scholarly journals Vision Difficulty and Engagement in Care Among Aging Men Living With HIV

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 177-178
Author(s):  
Alison Abraham ◽  
Weiqun Tong ◽  
Valentina Stosor ◽  
Mackey R Friedman ◽  
Roger Detels ◽  
...  
Keyword(s):  
Medical Care ◽  
Repeated Measures ◽  
Smoking Status ◽  
Vision Impairment ◽  
Medical Visit ◽  
Care Needs ◽  
Aging Men ◽  
Aging Adults ◽  
Hiv Antiretroviral Therapy ◽  
Living With Hiv

Abstract For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (> 2 questions at a medical visit). A modified version of the National Eye Institute vision function questionnaire was administered at three semi-annual visits (from October 2017 to April 2018) to assess difficulty performing vision-dependent tasks (no, a little, moderate to extreme difficulty). We included 1063 AALH participants (median age 60 years, 24% Black). Data were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for fixed race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task (18%) had 1.95 times higher odds (95% CI: 1.36, 2.79) of having less than optimal ART adherence and 1.92 times higher odds [95% CI: 1.06, 3.47]) of avoiding necessary medical care, but 1.6 times higher odds [95%CI: 0.93, 2.72] of asking more questions. These findings suggest that vision impairment plays a role in medical care engagement among older adults living with HIV, and may contribute to poorer management of HIV and chronic comorbidities.

Living with HIV in the Time of COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 5-7
Author(s):  
Muhammad Naveed Noor
Keyword(s):  
Medical Care ◽  
Developing Country ◽  
People Living With Hiv ◽  
Evidence Based ◽  
Comorbid Conditions ◽  
Increased Risk ◽  
Associated Conditions ◽  
Living With Hiv

This commentary foregrounds the need to examine how the coronavirus disease 2019 (COVID-19) pandemic and associated conditions may be affecting the lives of people living with HIV (PLWH) in a developing country context like Pakistan. It raises some important questions on medical care and updated information regarding PLWH in the time of COVID-19. Since PLWH are at an increased risk of developing comorbid conditions – something that makes them more vulnerable to COVID-19 – it is critical that timely research and evidence-based actions are undertaken to protect their health.

scholarly journals System models for resilience in gerontology: application to the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katarzyna Klasa ◽  
Stephanie Galaitsi ◽  
Andrew Wister ◽  
Igor Linkov
Keyword(s):  
The Elderly ◽  
System Level ◽  
Improve Quality ◽  
Care Needs ◽  
Individual Level ◽  
Chronic Stressors ◽  
The World ◽  
Aging Adults ◽  
The Individual

AbstractThe care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual’s systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic.

scholarly journals Urine Biomarkers of Kidney Tubule Health and Incident CKD Stage 3 in Women Living With HIV: A Repeated Measures Study

2021 ◽  
Author(s):  
Simon B. Ascher ◽  
Rebecca Scherzer ◽  
Michelle M. Estrella ◽  
Vasantha K. Jotwani ◽  
Judy Shigenaga ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Kidney Tubule ◽  
Women Living With Hiv ◽  
Urine Biomarkers ◽  
Ckd Stage ◽  
Living With Hiv

Disparities in Health Status and Health Care Access and Use Among Older American Indians and Alaska Natives and Non-Hispanic Whites in California

2012 ◽  
Vol 24 (5) ◽  
pp. 799-811 ◽  
Author(s):  
Giyeon Kim ◽  
Ami N. Bryant ◽  
R. Turner Goins ◽  
Courtney B. Worley ◽  
David A. Chiriboga
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
American Indians ◽  
Health Care Access ◽  
Alaska Natives ◽  
California Health Interview Survey ◽  
Health Care Needs ◽  
Care Needs ◽  
Care Access

Objectives: The present study compared the characteristics of health status and health care access and use among older American Indians and Alaska Natives (AIANs) to those of non-Hispanic Whites (NHWs). Methods: Data were drawn from the 2009 California Health Interview Survey, with a total of 17,156 adults aged 60 and older (198 AIANs and 16,958 NHWs) analyzed. Results: Older AIANs reported poorer physical and mental health than did NHWs. AIANs were less likely than NHWs to see a medical doctor and have a usual source of medical care and were more likely than NHWs to delay getting needed medical care and report difficulty understanding the doctor at their last visit. Discussion: These findings highlight the vulnerability and unmet health care needs of older AIANs. More research on the older AIAN population is clearly needed to document their health care needs in order to better inform efforts to reduce health disparities.

Two-Year Repeated Study on Health Effect of Net-Step Exercise Program in Community-Dwelling Older Persons

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Mori M ◽  
◽  
Seko T ◽  
Ogawa S ◽  
Kitazawa K ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Older Persons ◽  
Smoking Status ◽  
Health Effect ◽  
Exercise Program ◽  
Community Dwelling ◽  
Confounding Variables ◽  
One Year ◽  
Male Subjects ◽  
Female Subjects

Background: A light-burden and indoor physical exercise program called Net-Step Exercise (NSE) has been developed in Hokkaido, Japan. Conducting the two-year repeated survey with the Kihon Checklist (KCL) for the same older subjects living in a rural area of Hokkaido where a relatively large proportion of the older persons have participated in NSE activity, we assessed the effectiveness of NSE activity. Methods: The whole of 3,155 community-dwelling persons aged from 75 years to 79 years in 8 towns were the candidates of the study subjects, and 2,183 subjects (69.2%) responded to the first survey (2018 Survey), answering the questions about both frequency of participation in NSE and each item in KCL. The same survey (2019 Survey) was conducted one year later, and completed by 1,956 subjects (93.3%), excluding 25 dead persons or 60 persons who had moved away from the community during the year. In the 2018 Survey as well as the 2019 Survey, Adjusted Odds Ratio (AOR) and its 95% confidence interval (95%CI) of each sub-category of KCL for NSE Participants compared with NSE Non-participants was calculated with unconditional logistic regression by sex, adjusting for age, smoking status, and other potentially confounding variables. Repeated-measures Analysis of Variance (ANOVA) was also applied by sex. Results: Significantly reduced risk (AOR with 95% CI) was observed in NSE participants in difficulty in activities of daily living in the male subjects in the 2018 Survey (0.64, 0.42-0.98) and in the 2019 Survey (0.50, 0.32-0.79), as well as in the female subjects in the 2018 Survey (0.52, 0.38-0.70) and in the 2019 Survey (0.46, 0.33-0.65), houseboundness in the female subjects in the 2018 Survey (0.42, 0.29-0.60) and in the 2019 Survey (0.70, 0.51-0.96), impaired cognitive function in the male subjects in the 2018 Survey (0.58, 0.36-0.92), and depressive status in the female subjects in the 2018 Survey (0.66, 0.49-0.88). Significant findings were also shown in most of the above four sub-categories by analysis with repeated-measures ANOVA. Conclusion: Either performance of NSE itself or participation in the program, or both, may promote healthy status in the older persons.

The Role of the Primary Care Physician in the Care of Children with Serious Heart Disease

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 284-290
Author(s):  
Paul C. Young ◽  
Yu Shyr ◽  
M. Anthony Schork
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Chronic Illness ◽  
Medical Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Services

Objective. To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease. Setting. Pediatric Cardiology Division; Tertiary Care Children's Hospital. Subjects. Convenience sample of parents, primary care physicians, and pediatric cardiologists of 92 children with serious heart disease. Design. Questionnaire study; questionnaires based on 16 medical care needs, encompassing basic primary care services, care specific to the child's heart disease and general issues related to chronic illness. Results. All children had a primary care physician (PCP), and both they and the parents (P) reported high utilization of PCP for basic primary care services. However, there was little involvement of PCP in providing care for virtually any aspect of the child's heart disease. Parents expressed a low level of confidence in the ability of PCP in general or their child's own PCP to meet many of their child's medical care needs. Both PCP and pediatric cardiologists (PC) were significantly more likely than parents to see a role for PCP in providing for care specific to the heart disease as well as more general issues related to chronic illness. PC and PCP generally agreed about the role PCP should play, although PC saw a bigger role for PCP in providing advice about the child's activity than PCP themselves did. PC were less likely to see the PCP as able to follow the child for long term complications than PCP did. PC were more likely than PCP to believe that PCP were too busy or were inadequately reimbursed to care for children with serious heart disease. Only about one-third of parents reported discussing psychosocial, family, economic, or genetic issues with any provider, and PCP were rarely involved in these aspects of chronic illness. Conclusions. Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.

scholarly journals Epidemiological features and medical care-seeking process of patients with COVID-19 in Wuhan, China

2020 ◽  
Vol 6 (2) ◽  
pp. 00142-2020 ◽  
Author(s):  
Jing Hua ◽  
Rongzhang Chen ◽  
Liming Zhao ◽  
Xiaodong Wu ◽  
Qian Guo ◽  
...  
Keyword(s):  
Medical Care ◽  
Early Recognition ◽  
Early Stage ◽  
Evaluation Process ◽  
Clinical Information ◽  
Healthcare Setting ◽  
Care Seeking ◽  
Medical Visit ◽  
Illness Onset ◽  
Clinical Recovery

BackgroundWe aimed to investigate the epidemiological and clinical features, and medical care-seeking process of patients with the 2019 coronavirus disease (COVID-19) in Wuhan, China, to provide useful information to contain COVID-19 in other places with similar outbreaks of the virus.MethodsWe collected epidemiological and clinical information of patients with COVID-19 admitted to a makeshift Fangcang hospital between 7 and 26 February, 2020. The waiting time of each step during the medical care-seeking process was also analysed.ResultsOf the 205 patients with COVID-19 infection, 31% had presumed transmission from a family member. 10% of patients had hospital-related transmission. It took as long as a median of 6 days from the first medical visit to receive the COVID-19 nucleic acid test and 10 days from the first medical visit to hospital admission, indicating early recognition of COVID-19 was not achieved at the early stage of the outbreak, although these delays were shortened later. After clinical recovery from COVID-19, which took a mean of 21 days from illness onset, there was still a substantial proportion of patients who had persistent SARS-CoV-2 infection.ConclusionsThe diagnostic evaluation process of suspected patients needs to be accelerated at the epicentre of the outbreak and early isolation of infected patients in a healthcare setting rather than at home is urgently required to stop the spread of the virus. Clinical recovery is not an appropriate criterion to release isolated patients and as long as 4 weeks' isolation for patients with COVID-19 is not enough to prevent the spread of the virus.

scholarly journals Lifestyle of Students Studying in the Specialty «Nursing»

2017 ◽  
pp. 131-134 ◽  
Author(s):  
Nataliia Semenova ◽  
Romana Sirenko ◽  
Maryana Ripak ◽  
Liubov Chekhovska
Keyword(s):  
Physical Activity ◽  
Medical Care ◽  
Young Men ◽  
Female Students ◽  
After School ◽  
Care Needs ◽  
The Future ◽  
Alcoholic Drinks ◽  
Medical Colleges

The article analyzes the lifestyle of students studying in the specialty «Nursing». Among students of medical colleges there was conducted a survey, which was attended by young men (n = 10) and women (n = 106), aged 15 to 21 years. The study revealed a small number of students who smoke cigarettes, but alcohol and low alcoholic drinks were consumed by about 73 % of female students, of which 28 people were underage. There was discovered low physical activity among students after school - 107,08 ± 14,9 min. per week, which is about 15 minutes. for a day. It is already stated, that the lifestyle of students studying with a speciality called «Medical care» needs a constant and purposeful forming during the whole learning period.The realizing of the importance of health preservation for patients and first of all for yourself the change of students attitude according to the lifestyle and forming of the value relation to own health – all of it will promote a success full realization of social and professional functions of the future nurses.

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