scholarly journals Exercise-Based Cardiac Rehabilitation: Secondary Data Analyses of Mortality and Working Capacity in Germany, 2010–2017

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lars Gabrys ◽  
Johannes Soff ◽  
Christian Thiel ◽  
Christian Schmidt ◽  
Enno Swart ◽  
...  

Abstract Background Exercise-based cardiac rehabilitation is safe and implemented in international cardiac rehabilitation guidelines. Evidence for long-term health effects is scarce and rare for health care service research. Objective The aim of this study is to evaluate the effectiveness of exercise-based phase III cardiac rehabilitation programs in improving mortality and working capacity outcomes. Methods The present analyses used claims data of the German pension fund from 2010 to 2017. Overall, 54,163 patients with coronary heart disease (ICD10 I20.–I25.) were included and followed up for exercise-based cardiac rehabilitation participation (mean 4.3 ± 1.9 years). All patients were categorized according to participation duration (long: ≥ 90 days, short: < 90 days, no). The effectiveness of exercise-based rehabilitation was analyzed by calculating adjusted hazard ratios for mortality and reduced working capacity in relation to program participation. Results Of all the cardiac patients, 57.6% received medical recommendations for exercise-based phase III rehabilitation, and 16.8% participated in this rehabilitation. In total, 1776 (3.3%) patients died during the study period, and 3050 (5.5%) received reduced earning capacity pensions. Mortality risk was nearly doubled for those who did not participate in exercise-based cardiac rehabilitation compared to those who participated for a long duration (HR 1.97, 95% CI 1.60–2.43) and 44% higher compared to a short participation (HR 1.44, 95% CI 1.03–2.01). Furthermore, the risk of reduced working capacity was higher for those who did not participate compared to those who participated for a short duration (HR 1.24, 95% CI 1.00–1.54). Conclusion Exercise-based phase III cardiac rehabilitation is independently associated with reduced mortality and reduced loss in working capacity. Strong efforts should be made to increase participation rates to improve cardiac patients care.

2005 ◽  
Vol 100 (2) ◽  
pp. 357-361 ◽  
Author(s):  
Meir Magal ◽  
Robert F. Zoeller

Ratings of perceived exertion (RPE) are used for exercise programming of cardiac rehabilitation patients, whenever it is difficult to use heart rate to set intensity due to medication or other factors. This investigation examined the physiological responses to two stepping exercise modes (upright and recumbent) at the same RPE. Analysis indicated significant physiological differences between the modes of exercise which may be mediated by postural differences. Specifically, the physiological responses to the recumbent exercise, but not the upright exercise, had the expected relationship with RPE, with recumbent stepping requiring less physiological effort than the upright stepping at the same RPE. As such, we cannot recommend with confidence that the prescription for upright exercise be made based on data from recumbent exercise or vice-versa.


2020 ◽  
Vol 8 (2) ◽  
pp. 47-61
Author(s):  
Norvy Paul ◽  
Elsa Mary Jacob ◽  
Sheena Rajan Philip

Kerala, a state with high development indices distinguished with its Kerala Model of Development (UN, 1975), is also affected by recent Pandemic COVID'19 as other states and nations worldwide.  The existing socio-economic analysis of the State reveals that the land reforms, promotion of education, and early introduction of participatory governance through Panchayati Raj Institutions (PRIs) have contributed to the State's socio-economic and political advancement. These factors played a significant role in the fight against the pandemic. This study is an attempt to answer what are the future economic and health challenges as the State, Kerala Model of Development, is faced with COVID'19? The specific objectives further guide this— to study the economic challenges ahead of the State as the tertiary sector is faced with challenges to contribute to the economy and attempted to study the possible ways to address health issues in the State. The researchers conducted an in-depth interview among 10 social scientists and economists of Kerala using purposive sampling to obtain primary data, which has been supported by secondary resources. The researchers did a thematic analysis of the primary data collected, further corroborated by secondary data. The study reveals that the State's current scenario during the pandemic, the grass-root empowerment in all spheres of life clubbed with administrative guidance, resulted in well-equipped public health care service delivery. The fall in the tertiary sector's income has decisively affected the State's economy, especially in agriculture, health, IT, tourism, labour, and foreign remittance. The State's economic and social equilibrium will face challenges in addressing issues in the post-COVID era. Even though the State suffered some increased Covid-19 cases recently, after expatriates' return, the dimensions mentioned above assisted the State in its fight against COVID'19. To address the challenges to the Kerala Model of Development, especially the post-COVID-19 requirements of the State demands interrogation, introspection, and integration of the current policies that majorly depend on the tertiary sector and initiate policies, plans, and programmes to strike a balance between all sectors, especially providing impetus to the primary sector so that a failure in one sector can be compensated by the other.


2019 ◽  
Vol 23 (4) ◽  
pp. 475-495 ◽  
Author(s):  
Eva Diniz ◽  
Sónia F. Bernardes ◽  
Paula Castro

Dehumanization is an everyday, pervasive phenomenon in health contexts. Given its detrimental consequences to health care, much research has been dedicated to understanding and promoting the humanization of health services. However, health care service research has neglected the sociopsychological processes involved in the dehumanization of self and others, in formal but also informal health-related contexts. Drawing upon sociopsychological models of dehumanization, this article will bridge this gap by presenting a critical review of studies on everyday meaning-making and person perception processes of dehumanization in health-related contexts. A database search was conducted in PsycINFO, Web of Science, Scopus, and PubMed, using a combination of keywords on dehumanization and health/illness/body; 3,229 references were screened; 95 full texts were assessed for eligibility; 59 studies were included. Most studies focused on informal contexts, reflecting a decontextualized and one-sided view of dehumanization (i.e., not integrating actors’ and victims’ perspectives). Despite the dominant focus on self-dehumanization, emerging perspectives uncover the role of processes that deny human uniqueness to others, and their individual determinants and consequences for mental health. A few studies bring to light the functions of a variety of dehumanizing body metaphors on self- and other-dehumanization. These trends in the literature leave several gaps, which are here critically analyzed to inform future research.


2013 ◽  
Vol 9 (2) ◽  
Author(s):  
Shatabdi Bagchi ◽  
Priyanka Bakhshi

Financing is the most crucial part of the of the health care service delivery system and health care finance is one of the most critical factor contributing in the poverty scenario of any country.  In developing countries like India where the health system should be more equitable and cost effective, the soaring problem of ‘out of pocket expenditure’ on Health System has shown a gloomy face and raises question on health equity. Evidences from several studies In India show that out of pocket expenditures on health care services intensify poverty.  In the World Health Survey of 2011, India was ranked 42nd in the list of countries with highest average of out of pocket expenditure. The survey found that 74.4 per cent of private expenditure on health was paid out of pocket. The article discusses the triggering factors which lead to the inequitable out of pocket health expenditure. Secondary Data from World Health Statistics 2010, NSSO 52nd and 60th round have been used here as evidence.


Author(s):  
Igor Urbano ◽  
Anna Carolina Souza Marques ◽  
Matheus Milanez

Intrinsic socio-cultural and motivational dance aspects, physical demands,general and styles characteristics, may promote positive influence on cardiac rehabilitation programs development and progression, if dance is approached as a supplementary activity and resource for cardiac patients. The aim of this study was to conduct an integrative literature review to evaluate dance as a supplementary activity on cardiac rehabilitation, considering physical demands, dance socio cultural aspects and regular practice related effects on cardiac patients' health and quality of life. Classical ballet and modern dance are not supported by this revision as appropriated alternatives to improve cardiovascular capacities for cardiopaths However, belly dance, ballroom dance, emphasis on Samba, Samkya showed multiple positive effects: glycemia levels reduction, resting heart rate reduction, cholesterol (HDL, LDL) and triglycerides level regulation, BP reduction, cardio respiratory increment and body relaxation.


2009 ◽  
Vol 4 (1) ◽  
pp. 270
Author(s):  
Caroline Evelin Nascimento Kluczynik ◽  
Danielle Rocha Silva ◽  
João Batista De Sousa Neto ◽  
Raïssa Mayer Ramalho Catão

ABSTRACTObjectives: describing the epidemiological profile of pregnant teenagers in a public maternity in Campina Grande-PB and evaluating the prenatal care offered. Methods: this is about a cross-sectional, exploratory study, developed through interviews, with 52 women who fulfilled the following prerequisites: seen at prenatal ISEA, were less than 19 years, were in the gestational period of not less than 16 weeks and agreed to participate in this study, after approval by the Ethics in Research State University of Paraíba (0367.0.133.000-08). Results: the participants meet the quality of life compromised, more than half haven’t finished elementary school and dropped out of school, living with family income than minimum wage, they had their first sexual intercourse with up to 14 years old and they are primiparous. On admission the research to most of participants had not made any urine test, still, the most had a clinical diagnosis of Urinary Tract Infection in his mother's card. Conclusions: it is believed that this study enhance knowledge in the health care service research, especially in the service organizations and health actions based on the epidemiological reality presented in order to encourage the inclusion of these tennagers and their children, opening modify the current condition. We also pont out that in this service pregnant diagnosed with urinary tract infection who haven’t undergove drug treatment and in this is routine antibiotic therapy without further tests. Descriptors: pregnancy in adolescence; prenatal care; urine. RESUMOObjetivos: traçar o perfil epidemiológico das gestantes adolescentes atendidas na maternidade pública de Campina Grande-PB e avaliar a assistência pré-natal oferecida. Métodos: estudo transversal, exploratório, desenvolvido através de entrevistas, com 52 gestantes que se enquadraram nos seguintes pré-requisitos: atendidas no pré-natal do ISEA, tinham até 19 anos, estavam em período gestacional igual ou superior a 16 semanas e aceitaram participar desta pesquisa, após aprovação pelo Comitê de Ética em Pesquisa da Universidade Estadual da Paraíba (UEPB) (0367.0.133.000-08). Resultados: as participantes encontram-se com a qualidade de vida comprometida, visto que a maioria não tem o ensino fundamental completo e abandonaram os estudos; vive com renda familiar inferior a um salário mínimo, teve a sexarca com até 14 anos e são primíparas. Na admissão a maioria não havia realizado qualquer exame de urina e tinha o diagnóstico clínico de Infecção do Trato Urinário (ITU) anotado no cartão da gestante. Conclusões: acredita-se que este estudo venha enriquecer os conhecimentos de atenção à saúde, principalmente na organização de serviços e ações baseadas na realidade epidemiológica apresentada, de modo a incentivar a inclusão social dessas adolescentes e de seus filhos, abrindo perspectivas de modificar a condição atual. Destaca-se ainda, que neste serviço há gestantes diagnosticadas com ITU que não foram submetidas a tratamento medicamentoso e é rotina a antibioticoterapia sem realização de exames. Descritores: gravidez na adolescência; cuidado pré-natal; urina. RESUMENObjetivos: remontar el perfil epidemiologico de las gestantes adolescentes atendidas en la maternidad pública de Campina grande y evaluar la ayuda prenatal ofrecida. Métodos: el estudio es transversal, exploratório, desarrollado con entrevistas, con 52 mujeres que cumplen los siguientes requisitos: estar al servicio de prenatal del ISEA, hasta los 19 años, se encontraban en el período de gestación de no menos de 16 semanas y de acuerdo en participar en este estudio, después de la aprobación por el Comité de Ética en Investigación del la Universidad del Estado de Paraíba (0367.0.133.000-08). Resultados: las participantes apresentavam-se con la calidad de vida comprometida, puesto que la mayoría no tiene educación básica completa y había abandonado los estudios; viven con renta familiar inferior a un salario mínimo, habían tenido el sexarca con hasta 14 años y son primíparas (92%). En la admisión a la investigación, la mayoría de las participantes no habíam realizad ningun exame de orina, mesmo así, la mayoría de ellas teníam lo diagnostico clínico de la infección del aparato urinário en su tarjeta del gestante. Conclusiones: acredita-se que este estudio viene enriquecer en conocimiento el servicio de la atención pesquisado, principalmente en la organización de los servicios y de las acciones de la salud basados en realidad epidemiológica apresentada, estimular la inclusión social de estas adolescentes y de sus niños, siendo perspectivas para modificar la condición actual. Todavía destacamos, que en este servicio, tiene gestantes diagnosicadas con infección urinária que no fueram sometidas el tratamiento medicamentoso y que es rutina del servicio el antibioticoterapia sin la realización de exámenes de laboratmes. Descriptores: embarazo en adolescência; atención prenatal; orina. 


2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Vini Jamarin ◽  
Rosfita Rasyid ◽  
Selfi Renita Rusjdi

AbstrakSanitasi yang buruk dapat menjadi media transmisi agen penyakit berbasis lingkungan. Salah satu program puskesmas yang menelaah penyakit berbasis lingkungan adalah klinik sanitasi. Bukittinggi sudah menjalankan klinik sanitasi sejak tahun 2009. Tujuan penelitian ini adalah untuk mengetahui gambaran pelaksanaan program klinik sanitasi puskesmas di Kota Bukittinggi. Penelitian ini menggunakan metode deskriptif. Sampel diambil seluruhnya (total sampling), yaitu tujuh puskesmas di Bukittinggi dari September sampai Oktober 2013. Berdasarkan hasil kuesioner, dari tujuh puskesmas, seluruh petugas telah memiliki pendidikan yang baik, dua petugas telah mendapatkan pelatihan klinik sanitasi, satu puskesmas memiliki ruangan khusus klinik sanitasi, enam puskesmas memiliki poster dan leaflet, tiga puskesmas memiliki dana khusus, dan enam puskesmas memiliki seluruh buku pedoman. Berdasarkan data sekunder, jumlah penyakit berbasis lingkungan bervariasi dan fluktuatif dan jumlah klien yang datang masih sedikit dan jauh dari harapan. Penelitian ini menilai empat kegiatan klinik sanitasi, yaitu kunjungan ke rumah warga, kerjasama lintas program, kerjasama lintas sektor, dan evaluasi. Jumlah kunjungan ke rumah warga masih kurang dari harapan, kerjasama lintas program klinik sanitasi sudah berjalan di seluruh puskesmas, kerjasama lintas sektor sudah berjalan hampir di seluruh puskesmas, dan evaluasi sudah berjalan dengan jangka waktu yang bervariasi. Seluruh klinik sanitasi puskesmas kota Bukittinggi dinilai baik dengan nilai bervariasi antara 50-100%.Kata kunci: klinik sanitasi, puskesmas AbstractPoor sanitation could be the transmission media for environment-based diseases’ agents. The program of Primary Health Care Service (PHCS) which deals with environment-based disease is sanitation clinic. This program has been running in Bukittinggi since 2009. The objective of this study was to see how this program has been going on in PHCS in Bukittinggi. This descriptive study used total sampling, in which all seven PHCS in Bukittinggi are included. This research was done from September to October 2013. Based on quedionaire result, all sanitarians are well-educated, but only two of them had sanitation clinic training. Only one PHCS has a special room, six has posters and leaflets, two allocates special budget for sanitation clinic, and six has all kind of manual books. Based on secondary data, the accumulation of environment-based disease’s cases in all PHCS is variative and fluctuative and the accumulation of clients come to sanitation clinic is still below the expectation. House-visitting activity has not met the expectation yet, while trans-program activity has been running well, trans-sector activity has been running well in almost all PHCS, and evaluation has been running in a variative frequency. All sanitation clinic graded good in implementing sanitation clinic, within the range of 50-100%.Keywords: sanitation clinic, primary health care service


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