised as a vulnerable group, in that it could prioritise their health rights and promote their access to healthcare and services. This article considers how identifying persons living with HIV as a vulnerable group could impact their treatment, care, and support. By looking at examples of countries where people living with HIV have been identified as vulnerable, and at how vulnerable groups are defined, an argument is made that it could be beneficial to persons living with HIV to be identified as a vulnerable group in terms of accessing treatment, care, and support.

9.
Rev Panam Salud Publica ; 48: e54, 2024.
Artigo em Português | MEDLINE | ID: mdl-39011234

RESUMO

Objective: To calculate the alcohol per capita consumption (APC) in Brazil (Brazil APC) using national data and to establish the Brazil APC as gold standard for the country, replacing the indicator previously calculated by the World Health Organization (WHO) based on international data. Method: The Brazilian public data sources necessary for calculating the recorded APC were selected, and the alcohol concentration was defined by beverage category. For the variables of tourist APC and unrecorded APC, which are unavailable in Brazil, estimates from the United Nations (UN) and the WHO were used. The Brazil APC indicator was calculated and compared to the indicator produced by the WHO through analysis of the medians obtained for the period from 2005 to 2020. Results: The national alcohol consumption indicator was 9.2 liters per capita in 2005, reaching 9.8 in 2020. The WHO indicator showed a consumption of 8.4 liters per capita in 2005, decreasing until 2016 and slightly increasing to 7.8 in 2020. Conclusion: The Brazil APC was calculated based on national sources and showed a distinct trend compared to the WHO indicator, which showed a decrease. The regular and transparent provision of this indicator through government channels will support the development of policies to address alcohol consumption in the country.


Objetivo: Calcular el indicador del consumo de alcohol per cápita en Brasil a partir de datos nacionales, con miras a establecerlo como patrón de referencia para el país en sustitución del indicador calculado anteriormente por la Organización Mundial de la Salud a partir de datos internacionales. Métodos: Se seleccionaron las fuentes públicas de datos de Brasil necesarias para estructurar el cálculo del consumo de alcohol per cápita registrado y se definió la concentración de alcohol por clase de bebida. Para las variables de consumo de alcohol per cápita por parte de turistas y consumo per cápita no registrado, que no están disponibles en Brasil, se utilizaron estimaciones de las Naciones Unidas y de la Organización Mundial de la Salud. Se calculó el indicador del consumo de alcohol per cápita en Brasil y se comparó con el indicador elaborado por la OMS mediante un análisis de las medianas correspondientes al período 2005-2020. Resultados: El indicador nacional del consumo de alcohol fue de 9,2 litros per cápita en el 2005, con un aumento a 9,8 en el 2020. El indicador de la Organización Mundial de la Salud mostró un consumo de 8,4 litros per cápita en el 2005, con una reducción hasta el 2016 y un leve aumento a 7,8 en el 2020. Conclusión: Se calculó el consumo de alcohol per cápita en Brasil a partir de fuentes nacionales, lo que mostró una tendencia distinta de la tendencia descendente del indicador de la Organización Mundial de la Salud. La disponibilidad transparente y regular de este indicador por medio de los canales gubernamentales permitirá su seguimiento, con lo cual se podrán formular políticas para enfrentar el consumo de alcohol en el país.

10.
Artigo em Inglês | MEDLINE | ID: mdl-38980597

RESUMO

Life expectancy (LE) is a health indicator of a population's health and well-being. Modeling the trajectory of LE aligns with the objectives of Indonesia's Vision 2045 and Oman's Vision 2040. This study examines the influence of health status-resources (HSR), macroeconomic (ME), and sociodemographic (SD) factors on LE in Indonesia and Oman. These two nations navigate the challenges of the middle-income trap in the Organization of Islamic Cooperation. This study adopted a national-scale population-based approach that focuses on retrospective observations. We used partial least square structural equation models with World Bank data from 1980 to 2020 to analyze the relationship between the mentioned factors and the LE of Oman and Indonesia. For Indonesia's model, the results showed that ME has a total effect of ß = 0.737 (p < 0.05) on LE, SD has a total effect of ß = 0.675 (p < 0.05) on LE, and HSR has a total effect of ß = 0.823 (p < 0.05) on LE. In Oman's model, ME has a total effect of ß = 0.848 (p < 0.05) on LE, SD has a total effect of ß = 0.755 (p < 0.05) on LE, and HSR has a total effect of ß = 0.335 (p < 0.05) on LE. The findings underscore the need for policies that meld health and societal perspectives to improve public health in both nations. A shift in public health interventions and perceptions towards socioeconomic well-being and societal issues is pivotal for advancing LE growth, potentially steering these countries from the middle-income trap.

11.
Nutrients ; 16(13)2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38999838

RESUMO

Arthritis is associated with health challenges. Lifestyle traits are believed to influence arthritis development and progression; however, data to support personalized treatment regimens based on holistic lifestyle factors are missing. This study aims to provide a comprehensive list of associations between lifestyle traits and the health status of individuals with arthritis in the Canadian population, using binary logistic regression analysis on data from the Canadian Community Health Survey, which includes 104,359 respondents. Firstly, we explored the association between arthritis and various aspects of health status including self-reported lifestyle factors. Secondly, we examined the associations between self-reported dietary intake and smoking status with general, mental, and oral health, and sleep disturbance among individuals both with and without arthritis. Our analysis revealed that individuals with arthritis reported considerably poorer general, mental, and oral health, and poorer sleep quality compared to those without arthritis. Associations were also found between self-reported dietary intake and various measures of health status in individuals with arthritis. Smoking and exposure to passive smoking were associated not only with arthritis but also with compromised sleep quality and poorer general, mental, and oral health in people with and without arthritis. This study highlights the need for personalized and holistic approaches that may include a combination of dietary interventions, oral health improvements, sleep therapies, and smoking cessation for improved arthritis prevention and care.


Assuntos
Artrite , Inquéritos Epidemiológicos , Estilo de Vida , Saúde Mental , Saúde Bucal , Qualidade do Sono , Fumar , Humanos , Masculino , Estudos Transversais , Feminino , Canadá/epidemiologia , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Artrite/epidemiologia , Adulto , Fumar/epidemiologia , Idoso , Dieta , Nível de Saúde , Autorrelato , Transtornos do Sono-Vigília/epidemiologia , Ingestão de Alimentos
12.
Stroke ; 55(8): 2055-2065, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38946533

RESUMO

BACKGROUND: There is a well-known association between low socioeconomic status (SES), poor survival, and clinician-reported outcomes after stroke. We aimed to assess socioeconomic differences in Patient Reported Outcome Measures 3 months after stroke. METHODS: This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients. RESULTS: The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old. CONCLUSIONS: There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.


Assuntos
Atividades Cotidianas , Medidas de Resultados Relatados pelo Paciente , Sistema de Registros , Acidente Vascular Cerebral , Humanos , Masculino , Feminino , Suécia/epidemiologia , Idoso , Pessoa de Meia-Idade , Acidente Vascular Cerebral/epidemiologia , Idoso de 80 Anos ou mais , Estudos de Coortes , Fatores Socioeconômicos , Classe Social , Adulto
13.
BMC Public Health ; 24(1): 1847, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987767

RESUMO

BACKGROUND: College and university students were an important population group of blood donors, especially in the current situation of tight blood supply. This study aimed to investigate the current status and determinants of blood donation among this population group in Wuhan using a structural equation model. METHODS: We conducted a cross-sectional study involving 12 colleges and universities in Wuhan, China, including 5168 students. Sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation were treated as latent variables, with blood donation as the observed variable. Confirmatory factor analysis was conducted using the Mplus 8.0 statistical software application, followed by the establishment of a structural equation model to assess the relationships that exist between these variables. RESULTS: The overall blood donation rate among college and university students was 24.71%. The established model indicated that sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation showed significant positive effects (0.135, 0.056, 0.321, and 0.389, respectively) on blood donation, among them, the direct effects were 0.076, -0.110, 0.143, and 0.389, respectively (P < 0.01). Additionally, sociodemographic characteristics, health status, and knowledge about blood donation had indirectly affected blood donation through the mediating effect of attitude towards blood donation. Their effects on attitude towards blood donation were 0.099, 0.243, and 0.468, respectively. (P < 0.01). The model could explain explained 22.22% of the variance in blood donation behavior among college and university students in Wuhan. CONCLUSION: Blood donation among college and university students in Wuhan was associated with sociodemographic characteristics, health status, knowledge about blood donation, and attitude towards blood donation, with attitude being the primary influencing factor. Tailored recruitment strategies for blood donation among students should prioritize initiatives aimed at enhancing knowledge about blood donation and fostering positive attitudes toward it.


Assuntos
Doadores de Sangue , Conhecimentos, Atitudes e Prática em Saúde , Estudantes , Humanos , Doadores de Sangue/psicologia , Doadores de Sangue/estatística & dados numéricos , China , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Masculino , Feminino , Estudos Transversais , Universidades , Adulto Jovem , Adolescente , Adulto , Análise de Classes Latentes , Nível de Saúde , Inquéritos e Questionários , Doação de Sangue
14.
Int J Cardiol ; 413: 132341, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38971536

RESUMO

BACKGROUND: Heart failure (HF) patients often experience poor health-related quality-of-life (HR-QoL). The Kansas City Cardiomyopathy Questionnaire (KCCQ) is frequently used for assessing HR-QoL in HF. Whether KCCQ scores vary in a clinical meaningful manner according to the setting (home vs office) where patients respond to the questionnaire is currently unknown. AIMS: Assess the differences in the responses to KCCQ-23 questionnaire when completed at home or office. METHODS: Randomized parallel-group study, including patients with HF with reduced ejection fraction (HFrEF). Primary outcome was home vs office comparison of overall summary score (KCCQ-OSS). Main secondary outcomes were clinical summary score (KCCQ-CSS) and total symptom score (KCCQ-TSS). RESULTS: A total of 100 patients were included in the study: 50 home vs 50 office. Mean age was 71 yrs. Most baseline characteristics were well balanced between groups, except male sex, MRA use, and prior HF hospitalizations which were more frequent in the home group. No statistically-significant between-group differences were found regarding KCCQ-OSS (median [percentile25-75]) scores: home 69.1 (42.0-86.5) vs office 63.1 (44.3-82.3) points, P-value = 0.59, or main secondary outcomes: KCCQ-CSS home 62.2 (46.5-79.9) vs office 68.1 (51.9-79.2) points, P-value = 0.69, and KCCQ-TSS home 84.7 (59.7-97.2) vs office 76.4 (66.7-94.4) points, P-value = 0.85. Results remained similar after adjustment for differences in baseline characteristics and using non-parametric regressions. CONCLUSIONS: No major differences were found in KCCQ-23 scores regardless of whether the questionnaire was completed at home or office. These findings can be useful to make HR-QoL more accessible, allowing patients to respond at home using email or cell-phone applications.

15.
Animals (Basel) ; 14(13)2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38998076

RESUMO

This systematic review examines the impact of varying Spirulina (Limnospira platensis) intake levels on broiler chickens, focusing on growth performance, blood health markers and carcass traits. The data revealed cumulative Spirulina intakes from 3.13 g to 521 g per bird (total feed consumed multiplied by its proportion in the diet) establish a cubic relationship between dosage and growth outcomes. Initial benefits peak and diminish with increased intake, with the optimal threshold for growth performance identified at 45 g per bird. Lower intakes between 14 g and 29 g per bird enhance blood health markers, improving lipid profiles and antioxidant capacity. Similarly, cumulative intakes of 14 g to 37 g per bird optimise meat quality, resulting in better dressing percentages, breast and thigh yields and meat tenderness while minimizing undesirable traits like abdominal fat and cooking loss. These findings underscore the importance of precisely calibrated Spirulina supplementation strategies to maximise growth, health and meat quality benefits while avoiding adverse effects at higher doses. Future research should focus on identifying optimal dosage and duration, assessing long-term implications, elucidating mechanisms of action and ensuring safety and regulatory compliance. Comparative studies with other feed additives could further establish Spirulina's effectiveness and economic viability in poultry production.

16.
Animals (Basel) ; 14(13)2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38998105

RESUMO

In the last few decades, the cuttlefish market has grown to approximately 14% of the world's fisheries, and operators have begun to express concerns about the decline of this resource. In this context, the production of cuttlefish through aquaculture could offer a diversifying and valuable response to the increasing market demand and help alleviate the environmental pressure on this species. Therefore, the aim of this study is to identify a dry, cost-effective, and easy-to-administer diet that can successfully support the initial phases of cuttlefish growth and provide a similar performance to a krill-based diet, which closely mimics their natural diet. To achieve this objective, cuttlefish hatchlings were distributed among different experimental tanks, each receiving one of the five different diets (namely Diets A to E). Mortality and morphological parameters were monitored until day 10 post hatching, and the two most effective diets (Diets A and B) were chosen for further trials. The results indicated that Diet B had similar survival and growth rates to Diet A, which was based on frozen krill. Histological analysis revealed a comparable degree of gut maturity between the organisms fed the two diets. Likewise, levels of amylase and trypsin enzymes and hsp70, cat, and sod mRNA did not exhibit significant differences between the two groups. In conclusion, our findings provide preliminary evidence supporting the possibility of cultivating cuttlefish in captivity using a pelleted diet, representing a promising starting point for larger-scale breeding efforts.

17.
Ann Behav Med ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38990643

RESUMO

BACKGROUND: Previous research has shown sexual minority women (SMW) are more likely to report multiple maternal and infant health outcomes compared to heterosexual women and that these outcomes are moderated by the policy environment. Little is known, however, about prenatal care use disparities or the social determinants of prenatal care use for SMW. PURPOSE: To examine the relationship between sexual orientation-specific policies that confer legal protections (e.g., hate crime protections, housing discrimination, same-sex marriage) and prenatal care use among women using a prospective, population-based data set. METHODS: Using the National Longitudinal Study of Adolescent to Adult Health and logistic regression, we link measures of state policies to the use of prenatal care in the first trimester among women who had live births. The use of prospective data allows us to adjust for covariates associated with preconception care use prior to pregnancy (n = 586 singleton births to SMW; n = 4,539 singleton births to heterosexual women). RESULTS: Sexual orientation-specific policies that conferred protections were associated with increased use of prenatal care among pregnancies reported by SMW (OR = 1.86, 95% CI 1.16, 2.96). In fact, in states with zero protections, we found no differences in prenatal care use by sexual minority status; however, in states with two or more protective policies, SMW were more likely to access prenatal care in the first trimester than heterosexual women. There was no relationship between sexual orientation-specific policy environments and prenatal care use among pregnancies reported by heterosexual women. CONCLUSIONS: Recent research has documented that SMW are more likely to have adverse perinatal and obstetrical outcomes than their heterosexual peers. These findings suggest that Lesbian/Gay/Bisexual-specific policy protections may facilitate the use of prenatal care among SMW, a potentially important pathway to improve reproductive health among this population.


Previous studies have found that sexual minority women (SMW) are more likely to report adverse infant outcomes, particularly for women who do not live in states with anti-discrimination policies against lesiban, gay, bisexual, transgnder, or queer (LGBTQ) populations. This is the first to examine sexual orientation disparities in prenatal care use using a nationally representative, prospective data set. Additionally, we examined whether prenatal care use varied by the number of state-level policies that protect against discrimination based on sexual orientation. Our results show high rates of prenatal care use in the first trimester across all sexual orientations, however, in states with states with two or more policies that prevent discrimination by sexual orientation, sexual minority women were more likely to access prenatal care in the first trimester than heterosexual women. These findings suggest that more inclusive state-level environments promote healthcare-seeking behaviors during pregnancy for sexual minority women.

18.
J Dairy Sci ; 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-39004136

RESUMO

The objective of this randomized controlled trial was to determine if providing a rest period (RP) to surplus calves transported for 16 h reduced the impact of long-distance transportation on health, growth, and activity after arrival to a calf-raising facility. Between September 2022 to January 2023, 6 to 24 d old surplus calves were randomly assigned to one of 2 treatment groups: 1) continuous transportation by road for 16 h (n = 86) or 2) 8 h of transport, 8 h RP, then a further 8 h of transport to a single commercial calf-raising facility in Ontario, Canada (n = 84). Calves that received the RP were fed 2 L of milk replacer at the time of unloading for the RP and again before reloading for the second leg of transportation. Calves were weighed before and after transportation and once weekly until they left the calf-raising facility at 11 weeks after arrival. Additionally, fecal consistency and respiratory health were assessed immediately before and after transportation, as well as twice daily following arrival. The odds of abnormal fecal and respiratory scores were assessed with mixed effects logistic regression models, whereas cox proportional hazards models were used to evaluate the hazard of treatment for diarrhea and respiratory disease. To evaluate weight loss during transportation, average daily gain, lying bouts, and steps, mixed linear regression models were used. Furthermore, mixed logistic regression models with repeated measures were built to assess associations with the odds of having a sunken flank and prolonged skin tent. There were no statistical differences in the odds of abnormal fecal or respiratory scores or the treatment for diarrhea between treatment groups; however, there was evidence that calves that received a rest period had a higher hazard of treatment for respiratory disease. Calves >10 d old had reduced odds of having an abnormal respiratory score and calves 13-24 d old had lower odds of arriving with a prolonged skin tent, lower odds of abnormal fecal score, and reduced hazard of treatment for diarrhea compared with calves 6-8 d old at transportation. During transportation, calves that received a rest period lost less weight than continuously transported calves. With respect to ADG over the 77-d study, an interaction between age at transport and treatment group was identified where calves aged 9 to 10 d old and received a rest period had higher ADG compared with calves that were 9 to 10 d old and did not receive a rest period. As for calf activity, calves receiving an RP spent more time lying on the day after transportation compared with calves that were continuously transported. The results of this trial show few differences in the health and growth of calves having a RP compared with those that underwent continuous transport. Furthermore, calves receiving a rest period may arrive more fatigued than calves who arrive to their destination in a shorter period of time overall. Transporting calves at older ages presents an opportunity to reduce the impact of long-distance transportation on subsequent health, growth, and activity.

19.
Ther Adv Respir Dis ; 18: 17534666241263439, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39049587

RESUMO

BACKGROUND: The extrafine single inhaler triple therapy (efSITT) containing beclomethasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 µg has proved to be efficacious in patients with chronic obstructive pulmonary disease (COPD) in randomized control trials. OBJECTIVE: TRIWIN study evaluated the effectiveness of efSITT delivering beclomethasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 µg in COPD patients previously treated with multiple-inhaler triple therapy (MITT) in a real-world study in Greece. DESIGN: Prospective, multicenter, observational, non-interventional study was conducted over 24 weeks. METHODS: A total of 475 eligible patients had moderate-to-severe COPD, an indication for treatment with efSITT, and were symptomatic despite receiving MITT. COPD Assessment Test (CAT) score, pulmonary function parameters, use of rescue medication, and adherence to inhaler use were recorded at baseline (Visit 1), 3 (Visit 2), and 6 months (Visit 3) after treatment. RESULTS: Mean CAT score decreased from 21.4 points at Visit 1, to 16.6 at Visit 2 and 15.1 at Visit 3 (p < 0.001 for all pair comparisons). At Visit 3, 79.8% of patients reached a CAT improvement exceeding minimal clinically important difference (⩾2), compared to baseline. Mean forced expiratory volume in 1 s (%pred.) increased from 55.4% at Visit 1 to 63.5% at the end of study period (p < 0.001), while mean forced vital capacity (%pred.) increased from 71.1% at Visit 1, to 76.7% at Visit 3 (p < 0.001). The mean Test of Adherence to Inhalers score increased from 42.5 to 45.3 and 46.3 points, for the three visits, respectively (p < 0.001 comparing Visits 1/2 and Visits 1/3; p = 0.006 comparing Visits 2/3). The percentage of patients showing good adherence rose from 33.7% at baseline to 58.3% at Visit 3. The percentage of patients using rescue medication during the last month dropped from 16.2% to 7.4% at the end of study period (p < 0.001). Pulmonary function parameters also improved. CONCLUSION: The TRIWIN results suggest that extrafine beclomethasone dipropionate/formoterol fumarate/glycopyrronium is effective in improving health status, pulmonary function, and adherence and in reducing rescue medication use in COPD patients previously treated with MITT, in a real-world setting in Greece.


Assuntos
Beclometasona , Broncodilatadores , Combinação de Medicamentos , Fumarato de Formoterol , Glicopirrolato , Nebulizadores e Vaporizadores , Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Masculino , Feminino , Idoso , Estudos Prospectivos , Pessoa de Meia-Idade , Beclometasona/administração & dosagem , Beclometasona/efeitos adversos , Administração por Inalação , Fumarato de Formoterol/administração & dosagem , Resultado do Tratamento , Broncodilatadores/administração & dosagem , Broncodilatadores/efeitos adversos , Glicopirrolato/administração & dosagem , Glicopirrolato/efeitos adversos , Grécia , Pulmão/fisiopatologia , Pulmão/efeitos dos fármacos , Índice de Gravidade de Doença , Antagonistas Muscarínicos/administração & dosagem , Antagonistas Muscarínicos/efeitos adversos , Fatores de Tempo , Volume Expiratório Forçado , Adesão à Medicação , Glucocorticoides/administração & dosagem , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos
20.
J Pers Med ; 14(7)2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-39063936

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a neurodegenerative immunological disease causing significant impairment in all life areas. Therefore, personality changes are observed and associated with higher prevalence of depression and anxiety disorders. Considering this relationship, we hypothesized that clinical symptoms and personality disorders are more prevalent in MS and that dysfunctional psychological mechanisms mediate the path from personality disorders to clinical symptoms. METHODS: The study sample consisted of 43 patients with MS (age M = 41.9, SD = 11.5) and 31 controls (age M = 39.8, SD = 10.3). Measures of personality, anxiety, depression, fatigue, health status, and dysfunctional psychological mechanisms were conducted. RESULTS: The prevalence of clinical symptoms was increased in MS patients as compared to controls. Also, dependent and schizoid personality traits (PTs) were observed in the patient sample. Negative automatic thoughts (NATs) were found to mediate the association between dependent PT and clinical symptoms. Along with schizoid PT, all dysfunctional psychological mechanisms impacted clinical symptoms. DISCUSSION: The results of our research are in line with previous studies showing that anxiety, depression, and dysfunctional personality traits are more prevalent in MS as compared to controls. CONCLUSIONS: PTs and dysfunctional psychological mechanisms predicted depression, anxiety, fatigue, and health status in MS patients. Cognition acts as a strong mediator between PTs and psychopathology in MS. Hence, integrative personalized psychological treatment is recommended to improve the quality of care in MS.

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