scholarly journals Reshuffling community prevention and care: a new model for healthy ageing

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Liotta
Keyword(s):  
Heat Waves ◽  
Functional Decline ◽  
Physical Activities ◽  
Healthy Ageing ◽  
Negative Events ◽  
Risk Of Death ◽  
Active Approach ◽  
Set Up ◽  
Structured Interventions ◽  
The Impact

Abstract Europe is facing a unprecedented change of the population structure due to demographic transition, that makes the European countries a laboratory for implementing policies aimed at healthy ageing. However, there is a paucity of evidence-based interventions, except for the ones focussed on changing individuals' life style, the main ones being nutrition, physical activities, smoking and drinking. Even in the case of life habits, there are no structured interventions, while health promotion activities are mainly entrusted to the GPs, who are responsible for communicating the needed changes of behaviours to the patients they meet. The increase of chronic diseases prevalence claims for rethinking this approach in order to set up structured prevention activities to mitigate the impact of diseases on functional decline. Based on the available data some elements to rethink community care and prevention can be identified. Bio-psycho-social frailty represents a synthetic indicator of the risk of negative events like the worsening of functional status, hospitalization, institutionalization and death, far more effective than single diseases or comorbidities or even than disabilities. The assessment of frailty should be pursued through a pro-active approach in order to fill the gap of the lack of awareness about frailty which is common. This approach should be reserved to the population with the highest risk of negative events, namely the over-75 one. At side of already well-known interventions on physical activities and malnutrition other risk factors for negative events such as social isolation or polypharmacotherapy should be considered. The increased frequency of heat waves should also be at the basis of yearly intervention able to reduce the risk of death and hospitalization, always associated to climate stressors. A schedule of prevention intervention should be formally structured in order to put the basis for a better aging in Europe as a model for other continents.

scholarly journals Role of neo-adjuvant chemotherapy followed by surgery in cervical cancer: a review

2020 ◽  
Vol 9 (9) ◽  
pp. 3912
Author(s):  
Ganesh Bharaswadkar
Keyword(s):  
Cervical Cancer ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Primary Treatment ◽  
Risk Of Death ◽  
Cancer Management ◽  
Neo Adjuvant Chemotherapy ◽  
Set Up ◽  
The Impact

Incidence of cervical cancer is predominantly found in developing countries. In Indian set up, it is most commonly found in rural locations in younger population. Chemotherapy was initially introduced for the treatment of recurrent/metastatic cervix cancer and has subsequently been explored in primary treatment either as neo-adjuvant prior to radiation or surgery in an attempt to reduce the incidence of loco-regional recurrence. The review study tries to evaluate the role of neoadjuvant chemotherapy (NACT) followed by surgery in cervical cancer management. Randomized trials and meta-analysis were analysed. Most of them used short course chemotherapy course of 4-6 weeks followed by surgery. patients with high risk pathological features received postoperative RT. The results of trials indicated significant reduction in the risk of death with NACT, but there were few differences between the trials. NACT followed by surgery is found to be associated with an improved response rate and progression-free survival. However, the impact on overall survival remains to be confirmed.

scholarly journals Thermal extremes mortality risk assessment in urban areas

Finisterra ◽  
2012 ◽  
Vol 45 (89) ◽  
Author(s):  
Paulo Canário
Keyword(s):  
Urban Areas ◽  
Heat Waves ◽  
Spatial Scales ◽  
Natural Phenomena ◽  
Risk Of Death ◽  
The Subject ◽  
The Impact ◽  
The Relationship ◽  
Population Sensitivity ◽  
Related Mortality

The impact of heat waves on mortality has been the subject of numerous studies and the focus of attention of various national and international governmental bodies. In the summer of 2003 alone, which was exceptionally hot, the number of deaths in 12 European countries increased by 70,000. The overall trend of warming will lead to an increase in frequency, duration and intensity of heat waves and to an increase in heat related mortality. The need to assess the risk of death due to extreme heat, at a detailed spatial scale, has determined the implementation of a research project based on a general model of risk for potentially destructive natural phenomena; the model uses the relationship between hazard and vulnerability and was designed primarily for urban areas. The major hazardous meteorological variables are those that determine the thermal complex (air temperature, radiative temperature, wind and humidity) and the variables related to air quality (mainly ozone and Particulate matter). Vulnerability takes into account the population sensitivity (at various spatial scales) and their exposure to thermal extremes.

MOTIF DAN DAMPAK PERNIKAHAN DINI DI INDARUNG NGALAU BATU GADANG

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Murisal Murisal
Keyword(s):  
Young Men ◽  
Early Marriage ◽  
Marriage Law ◽  
Men And Women ◽  
Home Life ◽  
Family Household ◽  
Set Up ◽  
The Impact ◽  
Husband And Wife

Motif and Impact of Early Marriage in Indarung Ngalau Batu Gadang.Penelitian is motivated by teenagers who married early on. Today, young men and women have a tendency to be less prepared to enter the home life, they are only ready to marry (ready here can be interpreted, maturity in terms of financial, understand what the meaning of marriage according to marriage law) is the bond of inner birth between a man and a woman as husband and wife for the purpose of forming a happy and eternal family (household) based on the Supreme Godhead while they are not ready to set up a home, whereas to build a household requires preparation both physically and spiritually . The purpose of this study to determine the motives underlying adolescents to make early marriage and the impact caused in the household as a result of the marriage.

Dissent and Education

2018 ◽  
Author(s):  
Mark Burden
Keyword(s):  
Eighteenth Century ◽  
Seventeenth Century ◽  
Educational Activity ◽  
Educational Institutions ◽  
Higher Educational Institutions ◽  
Legal Restrictions ◽  
Higher Educational ◽  
Set Up ◽  
The Impact ◽  
Dissenting Academies

Much eighteenth-century Dissenting educational activity was built on an older tradition of Puritan endeavour. In the middle of the seventeenth century, the godly had seen education as an important tool in spreading their ideas but, in the aftermath of the Restoration, had found themselves increasingly excluded from universities and schools. Consequently, Dissenters began to develop their own higher educational institutions (in the shape of Dissenting academies) and also began to set up their own schools. While the enforcement of some of the legal restrictions that made it difficult for Dissenting institutions diminished across the eighteenth century, the restrictions did not disappear entirely. While there has been considerable focus on Dissenting academies and their contribution to debates about doctrinal orthodoxy, the impact of Dissenting schools was also considerable.

scholarly journals Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery

2011 ◽  
Vol 114 (2) ◽  
pp. 283-292 ◽  
Author(s):  
Laurent G. Glance ◽  
Andrew W. Dick ◽  
Dana B. Mukamel ◽  
Fergal J. Fleming ◽  
Raymond A. Zollo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Noncardiac Surgery ◽  
Pulmonary Complications ◽  
Wound Complications ◽  
Severe Anemia ◽  
Thromboembolic Complications ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

Background The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively. Methods This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. Results Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37). Conclusions Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.

scholarly journals On Kaufmann's theory of the impact of the pianoforte hammer

1920 ◽  
Vol 97 (682) ◽  
pp. 99-110 ◽  
Keyword(s):  
Initial Conditions ◽  
Practical Importance ◽  
Prima Facie ◽  
Point Of View ◽  
Infinite Length ◽  
Modes Of Vibration ◽  
Rigorous Treatment ◽  
The Subject ◽  
Set Up ◽  
The Impact

The theory of the vibrations of the pianoforte string put forward by Kaufmann in a well-known paper has figured prominently in recent discussions on the acoustics of this instrument. It proceeds on lines radically different from those adopted by Helmholtz in his classical treatment of the subject. While recognising that the elasticity of the pianoforte hammer is not a negligible factor, Kaufmann set out to simplify the mathematical analysis by ignoring its effect altogether, and treating the hammer as a particle possessing only inertia without spring. The motion of the string following the impact of the hammer is found from the initial conditions and from the functional solutions of the equation of wave-propagation on the string. On this basis he gave a rigorous treatment of two cases: (1) a particle impinging on a stretched string of infinite length, and (2) a particle impinging on the centre of a finite string, neither of which cases is of much interest from an acoustical point of view. The case of practical importance treated by him is that in which a particle impinges on the string near one end. For this case, he gave only an approximate theory from which the duration of contact, the motion of the point struck, and the form of the vibration-curves for various points of the string could be found. There can be no doubt of the importance of Kaufmann’s work, and it naturally becomes necessary to extend and revise his theory in various directions. In several respects, the theory awaits fuller development, especially as regards the harmonic analysis of the modes of vibration set up by impact, and the detailed discussion of the influence of the elasticity of the hammer and of varying velocities of impact. Apart from these points, the question arises whether the approximate method used by Kaufmann is sufficiently accurate for practical purposes, and whether it may be regarded as applicable when, as in the pianoforte, the point struck is distant one-eighth or one-ninth of the length of the string from one end. Kaufmann’s treatment is practically based on the assumption that the part of the string between the end and the point struck remains straight as long as the hammer and string remain in contact. Primâ facie , it is clear that this assumption would introduce error when the part of the string under reference is an appreciable fraction of the whole. For the effect of the impact would obviously be to excite the vibrations of this portion of the string, which continue so long as the hammer is in contact, and would also influence the mode of vibration of the string as a whole when the hammer loses contact. A mathematical theory which is not subject to this error, and which is applicable for any position of the striking point, thus seems called for.

The Impact of Heat Waves on Agricultural Labor Productivity and Output

2021 ◽  
pp. 11-20
Author(s):  
Federico Castillo ◽  
Armando Sánchez Vargas ◽  
J. K. Gilless ◽  
Michael Wehner
Keyword(s):  
Labor Productivity ◽  
Heat Waves ◽  
Agricultural Labor ◽  
Agricultural Labor Productivity ◽  
The Impact

scholarly journals Urban Heat Islands and Thermal Comfort: A Case Study of Zorrotzaurre Island in Bilbao

2021 ◽  
Vol 13 (11) ◽  
pp. 6106
Author(s):  
Irantzu Alvarez ◽  
Laura Quesada-Ganuza ◽  
Estibaliz Briz ◽  
Leire Garmendia
Keyword(s):  
Thermal Comfort ◽  
Heat Waves ◽  
Urban Environments ◽  
Urban Heat Islands ◽  
Extreme Weather Events ◽  
Climate Index ◽  
Physiological Equivalent Temperature ◽  
Heat Islands ◽  
The North ◽  
The Impact

This study assesses the impact of a heat wave on the thermal comfort of an unconstructed area: the North Zone of the Island of Zorrotzaurre (Bilbao, Spain). In this study, the impact of urban planning as proposed in the master plan on thermal comfort is modeled using the ENVI-met program. Likewise, the question of whether the urbanistic proposals are designed to create more resilient urban environments is analyzed in the face of increasingly frequent extreme weather events, especially heat waves. The study is centered on the analysis of temperature variables (air temperature and average radiant temperature) as well as wind speed and relative humidity. This was completed with the parameters of thermal comfort, the physiological equivalent temperature (PET) and the Universal Temperature Climate Index (UTCI) for the hours of the maximum and minimum daily temperatures. The results demonstrated the viability of analyzing thermal comfort through simulations with the ENVI-met program in order to analyze the behavior of urban spaces in various climate scenarios.

scholarly journals Impact of Work and Recreational Physical Activity on Prediabetes Condition among U.S. Adults: NHANES 2015–2016

2021 ◽  
Vol 18 (4) ◽  
pp. 1378
Author(s):  
Lenin Pazmino ◽  
Wilmer Esparza ◽  
Arian Ramón Aladro-Gonzalvo ◽  
Edgar León
Keyword(s):  
Physical Activity ◽  
Protective Factor ◽  
Hemoglobin A1c ◽  
Physical Activities ◽  
Recreational Physical Activity ◽  
Physically Active ◽  
Hba1c Test ◽  
Health And Nutrition ◽  
The Impact

More minutes of physical activity (PA) accumulated during a day are associated with a lower risk of diabetes mellitus type 2. However, it is less known if distinct dimensions of PA can produce a different protective effect in the prevention of prediabetes. The aim of this study was to analyze the impact of work and recreational PA on prediabetes among U.S. adults during the period 2015–2016 using the National Health and Nutrition Examination Survey (NHANES) database. Individuals (n = 4481) with hemoglobin A1c (HbA1c) test values of 5.7% to 6.4% were included. A logistic regression multivariate-adjusted analysis was conducted to estimate the association between the odds ratios (ORs) and 95% confidence intervals (CIs) of prediabetes, with work and recreational PA. The prevalence of prediabetes among U.S. adults was lower in physically active individuals both at work (~24%) and recreational (~21%) physical activities compared to individuals who were not physically active (27 to 30%). Individuals lacking practice of recreational PA had a high risk of prediabetes (OR = 1.26, 95% CI: 1.080 to 1.466). PA may be a protective factor for prediabetes conditions depending on gender, age, ethnic group, waist circumference, and thyroid disease.

Functional Decline in Emergency Department Patients with Dyspnea; a Register-Based Cohort

2021 ◽  
Author(s):  
Karoline Stentoft Rybjerg Larsen ◽  
Marianne Lisby ◽  
Hans Kirkegaard ◽  
Annemette Krintel Petersen
Keyword(s):  
Emergency Department ◽  
Electronic Patient Record ◽  
Hospital Admissions ◽  
Functional Decline ◽  
Patient Characteristics ◽  
Risk Of Death ◽  
Record Data ◽  
Emergency Department Patients ◽  
One Year ◽  
Historic Cohort

Abstract Background Functional decline is associated with frequent hospital admissions and elevated risk of death. Presumably patients acutely admitted to hospital with dyspnea have a high risk of functional decline. The aim of this study was to describe patient characteristics, hospital trajectory, and use of physiotherapy services of dyspneic patients in an emergency department. Furthermore, to compare readmission and death among patients with and without a functional decline, and to identify predictors of functional decline. Methods Historic cohort study of patients admitted to a Danish Emergency Department using prospectively collected electronic patient record data from a Business Intelligence Registry of the Central Denmark Region. The study included adult patients that due to dyspnea in 2015 were treated at the emergency department (ED). The main outcome measures were readmission, death, and functional decline. Results In total 2,048 dyspneic emergency treatments were registered. Within 30 days after discharge 20% was readmitted and 3.9% had died. Patients with functional decline had a higher rate of 30-day readmission (31.2% vs. 19.1%, p<0.001) and mortality (9.3% vs. 3.6%, p=0.009) as well as mortality within one year (36.1% vs. 13.4%, p<0.001). Predictors of functional decline were age ≥60 years and hospital stay ≥6 days. Conclusion Patients suffering from acute dyspnea are seen at the ED at all hours. In total one in five patients were readmitted and 3.9% died within 30 days. Patients with a functional decline at discharge seems to be particularly vulnerable.

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