390 results
Search Results
2. A Systematic Review of the Indirect and Social Costs in Early and Young Onset Dementias.
- Author
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Ruiz-Adame, Manuel
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EXTERNALITIES ,DEMENTIA ,CAREGIVERS ,ECONOMIC impact ,GENERAL education ,SOCIAL participation ,JOB Descriptive Index ,PSYCHOLOGICAL tests ,AGE factors in disease ,QUESTIONNAIRES ,ECONOMIC aspects of diseases - Abstract
Background: The World Health Organization has estimated that worldwide around 50 million people have dementia. The World Alzheimer Report estimated that between 2 and 10% of all cases of dementia begin before the age of 65. Early and young onset dementias (EYOD) provoke more working, social, family, and economic consequences than late onset dementias. All general studies about costs of dementias show that most of them are indirect or social costs. Despite that, very few studies have been performed in EYOD.Objective: To do a systematic review of literature about indirect or social costs in EYOD to know the state of knowledge and to discover gaps that should be filled.Methods: A systematic review was performed in the main database: Scopus, PsychInfo, Web of Science (Web of Science Core Collection, Medline and SciELO), and CINAHL. Additionally, we looked for reviews in Cochrane and in the International Prospective Register Of Systematic Reviews (PROSPERO).Results: Most of the studies are about costs of dementias in general, but they do no differentiate costs for the case of EYOD. Many studies highlight the increased costs for EYOD but very little included evidence of that. 135 papers were selected. Finally, only two were studies providing data. EYOD reduce the odds to get or maintain a job. Most of the care is provided by informal caregivers. The costs in EYOD are 39.26% higher among EYOD than in late onset.Conclusion: There is a lack of studies about social and indirect costs in EYOD. More evidence is needed. [ABSTRACT FROM AUTHOR]- Published
- 2022
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3. A new model to understand the complexity of inequalities in dementia.
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Giebel, Clarissa
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DIAGNOSIS of dementia ,HEALTH services accessibility ,COMMUNITY health services ,HEALTH literacy ,SOCIAL determinants of health ,SOCIAL workers ,SERVICES for caregivers ,INFORMATION services ,AGE factors in disease ,RACE ,PROFESSIONS ,SOCIAL case work ,MATHEMATICAL models ,SOCIAL networks ,PSYCHOLOGY of caregivers ,HEALTH equity ,THEORY ,SOCIAL support ,EVIDENCE-based medicine ,DEMENTIA patients ,WELL-being - Abstract
Many people living with dementia and unpaid carers experience inequalities in care related to challenges in receiving a correct diagnosis, care and support. Whilst complexities of the evidence are well recognised including barriers in receiving a diagnosis or post-diagnostic care, no coherent model has captured the far-reaching types and levels of inequalities to date. Building on the established Dahlgren & Whitehead Rainbow model of health determinants, this paper introduces the new Dementia Inequalities model. The Dementia Inequalities model, similar to the original general rainbow model, categorises determinants of health and well-being in dementia into three layers: (1) Individual; (2) Social and community networks; and (3) Society and infrastructure. Each layer comprises of general determinants, which have been identified in the original model but also may be different in dementia, such as age (specifically referring to young- versus late-onset dementia) and ethnicity, as well as new dementia-specific determinants, such as rare dementia subtype, having an unpaid carer, and knowledge about dementia in the health and social care workforce. Each layer and its individual determinants are discussed referring to existing research and evidence syntheses in the field, arguing for the need of this new model. A total of 48 people with lived, caring, and professional experiences of dementia have been consulted in the process of the development of this model. The Dementia Inequalities model provides a coherent, evidence-based overview of inequalities in dementia diagnosis and care and can be used in health and social care, as well as in commissioning of care services, to support people living with dementia and their unpaid carers better and try and create more equity in diagnosis and care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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4. Referral reasons to a Victorian mental health triage service for individuals living with young-onset dementia.
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Loi, Samantha M. and Velakoulis, Dennis
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HOME care services ,MENTAL health services ,BEHAVIOR modification ,SUICIDAL ideation ,PARANOIA ,RETROSPECTIVE studies ,AGITATION (Psychology) ,ANXIETY ,DESCRIPTIVE statistics ,CHI-squared test ,AGE factors in disease ,AGGRESSION (Psychology) ,DEMENTIA ,DATA analysis software ,MEDICAL referrals ,MEDICAL triage ,MENTAL depression ,RESIDENTIAL care - Abstract
Objectives: Mental health triage services are the first contact for people wanting support for their mental health and provide access to public mental health services in Victoria, Australia. People living with young-onset dementia and their families may contact triage services seeking assistance for behaviour changes and pathways to care as there are few alternative services available. Methods: The authors reviewed the minimum triage dataset from one of the largest mental health services in Victoria, Australia from 2018 to 2021 investigating reasons for referral for people with young-onset dementia. Results: Of the 1766 referrals for 'dementia', 145 were for young-onset dementia. Of these, 69% were referred for behaviour changes. About half of the referrals for behaviour changes were triaged as 'advice only'. One-third of referrals were from general practitioners. Conclusions: The availability of dementia-specific support services that could provide advice on dementia as well as advice for behaviour changes related to the disease could potentially ease the burden of phone calls received by mental health triage services. What is known about the topic? Young-onset dementia refers to a dementia with onset at less than 65 years of age. People with young-onset dementia may contact mental health services for support but the reasons for contact are unknown. What does this paper add? The reasons for contacting one Victorian mental health service included behaviour changes such as agitation or aggression and psychotic symptoms (74%) and general advice, including about dementia pathways (14%). General practitioners made up one-third of referral sources. What are the implications for practitioners? Victorian mental health services are generally overloaded and complex. There is a need to promote alternative dementia support organisations in order to provide an alternative contact for people affected by young-onset dementia. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Younger people with dementia registered to public mental health services in Victoria, Australia.
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Loi, Samantha M., Eratne, Dhamidhu, and Velakoulis, Dennis
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PUBLIC hospitals ,HEALTH services accessibility ,MENTAL health services ,CENSUS ,SEX distribution ,DESCRIPTIVE statistics ,CHI-squared test ,AGE factors in disease ,DEMENTIA ,COMPARATIVE studies ,MEDICAL triage ,NOSOLOGY - Abstract
Objectives: Individuals living with young-onset dementia fall through the gaps of adult and geriatric services. Given that non-cognitive symptoms of dementia in younger people are often psychiatric and behavioural in nature, these people may contact mental health services. There is sparse information investigating the frequency of people with young-onset dementia who contact mental health triage in Victoria. Methods: Triage data were obtained from the Victorian Agency for Health Information. The data contained demographics for people registered with Victorian mental health services. Consumers who had an International Classification for Diseases code for dementia and were aged less than 65 years were identified as people with young-onset dementia. Using information of the frequency of people with young-onset dementia who were registered with each area-based mental health service, population census statistics were used to make estimates of the frequency of young-onset dementia. Results: Of the 6172 people who had a dementia diagnosis, 1020 of them were aged less than 65 years and had young-onset dementia. There were proportionally more men who had young-onset dementia compared to women. There were more people with young-onset dementia registered to rural mental health services compared to metropolitan services. Conclusion: Findings provide important information for service planning in Victoria. Recommendations include upskilling and education for the assessment of dementia for those clinicians who work in mental health services, particularly in rural regions. What is known about the topic? Young-onset dementia refers to a dementia with onset at an age less than 65 years. Accessing age-appropriate services for these people is difficult as they fall through the gaps of adult and aged services due to their age. What does this paper add? Due to the behavioural and psychiatric manifestations related to young-onset dementia, data is provided about mental health service involvement for these people. What are the implications for practitioners? There is a need to upskill mental health clinicians, especially in rural areas, as younger people with dementia are accessing these services. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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6. Application of machine learning in measurement of ageing and geriatric diseases: a systematic review.
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Das, Ayushi and Dhillon, Preeti
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SUPERVISED learning ,MACHINE learning ,NON-communicable diseases ,CARDIOVASCULAR diseases ,SUCCESSFUL aging ,AGE factors in disease ,DEEP learning - Abstract
Background: As the ageing population continues to grow in many countries, the prevalence of geriatric diseases is on the rise. In response, healthcare providers are exploring novel methods to enhance the quality of life for the elderly. Over the last decade, there has been a remarkable surge in the use of machine learning in geriatric diseases and care. Machine learning has emerged as a promising tool for the diagnosis, treatment, and management of these conditions. Hence, our study aims to find out the present state of research in geriatrics and the application of machine learning methods in this area. Methods: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and focused on healthy ageing in individuals aged 45 and above, with a specific emphasis on the diseases that commonly occur during this process. The study mainly focused on three areas, that are machine learning, the geriatric population, and diseases. Peer-reviewed articles were searched in the PubMed and Scopus databases with inclusion criteria of population above 45 years, must have used machine learning methods, and availability of full text. To assess the quality of the studies, Joanna Briggs Institute's (JBI) critical appraisal tool was used. Results: A total of 70 papers were selected from the 120 identified papers after going through title screening, abstract screening, and reference search. Limited research is available on predicting biological or brain age using deep learning and different supervised machine learning methods. Neurodegenerative disorders were found to be the most researched disease, in which Alzheimer's disease was focused the most. Among non-communicable diseases, diabetes mellitus, hypertension, cancer, kidney diseases, and cardiovascular diseases were included, and other rare diseases like oral health-related diseases and bone diseases were also explored in some papers. In terms of the application of machine learning, risk prediction was the most common approach. Half of the studies have used supervised machine learning algorithms, among which logistic regression, random forest, XG Boost were frequently used methods. These machine learning methods were applied to a variety of datasets including population-based surveys, hospital records, and digitally traced data. Conclusion: The review identified a wide range of studies that employed machine learning algorithms to analyse various diseases and datasets. While the application of machine learning in geriatrics and care has been well-explored, there is still room for future development, particularly in validating models across diverse populations and utilizing personalized digital datasets for customized patient-centric care in older populations. Further, we suggest a scope of Machine Learning in generating comparable ageing indices such as successful ageing index. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. Suicide risk and suicide risk factors among immigrants in Italy: A bi-center matched sample study.
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Berardelli, Isabella, Tarsitani, Lorenzo, Sarubbi, Salvatore, Pinucci, Irene, Rogante, Elena, Cifrodelli, Mariarosaria, Erbuto, Denise, Lester, David, Innamorati, Marco, and Pompili, Maurizio
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SUICIDE risk factors ,IMMIGRANTS ,LENGTH of stay in hospitals ,PSYCHOTHERAPY patients ,SUBSTANCE abuse ,ALCOHOLISM ,AGE distribution ,HEALTH status indicators ,RISK assessment ,SUICIDAL ideation ,SEX distribution ,PSYCHOSOCIAL factors ,HOSPITAL care ,AGE factors in disease ,DISEASE duration ,SOCIODEMOGRAPHIC factors ,MENTAL illness - Abstract
Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with 152 Italian patients admitted to the same wards during the same time period by age, gender, and diagnosis. We also investigated sociodemographic and clinical characteristics of the two samples including psychiatric diagnosis, age of illness onset, duration of illness, previous hospitalizations, length of hospitalization, previous suicide attempts, and substance and alcohol abuse. There were no differences between immigrant and Italian patients in either suicidal ideation (previous or current) or suicide attempts (previous or current). Immigrant patients were more likely to have a shorter duration of illness than the Italian patients and Italian patients were more likely to report substance abuse than were immigrant patients. Despite similar suicide rates between immigrants and Italian psychiatric inpatients, appropriate assessment of suicide risk in these patients is essential in implementing therapeutic suicide prevention strategies. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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8. Nicotinamide N-Methyltransferase (NNMT): A New Hope for Treating Aging and Age-Related Conditions.
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Li, Jing-Jing, Sun, Wei-Dong, Zhu, Xiao-Juan, Mei, Ya-Zhong, Li, Wen-Song, and Li, Jiang-Hua
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NICOTINAMIDE ,NAD (Coenzyme) ,RNA interference ,AGING ,SMALL interfering RNA ,AGE factors in disease - Abstract
The complex process of aging leads to a gradual deterioration in the function of cells, tissues, and the entire organism, thereby increasing the risk of disease and death. Nicotinamide N-methyltransferase (NNMT) has attracted attention as a potential target for combating aging and its related pathologies. Studies have shown that NNMT activity increases over time, which is closely associated with the onset and progression of age-related diseases. NNMT uses S-adenosylmethionine (SAM) as a methyl donor to facilitate the methylation of nicotinamide (NAM), converting NAM into S-adenosyl-L-homocysteine (SAH) and methylnicotinamide (MNA). This enzymatic action depletes NAM, a precursor of nicotinamide adenine dinucleotide (NAD+), and generates SAH, a precursor of homocysteine (Hcy). The reduction in the NAD+ levels and the increase in the Hcy levels are considered important factors in the aging process and age-related diseases. The efficacy of RNA interference (RNAi) therapies and small-molecule inhibitors targeting NNMT demonstrates the potential of NNMT as a therapeutic target. Despite these advances, the exact mechanisms by which NNMT influences aging and age-related diseases remain unclear, and there is a lack of clinical trials involving NNMT inhibitors and RNAi drugs. Therefore, more in-depth research is needed to elucidate the precise functions of NNMT in aging and promote the development of targeted pharmaceutical interventions. This paper aims to explore the specific role of NNMT in aging, and to evaluate its potential as a therapeutic target. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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9. Advances in the study of the glymphatic system and aging.
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Xiong, Ying, Yu, Qingying, Zhi, Haimei, Peng, Huiyuan, Xie, Mingjun, Li, Renjun, Li, Kejian, Ma, Yuexiang, and Sun, Peng
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AGE factors in disease ,AGING ,TAU proteins ,NEURODEGENERATION ,FLUID flow - Abstract
The glymphatic system is cerebrospinal fluid–brain tissue fluid exchange flow mediated by aquaporin‐4 (AQP4) on the end feet of astrocytes for a system, which is capable of rapidly removing brain metabolites and thus maintaining brain homeostasis, and is known as the central immune system. Dysfunction of the glymphatic system causes accumulation of misfolded and highly phosphorylated proteins (amyloid‐β and Tau proteins), which destabilizes the proteins, and the body's neuroinflammatory factors are altered causing aging of the immune system and leading to neurodegenerative diseases. Damage to the glymphatic system and aging share common manifestations, as well as unstudied biological mechanisms that are also linked, such as mitochondria, oxidative stress, chronic inflammation, and sleep. In this paper, we first summarize the structure, function, and research methods of the glymphatic system and the relationship between the glymphatic system and the peripheral immune system, and second, sort out and summarize the factors of the glymphatic system in removing metabolites and resolving aging‐related diseases and factors affecting aging, to explore its related biological mechanisms, and moreover, to provide a new way of thinking for treating or intervening aging‐related diseases. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Chagas Disease across the Ages: A Historical View and Commentary on Navigating Future Challenges.
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Sereno, Denis, Oury, Bruno, and Grijalva, Mario J.
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CHAGAS' disease ,VECTOR control ,AGE factors in disease - Abstract
Chagas disease, discovered over a century ago, continues to pose a global health challenge, affecting millions mainly in Latin America. This historical review with commentary outlines the disease's discovery, its evolution into a global concern due to migration, and highlights significant advances in diagnostics and treatment strategies. Despite these advancements, the paper discusses ongoing challenges in eradication, including vector control, congenital transmission, the disease's asymptomatic nature, and socioeconomic barriers to effective management. It calls for a multidisciplinary approach, enhanced diagnostics, improved treatment accessibility, and sustained vector control efforts. The review emphasizes the importance of global collaboration and increased funding to reduce Chagas disease's impact. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Osteoporosis induced by cellular senescence: A mathematical model.
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Siewe, Nourridine and Friedman, Avner
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OSTEOPOROSIS ,BONE density ,MATHEMATICAL models ,HORMONE therapy ,CELLULAR aging ,AGE factors in disease ,SUICIDE statistics - Abstract
Osteoporosis is a disease characterized by loss of bone mass, where bones become fragile and more likely to fracture. Bone density begins to decrease at age 50, and a state of osteoporosis is defined by loss of more than 25%. Cellular senescence is a permanent arrest of normal cell cycle, while maintaining cell viability. The number of senescent cells increase with age. Since osteoporosis is an aging disease, it is natural to consider the question to what extend senescent cells induce bone density loss and osteoporosis. In this paper we use a mathematical model to address this question. We determine the percent of bone loss for men and women during age 50 to 100 years, and the results depend on the rate η of net formation of senescent cell, with η = 1 being the average rate. In the case η = 1, the model simulations are in agreement with empirical data. We also consider senolytic drugs, like fisetin and quercetin, that selectively eliminate senescent cells, and assess their efficacy in terms of reducing bone loss. For example, at η = 1, with estrogen hormonal therapy and early treatment with fisetin, bone density loss for women by age 75 is 23.4% (below osteoporosis), while with no treatment with fisetin it is 25.8% (osteoporosis); without even a treatment with estrogen hormonal therapy, bone loss of 25.3% occurs already at age 65. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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12. A multi-organization epigenetic age prediction based on a channel attention perceptron networks.
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Jian Zhao, Haixia Li, Jing Qu, Xizeng Zong, Yuchen Liu, Zhejun Kuang, and Han Wang
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EPIGENETICS ,AGE ,DNA methylation ,SHORT tandem repeat analysis ,ARTIFICIAL intelligence ,AGE factors in disease - Abstract
DNA methylation indicates the individual's aging, so-called Epigenetic clocks, which will improve the research and diagnosis of aging diseases by investigating the correlation between methylation loci and human aging. Although this discovery has inspired many researchers to develop traditional computational methods to quantify the correlation and predict the chronological age, the performance bottleneck delayed access to the practical application. Since artificial intelligence technology brought great opportunities in research, we proposed a perceptron model integrating a channel attention mechanism named PerSEClock. The model was trained on 24,516 CpG loci that can utilize the samples from all types of methylation identification platforms and tested on 15 independent datasets against seven methylation-based age prediction methods. PerSEClock demonstrated the ability to assign varying weights to different CpG loci. This feature allows the model to enhance the weight of age-related loci while reducing the weight of irrelevant loci. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Clinical factors associated with relapse in depression in a sample of UK primary care patients who have been on long-term antidepressant treatment.
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Duffy, Larisa, Lewis, Gemma, Marston, Louise, Kendrick, Tony, Kessler, David, Moore, Michael, Wiles, Nicola, and Lewis, Glyn
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PRIMARY health care ,SCIENTIFIC observation ,DRUG therapy ,TREATMENT duration ,ANXIETY ,TREATMENT effectiveness ,DECISION making ,AGE factors in disease ,ANTIDEPRESSANTS ,LONGITUDINAL method ,DISEASE relapse ,CONFIDENCE intervals ,MENTAL depression ,NOSOLOGY ,TIME ,PATIENT aftercare ,DISEASE risk factors - Abstract
Background: This paper investigates whether age of onset of depression, duration of the last episode, number of episodes, and residual symptoms of depression and anxiety are associated with depression relapse in primary care patients who have been on long–term maintenance antidepressant treatment and no longer meet ICD10 criteria for depression. Methods: An observational cohort using data from ANTLER (N = 478), a double-blind placebo-controlled trial. The primary outcome was time to relapse using the retrospective CIS-R. Participants were followed for 12 months. Results: Primary outcome was available for 468 participants. Time to relapse in those with more than five previous episodes of depression was shorter, hazard ratio (HR) 1.84 (95% confidence interval [CI] 1.23–2.75) compared to people with two episodes; HR 1.57 (95% CI 1.01–2.43) after adjustment. The residual symptoms of depression at baseline were also associated with increased relapse: HR 1.05 (95% CI 1.01–1.09) and HR 1.06 (95% CI 1.01–1.12) in the adjusted model. There was evidence of reduced rate of relapse in older age of onset group: HR 0.86 (95% CI 0.78–0.95); HR attenuated after adjustment HR 0.91 (95% CI 0.81–1.02). There was no evidence of an association between duration of the current episode and residual anxiety symptoms with relapse. Conclusions: The number of previous episodes and residual symptoms of depression were associated with increased likelihood of relapse. These factors could inform joint decision making when patients are considering tapering off maintenance antidepressant treatment or considering other treatments to prevent relapse. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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14. Exploring the Surge in Paediatric Type 2 Diabetes in an Inner-City London Centre—A Decade-Long Analysis of Incidence, Outcomes, and Transition.
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Abdelhameed, Farah, Giuffrida, Anna, Thorp, Ben, Moorthy, Myuri K., and Gevers, Evelien F.
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GLYCOSYLATED hemoglobin ,HYPERTENSION ,AUTOANTIBODIES ,ALBUMINS ,CARDIOVASCULAR diseases risk factors ,TRANSITION to adulthood ,CHILDHOOD obesity ,FATTY liver ,TRANSITIONAL care ,DISEASE incidence ,RETROSPECTIVE studies ,ACQUISITION of data ,CARDIOVASCULAR diseases ,MANN Whitney U Test ,BLOOD sugar ,PRADER-Willi syndrome ,TYPE 2 diabetes ,NATIONAL health services ,METABOLIC disorders ,TREATMENT failure ,HYPERLIPIDEMIA ,T-test (Statistics) ,INSULIN ,TREATMENT effectiveness ,SEVERITY of illness index ,DISEASE prevalence ,MEDICAL records ,DESCRIPTIVE statistics ,CHI-squared test ,SLEEP apnea syndromes ,AGE factors in disease ,RESEARCH funding ,METROPOLITAN areas ,BODY mass index ,DATA analysis software ,COMORBIDITY ,INTELLECTUAL disabilities ,LONGITUDINAL method ,DISEASE complications ,CHILDREN ,ADOLESCENCE - Abstract
The rising prevalence of paediatric type 2 diabetes (T2D) is concerning, particularly with limited medical intervention despite evidence of accelerated disease progression. This study of a Barts Health NHS Trust cohort from 2008 to 2022 aims to elucidate the incidence, clinical outcomes, and complications associated with paediatric T2D. A retrospective analysis utilising electronic and paper records identified 40 patients with T2D. The incidence doubled from 2.6/year in 2008–2013 to 5.4/year in 2014–2018. Sixty-eight percent exhibited co-morbidities, notably learning disabilities. At diagnosis, the mean BMI was 32.4 ± 6.71 kg/m
2 , with no gender-based disparity and no significant change over a two-year follow-up. The initial HbA1c was 75.2 ± 21.0 mmol/mol, decreasing to 55.0 ± 17.4 mmol/mol after three months (p = 0.001) and then rising to 63.0 ± 25.5 mmol/mol at one year (p = 0.07). While 22/37 patients achieved HbA1c < 48 mmol/mol, only 9 maintained this for a year. Several metabolic and cardiovascular complications were observed at diagnosis and follow-up, with no significant change in frequency. In 2022, 15 patients transitioned to adult services. HbA1c at transition was 74.7 ± 27.6 mmol/mol, showing no change one year post-transition (71.9 ± 26.9 mmol/mol, p = 0.34). This study highlights substantial therapeutic failure, with current management falling short in achieving a sustained reduction in BMI or HbA1c. Novel treatment approaches are needed to improve clinical outcomes and address the high burden of co-morbidities and complications. [ABSTRACT FROM AUTHOR]- Published
- 2024
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15. Preventative and therapeutic potential of tocotrienols on musculoskeletal diseases in ageing.
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Saud Gany, Siti Liyana, Kok-Yong Chin, Jen Kit Tan, Aminuddin, Amilia, and Makpol, Suzana
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MUSCULOSKELETAL system diseases ,AGE factors in disease ,MUSCULAR atrophy ,VITAMIN E ,OLDER people ,MUSCULOSKELETAL system ,JOINT hypermobility ,POSTURE - Abstract
Musculoskeletal health is paramount in an ageing population susceptible to conditions such as osteoporosis, arthritis and fractures. Age-related changes in bone, muscle, and joint function result in declining musculoskeletal health, reduced mobility, increased risk of falls, and persistent discomfort. Preserving musculoskeletal wellbeing is essential for maintaining independence and enhancing the overall quality of life for the elderly. The global burden of musculoskeletal disorders is significant, impacting 1.71 billion individuals worldwide, with age-related muscle atrophy being a well-established phenomenon. Tocotrienols, a unique type of vitamin E found in various sources, demonstrate exceptional antioxidant capabilities compared to tocopherols. This characteristic positions them as promising candidates for addressing musculoskeletal challenges, particularly in mitigating inflammation and oxidative stress underlying musculoskeletal disorders. This review paper comprehensively examines existing research into the preventive and therapeutic potential of tocotrienols in addressing age-related musculoskeletal issues. It sheds light on the promising role of tocotrienols in enhancing musculoskeletal health and overall wellbeing, emphasizing their significance within the broader context of age-related health concerns. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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16. Cataract Surgery in Low-Income Countries: A Good Deal!
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Flessa, Steffen
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TREATMENT of cataracts ,CATARACT ,SERVICES for caregivers ,MIDDLE-income countries ,EYEGLASSES ,AGE distribution ,MEDICAL care costs ,COST control ,CATARACT surgery ,COST analysis ,QUALITY of life ,LOW-income countries ,COST effectiveness ,AGE factors in disease ,ECONOMIC aspects of diseases ,QUALITY-adjusted life years - Abstract
Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor. In this paper, we analyse whether such an intervention could be cost-effective or even cost-saving for the respective health systems. We calculate the net value of the lifelong costs of cataract with and without surgery. This calculation includes direct costs (e.g., treatment, glasses, surgery) as well as indirect cost of the caregiver and the patient. We total all costs from the year of onset of cataract until death and discount the respective values to the year of onset. We define the surgery as cost-saving if the net-value of costs with surgery is lower than without surgery. If the cost per quality adjusted life year is lower than one gross national product per capita, we define the intervention as highly cost-effective. We find that the cost-effectiveness of cataract surgery depends on the age of onset of the disease and the age of surgery. If the surgery is performed with the beginning of severe impairment, even surgery of a 78-year-old patient is still cost-saving. Almost all possible constellations are highly cost-effective, only for the very old it is questionable whether the surgery should be performed. The simulations show that cataract surgery is one of the most cost-effective interventions. However, millions of people in low-income countries still have no chance to prevent or cure blindness due to limited resources. The findings of this paper clearly call for a stronger effort to reach poor and rural populations with this cost-effective service. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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17. Using a monolingual screening test for assessing bilingual children.
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Altman, Carmit, Harel, Efrat, Meir, Natalia, Iluz-Cohen, Peri, Walters, Joel, and Armon-Lotem, Sharon
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LANGUAGE disorder diagnosis ,REFERENCE values ,MOTHERS ,STATISTICS ,EDUCATION ,ONE-way analysis of variance ,COMMUNICATIVE competence ,LANGUAGE & languages ,TASK performance ,REGRESSION analysis ,MULTILINGUALISM in children ,LANGUAGE acquisition ,SEX distribution ,AGE factors in disease ,PHONETICS ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,RESEARCH funding ,SENSITIVITY & specificity (Statistics) ,ELEMENTARY schools ,DATA analysis software ,DATA analysis ,PARENTS - Abstract
Bilingual language development is different from monolingual language development. The lack of appropriate assessment tools geared to the bilingual population has led to inaccurate over-diagnosis of bilingual children with typical language development (TLD) as children with Developmental Language Disorder (DLD) and under-diagnosis of bilingual children with DLD. The present paper addresses this challenge by focusing on Hebrew as a second language (L2) of bilingual preschool children whose first language (L1) is either English or Russian, taking into consideration both chronological age (CA) and age of onset of bilingualism (AOB). This study aimed to generate bilingual standards for a monolingual screening test, Goralnik Screening Test for Hebrewby arriving at appropriate bilingual typical development cut-off points. A total of 443 bilingual Hebrew speaking children (397 with TLD and 46 with DLD), ages 61–78 months (M = 70; SD = 4), 199 with L1 English and 244 with L1 Russian, took part in the study. The results demonstrate low diagnostic accuracy when a monolingual test with monolingual norms is used for bilingual children, in contrast with increased diagnostic accuracy when bilingual standards are used for bilingual children. The paper concludes by showing the importance of bilingual standards when assessing clinical populations with varying ages of acquisition, and in particular, for those who were exposed to their second language after the age of four. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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18. Peer support for people living with rare or young onset dementia: An integrative review.
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Sullivan, Mary Pat, Williams, Veronika, Grillo, Adetola, McKee-Jackson, Roberta, Camic, Paul M, Windle, Gill, Stott, Joshua, Brotherhood, Emily, and Crutch, Sebastian J
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AFFINITY groups ,ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,CINAHL database ,MEDICAL databases ,SOCIAL support ,SYSTEMATIC reviews ,DEMENTIA patients ,CONCEPTUAL structures ,AGE factors in disease ,DESCRIPTIVE statistics ,MEDLINE ,THEMATIC analysis ,DATA analysis software - Abstract
Objectives: The aim of this integrative review was to identify and synthesize the literature on peer support interventions for people living with or caring for someone with a rare or young onset dementia. Design: A literature search of articles was performed using the Nipissing University Primo search system, a central index that enables simultaneous searches across databases which included MEDLINE (PubMed), Web of Science, PsycINFO, CINAHL, Sociological Abstracts, Cochrane Library. Results: The eleven papers that met the inclusion criteria spanned eighteen years and from five countries. Studies reported on peer support programs that were either hospital-based (n = 6) or community-based (n = 4), and were predominantly led by disciplines in the health sciences. Only one study did not involve delivering services. There was a range of methodological quality within the studies included in the review. Further analysis and synthesis led to the identification of three overarching peer support themes. These included: (1) peers as necessarily part of social support interventions; (2) a theoretical portmanteau; and (3) dementia spaces and relationality. Conclusion: Consistent with a much larger body of work examining peer involvement in social interventions, this review reinforced the valuable contribution of peers. A full understanding of the mechanisms of change was not achieved. Notwithstanding, the issue of studies neglecting to sufficiently conceptualize and describe interventions is an important one – drawing attention to the need to continue to explore varied delivery, including co-produced models, and more effective evaluation strategies to inform the dementia care sector. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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19. Lessons learnt from delivering the public and patient involvement forums within a younger onset dementia project.
- Author
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Parkes, Jacqueline, O'Malley, Mary, Stamou, Vasileios, La Fontaine, Jenny, Oyebode, Jan R, and Carter, Janet
- Subjects
DIAGNOSIS of dementia ,INFORMATION services ,COMMUNITY health services ,DEMENTIA patients ,HEALTH literacy ,AGE factors in disease ,DECISION making ,PATIENT education - Abstract
Including the 'voices' of people living with dementia in a meaningful way is pivotal in shaping local, national and international health and social dementia care research. The Alzheimer's Society (United Kingdom) funded Angela Project (2016–19) was aimed at improving the diagnosis and post-diagnostic support for younger people living with dementia. From the outset, the Project Team ensured that the knowledge and expertise of people living with a younger onset dementia was integral to all decisions taken in respect to overall project design, implementation, and dissemination processes. This was achieved by establishing two project public and patient involvement (PPI) forums; a London PPI Forum and a Bradford-based local PPI Hub. This paper describes how the two groups were formed; the format of the meetings; and the key points learnt by the Project Team from involving people with dementia in all aspects of developing and delivering the Angela Project. Ultimately, the aim is to demonstrate to other researchers in the dementia field how the perspectives of those with a diagnosis can be included in research studies in an active and meaningful way. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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20. Impact of Chemicals on the Age of Menarche: A Literature Review.
- Author
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Anastasiadis, Xristos, Matsas, Alkis, Panoskaltsis, Theodoros, Bakas, Panagiotis, Papadimitriou, Dimitrios T., and Christopoulos, Panagiotis
- Subjects
ONLINE information services ,AIR pollution ,MATERNAL exposure ,PHENOLS ,ETHERS ,SYSTEMATIC reviews ,MENARCHE ,SMOKE ,PLASTICIZERS ,HYDROCARBONS ,FLUOROCARBONS ,METALS ,AGE factors in disease ,INORGANIC compounds ,MEDLINE ,ENVIRONMENTAL exposure - Abstract
A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database until April 2023. The chemical factors found to affect menarche were prenatal and antenatal smoke, phthalates, phenols, organochlorines, perfluoroalkyls and polyfluoroalkyls, metals, air pollutants and polybrominated diphenyl ethers. Low or high exposure to each chemical compound could affect the age of menarche, leading to early or delayed menarche. Furthermore, the results show that intrauterine exposure may have a different impact from antenatal exposure. There is evidence that endocrine-disrupting chemicals affect the age of menarche, but more research needs to be conducted. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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21. Genotype–phenotype correlations of AR‐CMT2S in a cohort of axonal Charcot–Marie–Tooth patients from Central South China.
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Liu, Lei, Zeng, Sen, Li, Xiaobo, Xie, Yongzhi, Xu, Ke, Yang, Honglan, Huang, Shunxiang, Zhao, Huadong, and Zhang, Ruxu
- Subjects
- *
RESEARCH funding , *GAIT disorders , *FOOT abnormalities , *DNA , *DESCRIPTIVE statistics , *LONGITUDINAL method , *GENES , *AGE factors in disease , *ADENOSINE triphosphatase , *MUSCLE weakness , *NEUROLOGICAL disorders , *CHILD development deviations , *GENETIC mutation , *GENOTYPES , *PHENOTYPES , *CHARCOT-Marie-Tooth disease , *GENETIC testing , *SEQUENCE analysis - Abstract
Background and Aims: This study aimed to report nine Charcot–Marie–Tooth disease (CMT) families with six novel IGHMBP2 mutations in our CMT2 cohort and to summarize the genetic and clinical features of all AR‐CMT2S patients reported worldwide. Methods: General information, clinical and neurophysiological data of 275 axonal CMT families were collected. Genetic screening was performed by inherited peripheral neuropathy related genes panel or whole exome sequencing. The published papers reporting AR‐CMT2S from 2014 to 2023 were searched in Pubmed and Wanfang databases. Results: In our CMT2 cohort, we detected 17 AR‐CMT2S families carrying IGHMBP2 mutations and eight were published previously. Among these, c.743 T > A (p.Val248Glu), c.884A > G (p.Asp295Gly), c.1256C > A (p.Ser419*), c.2598_2599delGA (p.Lys868Sfs*16), c.1694_1696delATG (p.Asp565del) and c.2509A > T (p.Arg837*) were firstly reported. These patients prominently presented with early‐onset typical axonal neuropathy and without respiratory dysfunction. So far, 56 AR‐CMT2S patients and 57 different mutations coming from 43 families have been reported in the world. Twenty‐nine of 32 missense mutations were clustered in helicase domain and ATPase region. The age at onset ranged from 0.11to 20 years (Mean ± SD: 3.43 ± 3.88 years) and the majority was infantile‐onset (<2 years). The initial symptoms included weakness of limbs (19, 29.7%), delayed milestones (12, 18.8%), gait disturbance (11, 17.2%), feet deformity (8, 12.5%), feet drop (8, 12.5%), etc. Interpretation: AR‐CMT2S accounted for 6.2% in our CMT2 cohort. We firstly reported six novel IGHMBP2 mutations which expanded the genotypic spectrum of AR‐CMT2S. Furthermore, 17 AR‐CMT2S families could provide more resources for natural history study, drug research and development. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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22. Bilateral Warthin's tumour of the parotid gland: a 16-year retrospective analysis and systematic review.
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Siddiqui, Zohaib, Gupta, Ahaan, Nam, Ronald H K, Huynh, Richard C T, Jan, Mikaeel, Dusu, Keli, and Dhar, Vikram
- Subjects
- *
HEAD & neck cancer , *SEX distribution , *ONCOLOGY , *SYSTEMATIC reviews , *MEDLINE , *AGE factors in disease , *CANCER cells , *MEDICAL databases , *ONLINE information services , *HISTOLOGY , *HOSPITAL wards ,PAROTID gland tumors - Abstract
Objective: Warthin's tumours are the second most common benign parotid tumours in the UK. The World Health Organization states that 5–14 per cent of patients have bilateral Warthin's tumours. This study aimed to: assess the presence of contralateral Warthin's tumours in patients who underwent surgery over the past 16 years at a head and neck unit in England, and perform the first systematic literature review on bilateral Warthin's tumours. Methods: A retrospective analysis was conducted on patients diagnosed with Warthin's tumour based on histology between 2005 and 2020. Additionally, a systematic review (International Prospective Register of Systematic Reviews ('PROSPERO') registration number: CRD42022326846) was performed using PubMed and the Cochrane Library. Results: Among 290 patients diagnosed with Warthin's tumours based on histology following surgery, 24.5 per cent had bilateral Warthin's tumours. The systematic review identified 157 papers, with 14 meeting the inclusion criteria. Conclusion: This study revealed that 24.5 per cent of patients had bilateral Warthin's tumours, deviating from the suggested range. These findings are of interest to surgeons discussing the disease with patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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23. Isolated rapid eye movement sleep behaviour disorder (iRBD) in the Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Sleep Study: protocol and baseline characteristics.
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Bramich, Samantha, Noyce, Alastair J., King, Anna E., Naismith, Sharon L., Kuruvilla, Maneesh Varghese, Lewis, Simon J. G., Roccati, Eddy, Bindoff, Aidan D., Barnham, Kevin J., Beauchamp, Leah C., Vickers, James C., Pérez‐Carbonell, Laura, and Alty, Jane
- Subjects
- *
RAPID eye movement sleep , *BEHAVIOR disorders , *NEURODEGENERATION , *LEWY body dementia , *SLEEP disorders , *AGE factors in disease - Abstract
Summary: Isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) is a sleep disorder that is characterised by dream enactment episodes during REM sleep. It is the strongest known predictor of α‐synuclein‐related neurodegenerative disease (αNDD), such that >80% of people with iRBD will eventually develop Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy in later life. More research is needed to understand the trajectory of phenoconversion to each αNDD. Only five 'gold standard' prevalence studies of iRBD in older adults have been undertaken previously, with estimates ranging from 0.74% to 2.01%. The diagnostic recommendations for video‐polysomnography (vPSG) to confirm iRBD makes prevalence studies challenging, as vPSG is often unavailable to large cohorts. In Australia, there have been no iRBD prevalence studies, and little is known about the cognitive and motor profiles of Australian people with iRBD. The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Sleep Study will investigate the prevalence of iRBD in Tasmania, an island state of Australia, using validated questionnaires and home‐based vPSG. It will also explore several cognitive, motor, olfactory, autonomic, visual, tactile, and sleep profiles in people with iRBD to better understand which characteristics influence the progression of iRBD to αNDD. This paper details the ISLAND Sleep Study protocol and presents preliminary baseline results. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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24. Gender differences in prevalence and associated factors of metabolic syndrome in first-treatment and drug-naïve schizophrenia patients.
- Author
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Zeng, Kuan, Wang, Shuo, Zhang, Lin, Zhang, Yanting, and Ma, Jun
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METABOLIC syndrome risk factors ,TRIGLYCERIDES ,LIPOPROTEINS ,HDL cholesterol ,HEMOGLOBINS ,SCHIZOPHRENIA ,CROSS-sectional method ,SYSTOLIC blood pressure ,BLOOD platelets ,AGE distribution ,BLOOD sugar ,SEX distribution ,SEVERITY of illness index ,RISK assessment ,COMPARATIVE studies ,DIASTOLIC blood pressure ,METABOLIC syndrome ,DESCRIPTIVE statistics ,WAIST circumference ,AGE factors in disease ,CREATININE ,CHOLESTEROL - Abstract
Background: Metabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch. Methods: A total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS). Results: In the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors. Conclusion: There are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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25. Examining the computation of the underlying components of DALYs.
- Author
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Verguet, Stéphane and Chakrabarti, Averi
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LOW-income countries ,DISEASE duration ,AGE factors in disease - Abstract
Disability-adjusted life years (DALYs) capture the mortality and morbidity arising from a disease: they incorporate the years of life lost (YLLs) and the years of life lived with disability (YLD) due to a disease. The relative importance of YLLs and YLDs differs across diseases. The magnitudes of YLLs and YLDs depend on parameters such as the age of onset of disease, duration of disease, the case fatality ratio and disability weight. In this paper, we examine the mathematical computation of the DALY and its underlying components, YLDs and YLLs. We aim to demonstrate under which circumstances (e.g. sets of input parameters) disease-specific YLDs and YLLs become sizeable relative to one another using the parameters of a set of diseases in low-income country settings. Researchers could then focus on understanding the key inputs that drive the relative extents of YLDs and YLLs (e.g. determine whether a detailed estimation of disability weights is essential), while maintaining DALYs as their key outcome metric consistent with disease burden assessments. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
26. Self‐care activities among patients with type 2 diabetes mellitus: A cross‐sectional study.
- Author
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Tang, Jiao, Wu, Tingting, Hu, Xiling, and Gao, Lingling
- Subjects
ACADEMIC medical centers ,RESEARCH evaluation ,CROSS-sectional method ,BLOOD sugar monitoring ,MOTIVATION (Psychology) ,ONE-way analysis of variance ,MULTIPLE regression analysis ,FOOT care ,DIABETES ,TYPE 2 diabetes ,ATTITUDES toward illness ,NURSE-patient relationships ,T-test (Statistics) ,PSYCHOSOCIAL factors ,EMPLOYMENT ,AGE factors in disease ,DISEASE duration ,QUESTIONNAIRES ,SCALE analysis (Psychology) ,DESCRIPTIVE statistics ,CHI-squared test ,PATIENT education ,BODY mass index ,PATIENT-professional relations ,STATISTICAL correlation ,DATA analysis software ,HEALTH self-care ,PEOPLE with diabetes ,EDUCATIONAL attainment - Abstract
Aims: This study investigated self‐care activities and identified their related factors in Chinese patients with type 2 diabetes mellitus. Methods: A cross‐sectional study was conducted in Guangzhou, China, between September 2016 and February 2017, involving 202 Chinese patients with type 2 diabetes mellitus. Measures included the Summary of Diabetes Self‐Care Activities Questionnaire and Revised Illness Perception Questionnaire. Results: Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal overall. Foot care and blood sugar testing were the self‐care activities that were performed the least. One fifth of patients smoked. Some subscales of illness perceptions, receiving health education on diabetes, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in patients with type 2 diabetes mellitus. Conclusion: Health‐care providers and nurses should encourage greater engagement in self‐care activities in patients with type 2 diabetes mellitus, especially foot care and blood sugar testing. Illness perceptions may be used as a framework to guide interventions. Summary statement: What is already known about this topic? Diabetes is a global epidemic, and China has the largest number of patients with type 2 diabetes mellitus.Self‐care activities are a key factor in preventing complications and maintaining long‐term health in patients with type 2 diabetes mellitus.Illness perceptions are amendable to change by health‐care providers. What this paper adds? Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal; the least frequently performed self‐care activities were foot care and blood sugar testing, and one in five patients smoked.Some subscales of illness perceptions, receiving diabetes education, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in Chinese patients with type 2 diabetes mellitus. The implications of this paper: Illness perceptions may be used as a framework to guide interventions aimed at promoting self‐care activities in Chinese patients with type 2 diabetes mellitus.Interventions aimed at promoting self‐care activities should be tailored to the sociodemographic and clinical profiles of individual patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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27. Autism in Turkey: demographics, behavior problems, and accompanying medical conditions in a sample of Turkish youth with autism spectrum disorder.
- Author
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Doenyas, Ceymi, Ekici, Barış, Unay, Öykü Su, Gönen, İsmail, and Tatlı, Burak
- Subjects
DIAGNOSIS of autism ,AUTISM risk factors ,RISK-taking behavior ,AGE distribution ,SELF-injurious behavior ,VIOLENCE ,DIET ,BEHAVIOR disorders in children ,RISK assessment ,SEX distribution ,AUTISM ,AGE factors in disease ,SOCIODEMOGRAPHIC factors ,ALLERGIES ,COMORBIDITY ,EPIDEMIOLOGICAL research ,OBSESSIVE-compulsive disorder - Abstract
Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 ± 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
28. A principle‐based framework for disclosing a psychosis risk diagnosis.
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Zhang, Oliver Y., McConnell, Doug, Carter, Adrian, and Pugh, Jonathan
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DISCLOSURE ,PSYCHOSES ,DISCRIMINATION (Sociology) ,MENTAL health ,SOCIAL stigma ,EVIDENCE-based medicine ,CONCEPTUAL structures ,RISK assessment ,AGE factors in disease ,AUTONOMY (Psychology) ,DIAGNOSTIC errors ,BIOETHICS - Abstract
In recent decades, researchers have attempted to prospectively identify individuals at high risk of developing psychosis in the hope of delaying or preventing psychosis onset. These psychosis risk individuals are identified as being in an 'At‐Risk Mental State' (ARMS) through a standardised psychometric interview. However, disclosure of ARMS status has attracted criticism due to concerns about the risk–benefit ratio of disclosure to patients. Only approximately one quarter of ARMS patients develop psychosis after three years, raising concerns about the unnecessary harm associated with such 'false‐positive' results. These harms are especially pertinent when identifying psychosis risk individuals due to potential stigma and discrimination in a young clinical population. A dearth of high‐quality evidence supporting interventions for ARMS patients raises further doubts about the benefit accompanying an ARMS disclosure. Despite ongoing discussion in the bioethical literature, these concerns over the ethical justification of disclosure to ARMS patients are not directly addressed in clinical guidelines. In this paper, we aim to provide a unified disclosure strategy grounded in principle‐based analysis for ARMS clinicians. After considering the ethical values at stake in ARMS disclosure, and their normative significance, we argue that full disclosure of the ARMS label is favoured in the vast majority of clinical situations due to the strong normative significance of enhancing patients' understanding. We then compare our framework with other approaches to ARMS disclosure and outline its limitations. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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29. Is Aging a Disease? The Theoretical Definition of Aging in the Light of the Philosophy of Medicine.
- Author
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Saborido, Cristian and García-Barranquero, Pablo
- Subjects
PHILOSOPHY of medicine ,AGE factors in disease ,AGING ,DEFINITIONS ,MEDICALIZATION ,ACTIVE aging - Abstract
In the philosophical debate on aging, it is common to raise the question of the theoretical definition of aging in terms of its possible characterization as a disease. Understanding aging as a disease seems to imply its medicalization, which has important practical consequences. In this paper, we analyze the question of whether aging is a disease by appealing to the concept of disease in the philosophy of medicine. As a result of this analysis, we argue that a pragmatist approach to the conception of disease is the best alternative to highlight the relevance of the medicalization of aging. From this pragmatist perspective, it can be seen that the notion of aging is going through a conceptual change, and aging can today be understood as a not radically different process from any other condition that is usually considered a disease. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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30. ASSOCIATION AMONG FUNCTION-RELATED TESTS, PAIN, AND DEMOGRAPHIC DATA IN INDIVIDUALS WITH SHOULDER DISORDERS.
- Author
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Sakulsriprasert, Prasert, Adisaiphaopan, Rachaneewan, Suwannarat, Sarawut, Sa-ngounsak, Thachakorn, Junsiri, Pathtarajaree, Praoprirtpirom, Kamonwan, and Suwanasri, Chompunoot
- Subjects
SHOULDER disorders ,RANK correlation (Statistics) ,PAIN management ,AGE factors in disease ,STATISTICAL correlation ,DIABETES - Abstract
Background: Function-related tests for shoulder disorders are probably related to pain and demographic data which need to be investigated. This paper aimed to study the associations among function-related tests, pain, and demographic data in individuals with shoulder disorders. Methods: The demographic data, pain by numerical rating scale (NRS), and function-related tests which are hand behind neck (HBN) and hand behind back (HBB) tests were collected. The associations were analyzed using the Spearman correlation coefficient and point-biserial correlation. Results: Five hundred sixty-six individuals with shoulder disorders participated. High significant association was reported between HBN and HBB ( r s = 0. 7 8 0 , p < 0. 0 0 1). Also, NRS ( r s = –0.196, r s = –0.237), age ( r s = –0.258, r s = –0.241), number of underlying diseases ( r s = –0.161, r s = –0.171), and diabetes mellitus (DM) ( r p b = –0.124, r p b = –0.143) had significant correlations with HBN and HBB tests. Conclusion: The association among HBN, HBB, NRS, age, number of underlying diseases, and DM reflected the importance of pain management and the considerations of the patient's background involving age and underlying diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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31. Interpretation for Individual Brain Age Prediction Based on Gray Matter Volume.
- Author
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Sun, Jiancheng, Tu, Zongqing, Meng, Deqi, Gong, Yizhou, Zhang, Mengmeng, and Xu, Jinsong
- Subjects
GRAY matter (Nerve tissue) ,BRAIN degeneration ,CENTRAL nervous system ,AGE factors in disease ,PROPERTIES of matter - Abstract
The relationship between age and the central nervous system (CNS) in humans has been a classical issue that has aroused extensive attention. Especially for individuals, it is of far greater importance to clarify the mechanisms between CNS and age. The primary goal of existing methods is to use MR images to derive high-accuracy predictions for age or degenerative diseases. However, the associated mechanisms between the images and the age have rarely been investigated. In this paper, we address the correlation between gray matter volume (GMV) and age, both in terms of gray matter themselves and their interaction network, using interpretable machine learning models for individuals. Our goal is not only to predict age accurately but more importantly, to explore the relationship between GMV and age. In addition to targeting each individual, we also investigate the dynamic properties of gray matter and their interaction network with individual age. The results show that the mean absolute error (MAE) of age prediction is 7.95 years. More notably, specific locations of gray matter and their interactions play different roles in age, and these roles change dynamically with age. The proposed method is a data-driven approach, which provides a new way to study aging mechanisms and even to diagnose degenerative brain diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
32. Parent, carer and professional views of specialist child and adolescent mental health care during the COVID-19 pandemic.
- Author
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Archard, Philip John, Giles, Emma, Moore, Isobel, Awhangansi, Sewanu, Fitzpatrick, Siobhan, Kulik, Leanne, and O'Reilly, Michelle
- Subjects
PARENT attitudes ,CAREGIVER attitudes ,CAREGIVERS ,HEALTH services accessibility ,ATTITUDES of medical personnel ,RESEARCH methodology ,PHYSICIAN-patient relations ,ADOPTIVE parents ,INTERVIEWING ,COMPARATIVE studies ,MEDICAL protocols ,QUESTIONNAIRES ,AGE factors in disease ,EPIDEMICS ,DESCRIPTIVE statistics ,QUALITY assurance ,STAY-at-home orders ,STATISTICAL sampling ,ETHNIC groups ,COVID-19 pandemic ,MENTAL health services ,PARENTS ,PSYCHOLOGICAL stress ,TELEMEDICINE ,HEALTH promotion ,CHILDREN ,ADOLESCENCE - Abstract
Purpose: The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children's services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery. Design/methodology/approach: Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires. Findings: Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers' accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children's birth families there were more mixed and negative impressions. Originality/value: Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
33. Overview of Traditional Mongolian Medical Warm Acupuncture.
- Author
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Guo Shao, Wei Xie, Xiaoe Jia, Rengui Bade, Yabing Xie, Ruifang Qi, Kerui Gong, Haihua Bai, Lengge Si, Yingsong Chen, Kai Sun, and Agula Bo
- Subjects
ACUPUNCTURE ,MONGOLIAN medicine ,AGE factors in disease - Abstract
Mongolian medical warm acupuncture is a traditional therapy of Mongolian medicine and was developed by people living on the Mongolian Plateau. This kind of traditional oriental medicine has a long history. The main characteristics of Mongolian medical warm acupuncture are the acupoints and the needles used. Its theory is based on the human anatomical structure and the distinct local culture. Mongolian medical warm acupuncture has been practiced for centuries and proved to be very effective in the treatment of age-related diseases, including the musculoskeletal and nervous diseases. This paper aims to briefly introduce the history and scope of Mongolian medical warm acupuncture, with a particular focus on age-related diseases, where Mongolian medical warm acupuncture has shown significant beneficial effects. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
34. Creating change: the experiences of women living with young onset dementia.
- Author
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Broders, Kirstin and Wiersma, Elaine C.
- Subjects
DIAGNOSIS of dementia ,FRIENDSHIP ,PATIENT advocacy ,SOCIAL support ,WORK ,INTERVIEWING ,EXPERIENCE ,DEMENTIA patients ,PSYCHOLOGY of women ,AGE factors in disease ,DEMENTIA ,OCCUPATIONAL health services - Abstract
People with dementia have typically been treated as homogenous groups with little recognition of unique aspects of identities, including age and gender. The purpose of this paper is to illuminate the experiences of women living with young onset dementia which led them to take up advocacy roles as a result of their experiences. Five women from Canada who were diagnosed with young onset dementia and had then taken on advocacy roles were interviewed. Two main themes emerged–Moving In (the challenges of a diagnosis) and Moving On (into a new life). They described the challenges of a diagnosis as stopping work, being taken seriously, fighting for support, failing to meet requirements for programs and services, and changing relationships with friends. The challenges led them to move into a new life, accepting their diagnosis, and moving into new roles of advocacy and supporting others with dementia in their journey. Further research should seek to explore diversity, rather than treating people with dementia as the same. The experience of dementia is different for everyone. From getting a diagnosis to living a life with dementia, these experiences are unique. Based on interviews with five women living with dementia diagnosed before age 65, it was found that the challenges of getting a diagnosis led the women to become advocates for supporting others with dementia in their journey. The challenges of a diagnosis included stopping work, being taken seriously, fighting for support, not meeting requirements for programs and services, and changing relationships with friends. As a result of their experiences, the women moved on into a new life, accepting their diagnoses, and taking on advocacy roles to create change for others living with dementia. The advocacy roles undertaken by these women demonstrate the need to recognize the unique aspects of people with dementia, in particular women with young onset dementia, without making assumptions that the experience of dementia is the same for everyone. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. Food Insecurity, Dietary Patterns, and Non-Communicable Diseases (NCDs) in Windhoek, Namibia.
- Author
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Kazembe, Lawrence N., Nickanor, Ndeyapo, and Crush, Jonathan
- Subjects
FOOD security ,NON-communicable diseases ,FOOD consumption ,AGE factors in disease ,STATISTICAL sampling - Abstract
This paper investigates the relationship between dietary patterns and non-communicable diseases (NCDs) in Windhoek based on data from a cross-sectional random sample of 863 households. We identify three major dietary patterns: starch–sugar–oil, fruits–vegetables, and meat–fish, which explain more than 43% of the variation in food consumption. High uptake levels of starch–sugar–oil diets are associated with diabetes, and also increase heart problems. Females were at greater risk of cardio-vascular disease (CVD) and hypertension, while there is an increased risk of disease with age. Highly food insecure residents in informal settlements displayed lower than expected rates of NCDs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
36. A comprehensive framework for early-onset colorectal cancer research.
- Author
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Eng, Cathy, Jácome, Alexandre A, Agarwal, Rajiv, Hayat, Muhammad Hashim, Byndloss, Mariana X, Holowatyj, Andreana N, Bailey, Christina, and Lieu, Christopher H
- Subjects
- *
COLORECTAL cancer , *HEREDITARY nonpolyposis colorectal cancer , *CANCER research , *OLDER people , *DISEASE prevalence , *CANCER diagnosis , *GENOMICS , *AGE factors in disease , *RESEARCH funding - Abstract
Sporadic colorectal cancer has traditionally been viewed as a malignancy of older individuals. However, as the global prevalence of the disease diagnosed in younger individuals (<50 years) is expected to increase within the next decade, greater recognition is now being given to early-onset colorectal cancer. The cause of the predicted rise in prevalence is largely unknown and probably multifactorial. In this Series paper, we discuss the potential underlying causes of early-onset colorectal cancer, the role of energy balance, biological and genomic mechanisms (including microbiome aspects), and the treatment of early-onset colorectal cancer. We have specifically considered the psychosocial challenges of being diagnosed with colorectal cancer at younger age and the potential financial toxicity that might ensue. This Series paper brings a comprehensive review based on the existing data in the hopes of optimising the overall outcomes for patients with early-onset colorectal cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
37. Growing rods in Early Onset Scoliosis: The current scenario.
- Author
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Mehta, Jwalant S., Tognini, Martina, and Hothi, Harry
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PROSTHETICS ,ORTHOPEDIC surgery ,ARTIFICIAL implants ,MAGNETIC resonance imaging ,TREATMENT effectiveness ,SCOLIOSIS ,AGE factors in disease - Abstract
The treatment of early onset scoliosis is a challenge. Some curves resolve spontaneously, while the more aggressive ones require surgical intervention. Several surgical strategies have been explored in this unique group of patients, though the distraction based growing rods are the mainstay of treatment. The aim of this paper is to consider the current scenario with the surgical treatment for early onset scoliosis with growing rods. This is a narrative review that explores the various types of growing rod options that are currently available. The results, as reported in literature, are discussed. The complications and problems with the commonly used growing rods are explored, based on the reported literature and on retrieval analysis that we have published. We discuss some of the newer modifications of growing rods. There is no real consensus on the ideal timing for the surgery or ways to assess the outcomes of the treatment. The Cobb angle measurement and measures of thoracic growth are surrogate markers. The main indication for surgery is to an increase in the thoracic dimensions and allowing for lung growth. Measures that are linked to lung function are more useful. We report some newer MRI scanning technology. Distraction-based growing rods have been reported to produce consistent and good results. Frequent return to theatre with the Traditional Growing Rods (TGR) and the metallosis related problems with the MCGR are reported. We have learned a lot from the TGR and MCGR experiences. There is a scope for ongoing research to improve the design of the implant systems and better assess the outcomes on lung function. This review outlines these and helps identify the future trends. [ABSTRACT FROM AUTHOR]
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- 2023
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38. Significant myopic shift over time: Sixteen-year trends in overall refraction and age of myopia onset among Chinese children, with a focus on ages 4-6 years.
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Zhi Chen, Dantong Gu, Bingjie Wang, Pauline Kang, Kathleen Watt, Zuyao Yang, and Xingtao Zhou
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MYOPIA ,CONFIDENCE intervals ,CROSS-sectional method ,MULTIVARIATE analysis ,HYPEROPIA ,MANN Whitney U Test ,RISK assessment ,T-test (Statistics) ,AGE factors in disease ,RESEARCH funding ,CHI-squared test ,DESCRIPTIVE statistics ,MEDICAL appointments ,DATA analysis software ,REFRACTIVE errors ,EYE examination ,PROPORTIONAL hazards models ,DISEASE risk factors ,CHILDREN - Abstract
Background Myopia or near-sightedness is a major cause of blindness in China and typically develops between the ages of 6-12 years. We aimed to investigate the change in refractive error and the age of myopia onset in Chinese children from 2005 to 2021. Methods We first conducted a series of cross-sectional studies to determine the refractive states and the age of myopia onset over time, after which we analysed longitudinal data to investigate the dose-response relationship between hyperopic reserve and future risk of myopia. The analysis was based on the refraction data of children aged 4-18 years who visited the Fudan University Eye and Ear, Nose, and Throat (FUEENT) Hospital, a large tertiary hospital in Shanghai, China, for eye examinations between 2005 and 2021. We examined the prevalence of hyperopia (spherical equivalent refractive error (SERE) >0.75D), pre-myopia (-0.50D < SERE ≥ 0.75D), and myopia (SERE ≥-0.50D), the average SERE for each age group at the initial visit, the average age of myopia onset, and the safety threshold of hyperopic reserve against myopia onset. Results We included 870 372 eligible patients aged 4-18 years who attended examination between 2005 and 2021, 567 893 (65.2%) of whom were myopic at their initial visit to FUEENT. The mean SERE decreased in most (n/N = 14/15) of the age groups over the 16 calendar years, with a mean SERE for the whole cohort decreasing from -1.01D (standard deviation (SD) = 3.46D) in 2005 to -1.30D (SD = 3.11D) in 2021. The prevalence of pre-myopia increased over the 16 years (P < 0.001), while those of myopia and hyperopia remained largely stable (both P > 0.05). We observed a significant decrease in the prevalence of hyperopia (2005: 65.4% vs 2021: 51.1%; P < 0.001) and a significant increase in the prevalence of pre-myopia (2005: 19.0% vs 2021: 26.5%; P < 0.001) and myopia (2005: 15.6% vs 2021: 22.4%; P < 0.001) in children aged 4-6 years. We found an earlier myopia onset over time, with the mean age of onset decreasing from 10.6 years in 2005 to 7.6 years in 2021 (P < 0.001). Children with a hyperopic reserve of less than 1.50D were at increased risk of developing myopia during a median follow-up of 1.3 years. Conclusions We found an overall myopic shift in SERE in Chinese children aged 4-18 years over the past 16 years, particularly in those aged 4-6 years. The mean age of myopia onset decreased by three years over the same period. The "safety threshold" of hyperopic reserve we identified may help target the high-risk population for early prevention. [ABSTRACT FROM AUTHOR]
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- 2023
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39. Biological aging mediates the association between periodontitis and cardiovascular disease: results from a national population study and Mendelian randomization analysis.
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Zhang, Zhaoqi, Zhao, Xingru, Gao, Shang, Li, An, Deng, Ke, Yang, Kai, Liu, Wei, and Du, Mi
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HEALTH & Nutrition Examination Survey ,GENOME-wide association studies ,MYOCARDIAL infarction ,AGE factors in disease ,CHEMICAL vapor deposition - Abstract
Background: The relationship between periodontitis and cardiovascular disease (CVD) has been extensively studied, but the role of biological aging in this relationship remains poorly understood. This study is dedicated to investigating the effect of periodontitis on the incidence of CVD and to elucidating the potential mediating role of biological aging. Furthermore, this study will seek to elucidate the causal association between periodontitis, CVD, and biological aging. Methods: We included 3269 participants from the National Health and Nutrition Examination Survey (2009–2014) with diagnostic information on periodontitis and composite CVD events. Biological aging was evaluated by utilizing both the Klemera–Doubal method's calculated biological age (KDMAge) and phenotypic age (PhenoAge). Logistic regression, restricted cubic spline (RCS) analysis, and subgroup analysis were used for data analysis. Mediation analysis was employed to explore the mediating role of biological aging. Subsequently, Mendelian randomization (MR) analyses were performed using genome-wide association study databases to explore potential causal relationships between periodontitis, CVD, and biological aging. Results: Periodontitis was associated with a higher risk of CVD. Participants with periodontitis were found to have increased levels of biological aging, and elevated levels of biological aging were associated with increased CVD risk. Mediation analyses showed a partial mediating effect of biological aging (PhenoAge: 44.6%; KDMAge: 22.9%) between periodontitis and CVD risk. MR analysis showed that periodontitis played a causal role in increasing the risk of small vessel stroke, while myocardial infarction was found to increase the risk of periodontitis. In addition, reverse MR analysis showed that phenotypic aging can increase the risk of periodontitis, and there is a two-way causal relationship between CVD and biological aging. Conclusions: Periodontitis is associated with an increased CVD risk, partially mediated by biological aging, with a complex causal interrelationship. Targeted interventions for periodontal health may slow the biological aging processes and reduce CVD risk. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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40. Quantifying the risk of spillover reduction programs for human health.
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Nuismer, Scott L., Basinski, Andrew J., Schreiner, Courtney L., Eskew, Evan A., Fichet-Calvet, Elisabeth, and Remien, Christopher H.
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COMPUTER simulation ,AGE factors in disease ,MATHEMATICAL models ,RABIES ,HEALTH programs - Abstract
Reducing spillover of zoonotic pathogens is an appealing approach to preventing human disease and minimizing the risk of future epidemics and pandemics. Although the immediate human health benefit of reducing spillover is clear, over time, spillover reduction could lead to counterintuitive negative consequences for human health. Here, we use mathematical models and computer simulations to explore the conditions under which unanticipated consequences of spillover reduction can occur in systems where the severity of disease increases with age at infection. Our results demonstrate that, because the average age at infection increases as spillover is reduced, programs that reduce spillover can actually increase population-level disease burden if the clinical severity of infection increases sufficiently rapidly with age. If, however, immunity wanes over time and reinfection is possible, our results reveal that negative health impacts of spillover reduction become substantially less likely. When our model is parameterized using published data on Lassa virus in West Africa, it predicts that negative health outcomes are possible, but likely to be restricted to a small subset of populations where spillover is unusually intense. Together, our results suggest that adverse consequences of spillover reduction programs are unlikely but that the public health gains observed immediately after spillover reduction may fade over time as the age structure of immunity gradually re-equilibrates to a reduced force of infection. Author summary: Many pathogens, such as rabies, coronaviruses, and hantaviruses primarily circulate within wild animals but can infect humans when the opportunity arises. This pervasive challenge to public health has motivated the development of new methods designed to reduce the frequency of these spillover events. Although reducing spillover infection of humans appears to be an obvious win for public health, it is conceivable that altering historical patterns of spillover could change the age structure of human immunity in a way that undermines human health. Using mathematical and computational models we evaluate the conditions required for these counterintuitive impacts to occur. Our analyses demonstrate that reducing spillover from wild animals will generally improve public health and that negative outcomes can occur in only rare and unusual circumstances. Although negative impacts of spillover reduction are likely to be rare, our results show that the public health benefits of spillover reduction may fade over time unless a near total elimination of spillover can be achieved. [ABSTRACT FROM AUTHOR]
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- 2024
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41. Association between COVID-19 and the incidence of type 1 diabetes in Portugal – a registry study.
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Bjerregaard-Andersen, Morten, Da Silva, Jessica, Diogo, Rui, Claro, Ana Raquel, Ferro, Inês, Romana, Andreia, Rocha, Patrícia, Sá, Beatriz, Lobarinhas, Goreti, Rolim, Sara, Juhl, Claus Bogh, Højlund, Kurt, Fernandes, Isabel, Antunes, Sónia, Félix Calha, Maria Manuela, Gama, Guida, Amálio, Sofia, Figueiras, Mariana, Silva, Teresa, and Rosado, Margarida
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TYPE 1 diabetes ,RISK assessment ,PREPROCEDURAL fasting ,GLYCOSYLATED hemoglobin ,RESEARCH funding ,DIABETIC acidosis ,DESCRIPTIVE statistics ,BLOOD sugar ,C-peptide ,AGE factors in disease ,COVID-19 ,HOSPITAL wards ,DISEASE risk factors - Abstract
Background: Viral respiratory infections may precipitate type 1 diabetes (T1D). A possible association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, and the incidence of T1D is being determined. This study was carried out using Portuguese registries, aiming at examining temporal trends between COVID-19 and T1D. Methods: Hospital data, comparing the incidence before and during the COVID-19 pandemic, from children and young adults diagnosed with new-onset T1D, was acquired beginning in 2017 and until the end of 2022. Data was obtained from nine different Portuguese hospital units. The impact of the COVID-19 pandemic, beginning in March 2020, was assessed comparing the annual numbers of new-onset T1D cases. The annual median levels of glucose, glycated hemoglobin (HbA1c) and fasting C-peptide at T1D diagnosis were compared. The annual number of diabetic ketoacidosis (DKA) episodes among new T1D cases was also assessed at two centers. Results: In total, data from 574 newly diagnosed T1D patients was analyzed, including 530 (92.3%) children. The mean ages for child and adult patients were 9.1 (SD 4.4) and 32.8 (SD 13.6) years, respectively. 57.8% (331/573) were male, one patient had unknown sex. The overall median (25–75 percentiles) levels of glucose, HbA1c and fasting C-peptide at diagnosis were 454 mg/dL (356–568), 11.8% (10.1–13.4) and 0.50 µg/L (0.30–0.79), respectively. DKA at T1D diagnosis was present in 48.4% (76/157). For eight centers with complete 2018 to 2021 data (all calendar months), no overall significant increase in T1D cases was observed during the COVID-19 pandemic, i.e. 90 cases in 2018, 90 cases in 2019, 112 in 2020 and 100 in 2021 (P for trend = 0.36). Two of the centers, Faro (CHUA) and Dona Estefânia (CHULC) hospitals, did however see an increase in T1D from 2019 to 2020. No significant changes in glucose (P = 0.32), HbA1c (P = 0.68), fasting C-peptide (P = 0.20) or DKA frequency (P = 0.68) at the time of T1D diagnosis were observed over the entire study period. Conclusion: The T1D incidence did not increase significantly, when comparing the years before and during the COVID-19 pandemic, nor did key metabolic parameters or number of DKA episodes change. [ABSTRACT FROM AUTHOR]
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- 2024
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42. Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries.
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Qaisar, Rizwan, Hussain, M. Azhar, Franzese, Fabio, Karim, Asima, Ahmad, Firdos, Awad, Atif, Al-Masri, Abeer A., and Alkahtani, Shaea A.
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RISK assessment ,HYPERLIPIDEMIA ,FRAIL elderly ,LOGISTIC regression analysis ,AGE factors in disease ,LONGITUDINAL method ,ODDS ratio ,QUALITY of life ,STROKE ,BODY movement ,GRIP strength ,MENTAL depression ,DIABETES - Abstract
Objectives: A low handgrip strength (HGS) is a significant risk factor for multiple diseases. However, most relevant studies investigate the complications of a low HGS, while the risk potential of causative factors of low HGS remain poorly characterized. Methods: We investigated the potentials of quality of life, depression, dyslipidaemia, diabetes mellitus, cancer, Alzheimer's disease, stroke, frailty, and difficulties performing daily activities in predicting low HGS (≤ 27 kg for men, ≤ 16 kg for women) in European older adults aged 50 or above from 15 countries (n = 42,183). All data was collected from four successive waves of survey of health, ageing, and retirement in Europe (SHARE) conducted between 2013 and 2020. Logistic models are applied, and estimated effects are presented as odds ratios and probabilities. Results: Collectively, 3016 participants (men; n = 1395; 7.38%, women; n = 1621, 6.97%) developed low HGS during the 6.5 years study period. After adjusting for covariables, we identified an advancing age (1.6–48.1% points higher risk of low HGS), male gender (1.0%-point higher risk of low HGS), lower quality of life (1.6%-point higher), and stroke (1.5%-points) as significant risk factors for low HGS. We also found a dose-dependent association of Euro-D depression scores with the risk of low HGS, as the higher scores were associated with between 0.6- and 2.3%-points higher risk of developing low HGS than participants without depression. Among physical performance indicators, difficulty climbing stairs (2.0%-points higher low HGS risk) or rising from a chair (0.7%-points) were significantly associated with developing low HGS. Lastly, frailty (0.9%-points higher risk of low HGS) and the fear of falling down (1.6%-points higher risk) also increased the risk of developing low HGS. Conclusion: Altogether, we report several risk factors for developing low HGS. Our observations may help evaluating and monitoring high-risk population for developing low HGS in pre-clinical settings. [ABSTRACT FROM AUTHOR]
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- 2024
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43. Assessing Stroke Awareness and Behavioural Response Following the National 'Act Fast' Stroke Awareness Campaign – Insights from a Cross-Sectional Survey in Qatar.
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Bhutta, Zain A., Pathan, Sameer A., Puolakka, Tuukka, Akhtar, Naveed, Thomas, Stephen H., Harris, Tim, Shuaib, Ashfaq, Cameron, Peter A., and Castren, Maaret
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HEALTH literacy ,PEARSON correlation (Statistics) ,T-test (Statistics) ,RESEARCH funding ,FISHER exact test ,DESCRIPTIVE statistics ,CHI-squared test ,AGE factors in disease ,LONGITUDINAL method ,STROKE ,HEALTH promotion ,DATA analysis software ,SYMPTOMS - Abstract
Evaluating stroke campaigns and associated behavioural changes is crucial to assess intervention effectiveness and inform future strategies. We aimed to evaluate patient's and bystanders' foreknowledge of stroke signs and symptoms and their response at stroke onset. We interviewed stroke patients using a validated questionnaire or their bystanders if the stroke patient had disabling stroke. The questionnaire was administered to 165 participants, 142 (86.1%) stroke patients and 23 (13.9%) bystanders. The mean age was 52.6 (SD = 11.7), and male–female ratio was 7:1. Among the participants, 33 (20.1%) had foreknowledge of stroke signs, and of these, 27 (16.5%) were aware of the stroke campaign in Qatar. The behavioural responses at stroke onset included; activating Emergency Medical Services (EMS) (n = 55, 33.3%), calling friends/relatives (n = 69, 41.8%), driving to hospital (n = 33, 20%), waiting for improvement in condition (n = 21, 12.7%). There was no association of ethnicity, marital status, or campaign awareness with EMS activation. Despite limited community awareness of stroke signs and campaign, help-seeking behaviour through EMS activation was generally high, underscoring the need for focused educational efforts and public health interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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44. Objective findings in patients with multi-canal benign paroxysmal positional vertigo.
- Author
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Zhu, Yanhan, He, Xiaoming, Hu, Mei, Mao, Chun, Liu, Zheng, Yang, Xu, Yang, Jing, and Chang, Liying
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PATIENTS ,RESEARCH funding ,HOSPITAL admission & discharge ,EYE movement measurements ,SEX distribution ,RETROSPECTIVE studies ,DIAGNOSIS ,DESCRIPTIVE statistics ,AGE distribution ,BENIGN paroxysmal positional vertigo ,AGE factors in disease ,VESTIBULAR apparatus diseases ,EAR examination ,SEMICIRCULAR canals ,DISEASE risk factors ,SYMPTOMS - Abstract
Objective: The study aimed to investigate the clinical characteristics of patients with multi-canal benign paroxysmal positional vertigo (MC-BPPV). Methods: We performed a retrospective analysis of 927 patients with BPPV who were admitted to our hospital between January 1, 2016 and December 31, 2019. The clinical data of all patients were collected. The Dix-Hallpike, straight head-hanging, and supine Roll tests were performed in all patients. The nystagmus was recorded using videonystagmography. The clinical characteristics of patients with MC-BPPV and single canal BPPV (SC-BPPV) was analyzed and compared. Results: Among 927 patients included, 49 (5.29%) patients had MC-BPPV, 878 (94.71%) patients had SC-BPPV. There were significant differences in the male to female ratio (1:3.90 vs 1:1.81, P <.05), mean age (62.47±12.51 vs 59.04±13.72, P <.05), as well as the ratio of cupulolithiasis to canalithiasis (1:1.45 vs 1:4.78, P <.01) between patients with MC-BPPV and SC-BPPV. The frequency of involvement of PC, HC, and AC were involved for 66 (67.35%), 23 (23.47%), and 9 (9.18%) times, respectively, in patients with MC-BPPV, which were involved in 581 (66.17%), 281 (32.0%), and 16 (1.82%) patients, respectively, in patients with SC-BPPV. No significant difference was found in the frequency of involvement of PC and HC between patients with MC-BPPV and SC-BPPV, while there was significant difference in the frequency of AC involvement between 2 groups (P <.01). Ipsilateral PC-HC-BPPV (n = 18) and bilateral PC-BPPV (n=19) were the most common among patients with MC-BPPV. Twenty-six (53.06%) patients had ipsilateral MC-BPPV, 23 (46.94%) had bilateral MC-BPPV. Of the 26 patients with ipsilateral MC-BPPV, 7 patients combined with unilateral peripheral vestibular disorder. Conclusion: Patients with MC-BPPV had a significantly older mean age at disease onset and a higher proportion of females compared with patients with SC-BPPV. Cupulolithiasis was more common in MC-BPPV. AC involvement was also much more common in MC-BPPV than in SC-BPPV. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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45. Correlates of diabetes mellitus and hypertension in India: Change as evidenced from NFHS- 4 and 5 during 2015–2021.
- Author
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Rana, Rishabh Kumar, Jha, Ravi Ranjan, Sinha, Ratnesh, Kumar, Dewesh, Jaiswal, Richa, Patel, Urvish, Prasad, Jang Bahadur, Kar, Sitanshu Sekhar, and Goel, Sonu
- Subjects
DIABETES ,AGE groups ,HYPERTENSION ,LOGISTIC regression analysis ,AGE factors in disease ,TRENDS - Abstract
Both diabetes mellitus (DM) and hypertension (HTN) have been on the rise in recent decades all over the world more remarkably in developing countries like India. We intend to measure the prevalence of DM and HTN in the Indian population and to compare the trends and various correlates of these diseases in NFHS (National Family Health Survey)-4 and 5. Data of NFHS-4 and 5 were accessed from dhs program website. All statistical analyses were done in SAS (version 9.4). Mixed effects survey logistic regression models were used for estimating odds ratio (OR).p-values <0.05 were considered significant.1,637,762 individual case entries were evaluated. Both the diseases showed an increasing trend as per the advancing age in both sexes. The highest prevalence of DM is seen in the age group of 45–49 years (7.8%) in females and > 50 years (11.9%) in males as per NFHS-5. Similarly, the highest prevalence of HTN was seen in the age group of45–49 years (31.2%) in females and > 50 years (41.4%) in males as per NFHS-5. The OR (95% CI) of prevalence of DM, HTN and both the diseases in age group >50 years was 14.46 (13.14–15.7), 16.65 (15.78–17.6), 79.5 (64.76–97.73) respectively when compared to reference age group15-19 years. Highest odds for having both DM, HTN concurrently was in age >50 years with aOR(95% CI) 65.32 (52.26–72.63) in NFHS 4 and 35.57 (97.47–45.53) in NFHS 5.Rise in prevalence of DM, HTN and concurrent presence is noted with an apparent increase in cases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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46. Shattered childhood: Experiences of polio survivors in Finland 1950s and 1960s.
- Author
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Elomaa‐Krapu, Minna and Kaunonen, Marja
- Subjects
POLIO patients ,RESEARCH funding ,QUALITATIVE research ,EMPIRICAL research ,INTERVIEWING ,LONELINESS ,EXPERIENCE ,THEMATIC analysis ,AGE factors in disease ,CHILD care ,ADVERSE childhood experiences ,SOCIAL isolation - Abstract
Aim: To describe the childhood experiences of patients with polio from the acute phase of the disease during post‐war Finland in the 1950s and 1960s. Design: Qualitative empirical study based on self‐reported history of nursing rooted in the past, a history of experiences. Methodology: Interview materials were gathered in the form of themes (45) and written interviews (4) (29 September 2018 to 30 June 2019). Data were analysed by reflexive thematic analysis to highlight hidden and latent experiences. This approach generated the study's main theme, themes and subthemes. Results: The main theme, 'shattered childhood', generated from the study results and was then divided into two themes, both of which were influenced in part by the loss of a familiar childhood, the changed environment, the breakdown of the body and the absence of control. Through their childhood memories, polio survivors described their broken childhoods using the following themes: 'betrayal by their bodies' and 'isolation'. In the narratives, the theme 'betrayal by one's own body' was generated by the following subthemes: 'suddenness of the affliction', 'paralysis' and 'being moved to the hospital'. The 'isolation' theme developed from the subthemes 'isolation from the body and surroundings' and 'emotional and social loneliness'. Conclusion: Polio survivors' experiences during the acute stage of the disease were traumatic and demonstrated children's inferior nursing position in Finland in the 1950s and 1960s. Impact: The study increases our understanding of the history of caring for children and families who were affected and disabled by polio and the importance of their experiences in society and healthcare settings. Patient or Public Contribution: The authors collaborated with the Finnish Polio Association to recruit study participants and plan the study. Patients with polio during childhood underwent interviews, and their experiences formulated the data, which were analysed and the basis of the results. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ), a 32‐item checklist for interviews and focus groups, have been used as a reporting and checklist tool. All authors have agreed on the final version and the use of the COREQ criteria, relationship with participants, theoretical framework, setting, data collection and data analysis and report. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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47. The impact on employment and education of caregiving for a family member with young onset dementia: A scoping review.
- Author
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Kokorelias, Kristina M, Nadesar, Nirusa, Bak, Katherine, Boger, Jennifer, Nygård, Louise, Mäki-Petäjä-Leinonen, Anna, Nedlund, Ann-Charlotte, and Astell, Arlene
- Subjects
FAMILIES & psychology ,TREATMENT of dementia ,VOLUNTEER service ,GREY literature ,RESEARCH funding ,FAMILY roles ,DECISION making ,AGE factors in disease ,SYSTEMATIC reviews ,THEMATIC analysis ,FAMILY attitudes ,LITERATURE reviews ,QUALITY of life ,PARTICIPATION ,EXTENDED families ,PSYCHOLOGY of caregivers ,EMPLOYMENT ,PSYCHOSOCIAL factors - Abstract
Young-onset dementia (YOD) affects individuals under 65 years of age, often leading to loss of employment and independence. Families provide increasing levels of care to family members with YOD, resulting in changes to their daily lives, including their occupational pursuits. This review examines evidence of the occupational implications for family members who provide care to a family with YOD to identify: (i) the influence and impact caregiving tasks and responsibilities have on employment, volunteering, and education, and (ii) caregiver, and caregiving situation factors associated with changes in employment, volunteering, and education. A scoping review was performed using eight electronic databases. Included articles were narratively synthesized using a thematic analysis. Sixteen studies met the inclusion criteria and were included for review. The over-arching (main) theme of 'decision-making' was identified, with family members required to make choices about their own occupational goals and roles to be able to provide care to family living with YOD. The outcomes of these decisions are dynamic and changeable across the caregiving trajectory. Three caregiving factors influence decision-making: (1) Implications of Combining Caregiving and Occupations, (2) Altered Identity (3) Strategies to Support Caregivers of Individuals Living with YOD. A fourth theme was also identified 'Guidance for Researchers To Support Caregivers'. There is a scarce body of literature examining the influence caregiving has on occupational outcomes for the YOD caregiver population. Much of this work is descriptive and lacks focus on the implications, particularly long-term impacts. This review provides a foundational guide for future research and practices to support YOD family caregivers to obtain and sustain occupations. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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48. Experiences and Needs of Children Who Have a Parent with Young Onset Dementia: A Meta-ethnographic Review.
- Author
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Poole, Courtney and Patterson, Tom G.
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DIAGNOSIS of dementia ,PSYCHOLOGY information storage & retrieval systems ,ONLINE information services ,CINAHL database ,WELL-being ,MEDICAL information storage & retrieval systems ,CAREGIVERS ,SYSTEMATIC reviews ,CHILDREN of parents with disabilities ,ETHNOLOGY research ,AGE factors in disease ,PSYCHOSOCIAL factors ,INTERPERSONAL relations ,NEEDS assessment ,MEDLINE ,PARENTS - Abstract
Objectives: The aim of the present review was to critically evaluate empirical evidence regarding the needs and experiences of children who have a parent with young onset dementia (YOD). Methods: A systematic search of five databases was carried out and the resulting 16 studies were reviewed using a meta-ethnographic approach. Results: Three main themes arose from the data: 'Dementia Impact", which describes how the child experiences the deterioration in their parent and changes to relationships; "Psychological Impact", comprising the child's private emotional experiences and the psychological consequences of changes in roles; and "Practical Impact", detailing the ways in which children adapt their lives in response to parental YOD, and children's needs for support. Conclusions: These themes synthesize the existing literature and produce a line of argument explaining the experience of children whose parents have YOD. Clinical Implications: Information and policies regarding YOD should take account of the experiences of patients' children and should include targeted support for children of parents with YOD. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
49. The Causal Effect of Health on Out-of-Pocket Health Expenditures: Evidence for Middle-aged and Older Adults in China.
- Author
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Jingyi Gao
- Subjects
OLDER people ,CHRONIC diseases ,AGING ,AGE factors in disease - Abstract
With population aging, the presence of disability and chronic conditions has become a growing challenge among middle-aged and older adults in China. Using panel data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, this paper will explore the causal effects of Activities of Daily Living (ADL) limitations, Instrumental Activities of Daily Living (IADL) limitations, chronic conditions on Out-of-Pocket Expenditures (OOPEs) among middleaged and older adults in China. First difference model and difference-generalized method of moment (GMM) model are used to explore the causal relationships. This research for the first time examines the dynamic and causal relationship between health and OOPEs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
50. Recovery of olfactory and gustatory dysfunctions in coronavirus disease 2019 patients: a prospective cohort study.
- Author
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Taziki Balajelini, M H, Vakili, M A, Rajabi, A, Mohammadi, M, Tabarraei, A, and Hosseini, S M
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COVID-19 ,CONVALESCENCE ,SMELL ,KAPLAN-Meier estimator ,DESCRIPTIVE statistics ,AGE factors in disease ,TASTE ,PSYCHOPHYSIOLOGY ,SUDDEN onset of disease ,DATA analysis software ,LONGITUDINAL method - Abstract
Objective: This study aimed to determine the association of some demographic and clinical factors with recovery from olfactory and gustatory dysfunction in coronavirus disease 2019 patients in Iran. Methods: This prospective cohort study was performed on 242 coronavirus disease 2019 patients with olfactory and gustatory dysfunction. The time from onset to recovery for olfactory and gustatory dysfunction was estimated by the Kaplan–Meier estimator. Results: After six months, 239 patients (98.8 per cent) had completely recovered from olfactory dysfunction. Olfactory and gustatory dysfunction symptoms resolved in 80.99 per cent and 83.56 per cent of the patients, respectively, within the first 30 days of symptom onset. Mean recovery time for olfactory dysfunction (35.07 ± 4.25 days) was significantly longer in those infected during the first epidemic wave compared with those infected during the second wave (21.65 ± 2.05 days) (p = 0.004). A similar pattern in recovery time was observed for cases of gustatory dysfunction (p = 0.005). Conclusion: The recovery rate for coronavirus disease 2019 related olfactory and gustatory dysfunction is high within the first month of symptom onset. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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