Evaluation of functionality and disability of older elderly outpatients using the WHODAS 2.0

Abstract Objectives: To analyze the level of functionality and disability of older elderly persons receiving care at a university hospital in Curitiba, Paraná, and identify functional differences between men and women. Method: A descriptive, cross-sectional study with a quantitative approach, based on a convenience sample of elderly persons receiving outpatient care, was undertaken. The Brazilian version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Results: A total of 28 people with a mean age of 86.21 (±4.17) were evaluated. Of these 50.0 % were male, 46.4 % were widowed, and 57.1 % performed the evaluated activities independently. There were no significant differences between genders in terms of age (p≤0.635) or years of study (p≤0.329), although women showed a higher level of disability than men in general (p≤0.16). Conclusion: The WHODAS 2.0 proved to be a sensitive tool for the analysis and comparison of the level of functionality of the older elderly. However, it is important to develop prospective studies, with non-convenience samples, for a better reflection on the disability and functionality of older elderly persons.

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Quality of Life and Functioning of People With Mental Disorders Who Underwent Deinstitutionalization Using Assisted Living Facilities: A Cross-Sectional Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.622973 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rejane Coan Ferretti Mayer ◽

Maíra Ramos Alves ◽

Sueli Miyuki Yamauti ◽

Marcus Tolentino Silva ◽

Luciane Cruz Lopes

Keyword(s):

Quality Of Life ◽

Mental Disorders ◽

Assisted Living ◽

Cross Sectional Study ◽

World Health ◽

Assisted Living Facilities ◽

Cross Sectional ◽

Whodas 2.0 ◽

Health Organization

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, through interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’s t-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n = 65.8; 95%CI, 63.5–68.1 vs. n = 73.9; 95%CI, 67.5–80.3; p = 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n = 10.9; 95%CI, 9.6–12.2 vs. n = 5.1; 95%CI, 2.5–7.7; p = 0.01). A weak negative correlation (r = 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile.

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Pregnant teenagers treated at the obstetric center of a university hospital

International Journal for Innovation Education and Research ◽

10.31686/ijier.vol9.iss2.2950 ◽

2021 ◽

Vol 9 (2) ◽

pp. 247-261

Author(s):

Luana Maria Tassoni Ferro ◽

Ceny Longhi Rezende ◽

Cassia Barbosa Reis ◽

Alessandra Aparecida Vieira Machado ◽

Renato Sarmento dos Reis Moreno

Keyword(s):

Teenage Pregnancy ◽

Intrauterine Device ◽

Cross Sectional Study ◽

Point Of View ◽

University Hospital ◽

World Health ◽

Hospital Data ◽

Cross Sectional ◽

Significance Level ◽

Health Organization

According to the definition of the World Health Organization, adolescence is the phase of life between 10 and 19 years of age, a period marked by physiological and biopsychosocial changes, in which pregnancy is considered a risk factor for both mother and fetus from the biomedical point of view. Several factors have been associated with teenage pregnancy with negative maternal and neonatal impacts, such as: social vulnerability, low levels of education, income, and sexual education. This is a descriptive cross-sectional study with a quantitative approach, which aimed to identify obstetric factors and neonatal outcomes of greater frequency among pregnant adolescents treated at the obstetric center of a university hospital. Data collection was performed through a logbook of daily procedures at the obstetric center, so that all parturients under 19 years of age treated in 2018 were included in the study. The variables studied were age, parity, type of delivery, gestational age, diagnosis of syphilis and HIV, number of prenatal consultations, and insertion of an intrauterine device (IUD). As for the newborn, the following were analyzed: weight and hospital destination after birth. The data were processed using the SOFA.5.2 software (Statistics Open for All) and the significance level established was 95%, with a value of (P ≤ 0.05). Three thousand four hundred and thirty pregnant women were evaluated. There was a birth rate of 19.3% among adolescents, with a correlation between the low weight of the newborn with the longest hospital stay and the number of prenatal visits, and also the identification of low insertion of contraceptive methods immediately after delivery. Adolescent pregnancy was correlated with low-birth-weight newborns and a longer stay in neonatal units, consequences often associated with the insufficient number of prenatal consultations. Public health policies for the inclusion of qualified nursing professionals in the management of insertion of the intrauterine device for the prevention of subsequent pregnancies deserve special attention.

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Cardiovascular Risk Factors and Cardiovascular Risk in People Living with HIV: Comparison of Four Cardiovascular Risk Prediction Algorithms

Global Journal of Medical Research ◽

10.34257/ljmhrvol20is5pg57 ◽

2020 ◽

pp. 57-71

Author(s):

Abdou Razak Moukaila ◽

Edem Komi Mossi ◽

Nouroudine Amadou ◽

Komi Dzidzonu Nemi ◽

Mouhaman-Inouwa Kpelafia ◽

...

Keyword(s):

Cardiovascular Risk ◽

Pearson Correlation ◽

Cross Sectional Study ◽

University Hospital ◽

World Health ◽

People Living With Hiv ◽

Cross Sectional ◽

Health Organization ◽

Hiv Drugs ◽

Living With Hiv

Introduction: The objective of our study was to evaluate, in a population of Togolese People Living With HIV (PLWHIV), the agreement between three scores derived from the general population namely the Framingham score, the Systematic Coronary Risk Evaluation (SCORE), the evaluation of the cardiovascular risk (CVR) according to the World Health Organization (WHO) and the CVR evaluation equation derived from the Data collection on Adverse effects of anti-HIV Drugs (D.A.D). Methods: We conducted a descriptive and analytical cross-sectional study including 212 HIV-infected patients recruited from the day hospital of the Infectious Diseases Department of the Sylvanus Olympio University Hospital. The level of agreement between the different scores was estimated using the Pearson correlation test and the Cohen Kappa coefficient.

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Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

Current Drug Therapy ◽

10.2174/1574885515999200819092717 ◽

2020 ◽

Vol 15 ◽

Author(s):

Solomon Hambisa ◽

Rediet Feleke ◽

Ameha Zewudie ◽

Mohammed Yimam

Keyword(s):

Drug Use ◽

World Health Organization ◽

Teaching Hospital ◽

Cross Sectional Study ◽

University Teaching ◽

World Health ◽

Sectional Study ◽

Hospital Data ◽

Cross Sectional ◽

Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

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The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

International Breastfeeding Journal ◽

10.1186/s13006-021-00377-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Walusa Assad Gonçalves-Ferri ◽

◽

Fábia Martins Pereira-Cellini ◽

Kelly Coca ◽

Davi Casale Aragon ◽

...

Keyword(s):

Cross Sectional Study ◽

World Health ◽

Breastfeeding Support ◽

Cross Sectional ◽

Maternity Services ◽

Community Needs ◽

Care Services ◽

Skin Contact ◽

Health Organization ◽

The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

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The Utilization of Protective Face Masks among Polish Healthcare Workers during COVID-19 Pandemic: Do We Pass the Exam?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020841 ◽

2021 ◽

Vol 18 (2) ◽

pp. 841

Author(s):

Radomir Reszke ◽

Łukasz Matusiak ◽

Piotr K. Krajewski ◽

Marta Szepietowska ◽

Rafał Białynicki-Birula ◽

...

Keyword(s):

Healthcare Workers ◽

Medical Profession ◽

Cross Sectional Study ◽

Internet Survey ◽

World Health ◽

Cross Sectional ◽

Protective Measures ◽

Who Criteria ◽

The Face ◽

Health Organization

Relevant personal protective measures during the COVID-19 pandemic include face masks, possibly decreasing the risk of infection among the general population and healthcare workers (HCW) if utilized properly. The aim of the study was to assess whether different Polish HCW utilize face masks according to the 2020 World Health Organization guidance (WHO) criteria. This cross-sectional study included 1156 respondents who participated in an internet survey evaluating mask-related behaviors. All the WHO criteria were complied with by 1.4% of participants, regardless of medical profession, specialty or place of employment. HCW mostly adhered to criterion 1 (C1; strict covering of the face and mouth with the mask; 90.8%), C4 (washing/disinfecting the hands after touching/taking off the mask; 49%) and C3 (taking off the mask properly without touching the anterior surface; 43.4%), whereas C2 (avoidance of touching the mask with hands) was complied with least commonly (6.8%). HCW with mask-induced itch (31.6%) complied to C2 less often (odds ratio 0.53; p = 0.01). The study reveals that Polish HCW rarely adhere to all the 2020 WHO guidance criteria on the use of masks, whereas the adherence to particular criteria is variable and may be associated with the presence of skin-related conditions and other factors. Better compliance with the recommendations in the future is necessary to increase personal safety of HCW and prevent the transmission of SARS-CoV-2.

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Managing the Return to Football During the COVID-19 Pandemic: A Survey of the Head Team Physicians of the Football Bowl Subdivision Programs

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121992045 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712199204

Author(s):

Alexander D. Slabaugh ◽

John W. Belk ◽

Jonathan C. Jackson ◽

Richard J. Robins ◽

Eric C. McCarty ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

National Collegiate Athletic Association ◽

College Football ◽

Cross Sectional Study ◽

Return To Play ◽

World Health ◽

Cross Sectional ◽

Football Bowl Subdivision ◽

Health Organization

Background: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. Purpose: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. Study Design: Cross-sectional study. Methods: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. Results: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. Conclusion: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.

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An analysis of heavy metals contamination and estimating the daily intakes of vegetables from Uganda

Toxicology Research and Application ◽

10.1177/2397847320985255 ◽

2021 ◽

Vol 5 ◽

pp. 239784732098525

Author(s):

Keneth Iceland Kasozi ◽

Eric Oloya Otim ◽

Herbert Izo Ninsiima ◽

Gerald Zirintunda ◽

Andrew Tamale ◽

...

Keyword(s):

Heavy Metals ◽

Daily Intake ◽

Principal Component ◽

Absorption Spectrometry ◽

Cross Sectional Study ◽

Essential Elements ◽

World Health ◽

Cross Sectional ◽

Health Organization ◽

Daily Intakes

Background: Environmental contamination with elevated levels of copper (Cu), cobalt (Co), iron (Fe), zinc (Zn), lead (Pb), chromium (Cr6+), cadmium (Cd), and nickel (Ni)—all states of which are found in Uganda—raises health risk to the public. Pb, Cr6+, Cd, and Ni for instance are generally considered nonessential to cellular functions, notwithstanding the importance of the oxidative state of the metals in bioavailability. As such, we aimed in this study (i) to evaluate heavy metal concentrations in four vegetables from a typical open-air market in Uganda, (ii) to assess the safety of consuming these vegetables against the World Health Organization (WHO) recommended limits of heavy metals consumption, and (iii) to formulate a model of estimated daily intake (EDI) among consumers in the country. Methods: This was a cross-sectional study conducted in five georeferenced markets of Bushenyi district in January 2020. Amaranthus, cabbages, scarlet eggplants, and tomatoes were collected from open markets, processed, and analyzed by atomic absorption spectrometry. Modeled EDI, principal component (PCA) and cluster analysis (CA) were conducted to identify relationships in the samples. Results: The levels of essential elements in the four vegetables were found to fall from Co > Cu > Fe > Zn. Those of non-essential metals were significantly higher and followed the pattern Cd > Cr > Pb > Ni. The highest EDI values were those of Cu in scarlet eggplants, Zn in amaranthus, Fe in amaranthus, Co in amaranthus, Pb in cabbages, total Cr in scarlet eggplant, Cd in cabbages and tomatoes, and Ni in cabbages. In comparison to international limits, EDIs for Zn, Cu, Co and Fe were low while Ni in cabbages were high. PCA showed high variations in scarlet eggplant and amaranthus. The study vegetables were found to be related with each other, not according to the location of the markets from where they were obtained, but according to their species by CA. Conclusion: The presence of non-essential elements above WHO limits raises policy challenges for the consumption and marketing of vegetables in the study area. Furthermore, low EDIs of essential elements in the vegetables create demand for nutritious foods to promote healthy communities.

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Regional differences in general practitioners’ behaviours regarding influenza vaccination: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06177-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jonathan Arlt ◽

Kristina Flaegel ◽

Katja Goetz ◽

Jost Steinhaeuser

Keyword(s):

Influenza Vaccination ◽

General Practitioners ◽

Personal Characteristics ◽

Cross Sectional Study ◽

Central Research Institute ◽

World Health ◽

Central Research ◽

Cross Sectional ◽

Vaccination Rates ◽

Health Organization

Abstract Background The World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany. Methods In May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates. Results A total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly ‘very positive’ (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs’ influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12–16.60]), followed by the patient’s vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89–5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19–4.29]). Conclusions The results of this study suggest a correlation between GPs’ attitudes and regional vaccination rates. Beneath GPs’ individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.

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Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147499 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7499

Author(s):

Marga Decraene ◽

Vera Verbestel ◽

Greet Cardon ◽

Violeta Iotova ◽

Berthold Koletzko ◽

...

Keyword(s):

Sleep Duration ◽

Screen Time ◽

Total Sample ◽

Cross Sectional Study ◽

World Health ◽

Movement Behavior ◽

Cross Sectional ◽

Guideline Compliance ◽

Z Scores ◽

Health Organization

In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards.

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