functional health
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2022 ◽  
Vol 12 (1) ◽  
pp. 115
Author(s):  
Joseph J. Lamb ◽  
Michael Stone ◽  
Christopher R. D’Adamo ◽  
Andrey Volkov ◽  
Dina Metti ◽  
...  

The working definition of health is often the simple absence of diagnosed disease. This common standard is limiting given that changes in functional health status represent early warning signs of impending health declines. Longitudinal assessment of functional health status may foster prevention of disease occurrence and modify disease progression. The LIFEHOUSE (Lifestyle Intervention and Functional Evaluation-Health Outcomes SurvEy) longitudinal research project explores the impact of personalized lifestyle medicine approaches on functional health determinants. Utilizing an adaptive tent–umbrella–bucket design, the LIFEHOUSE study follows the functional health outcomes of adult participants recruited from a self-insured employee population. Participants were each allocated to the tent of an all-inclusive N-of-one case series. After assessing medical history, nutritional physical exam, baseline functional status (utilizing validated tools to measure metabolic, physical, cognitive, emotional and behavioral functional capacity), serum biomarkers, and genomic and microbiome markers, participants were assigned to applicable umbrellas and buckets. Personalized health programs were developed and implemented using systems biology formalism and functional medicine clinical approaches. The comprehensive database (currently 369 analyzable participants) will yield novel interdisciplinary big-health data and facilitate topological analyses focusing on the interactome among each participant’s genomics, microbiome, diet, lifestyle and environment.


Author(s):  
Shahryar M. Chowdhury ◽  
Eric M. Graham ◽  
Carolyn L. Taylor ◽  
Andrew Savage ◽  
Kimberly E. McHugh ◽  
...  

Background Heart failure phenotyping in single‐ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross‐sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e’/end‐diastolic volume) was >90th percentile (≥0.26 mL ‐1 ). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO 2 . Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P <0.01. DD patients had lower predicted peak VO 2 compared with controls (52% [20] versus 67% [23], P <0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), P <0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.


2022 ◽  
pp. 174239532110733
Author(s):  
Lennert Griese ◽  
Doris Schaeffer ◽  
Eva-Maria Berens

Objectives People with chronic illness are particularly dependent on navigating and using the health care system. This requires navigational health literacy (HL-NAV). The article aims to examine the distribution and predictors of HL-NAV in a sample of chronically ill individuals. Methods Data of 1,105 people with chronic illness from the general population in Germany were collected in December 2019 and January 2020. HL-NAV was assessed by 12 items (score 0–100). Bivariate and multiple linear regression analysis were performed. Results HL-NAV score was 39.1 (SD 27.3). In bivariate analyses, HL-NAV was lower among chronically ill persons aged 65 or above, with low education, limited functional health literacy, low social status, financial deprivation, poor social support, multiple chronic conditions, and an illness duration of 6–10 years. In multivariate analyses, advanced age, lower education, less functional health literacy, lower social status, and less social support remained associated with lower HL-NAV. Discussion The results underline the importance of promoting HL-NAV among people with chronic illness. Strategies should aim at strengthening individual competencies taking into account the social and situational factors but also at reducing the demands placed on chronically ill people by providing user-friendly and trustworthy information on the health care system along the illness trajectory.


Nanomaterials ◽  
2022 ◽  
Vol 12 (2) ◽  
pp. 221
Author(s):  
Sook Mei Khor ◽  
Joonhwa Choi ◽  
Phillip Won ◽  
Seung Hwan Ko

Recently, several studies have been conducted on wearable biosensors. Despite being skin-adhesive and mountable diagnostic devices, flexible biosensor patches cannot truly be considered wearable biosensors if they need to be connected to external instruments/processors to provide meaningful data/readings. A realistic and usable wearable biosensor should be self-contained, with a fully integrated device framework carefully designed and configured to provide reliable and intelligent diagnostics. There are several major challenges to achieving continuous sweat monitoring in real time for the systematic and effective management of type II diabetes (e.g., prevention, screening, monitoring, and treatment) through wearable sweat glucose biosensors. Consequently, further in-depth research regarding the exact interrelationship between active or passive sweat glucose and blood glucose is required to assess the applicability of wearable glucose biosensors in functional health monitoring. This review provides some useful insights that can enable effective critical studies of these unresolved issues. In this review, we first classify wearable glucose biosensors based on their signal transduction, their respective challenges, and the advanced strategies required to overcome them. Subsequently, the challenges and limitations of enzymatic and non-enzymatic wearable glucose biosensors are discussed and compared. Ten basic criteria to be considered and fulfilled in the development of a suitable, workable, and wearable sweat-based glucose biosensor are listed, based on scientific reports from the last five years. We conclude with our outlook for the controllable, well-defined, and non-invasive monitoring of epidermal glucose for maximum diagnostic potential in the effective management of type II diabetes.


2022 ◽  
Author(s):  
Helder Costa ◽  
Odete Amaral ◽  
João Duarte ◽  
Maria José Correia ◽  
Nélio Veiga ◽  
...  

Abstract Background Health literacy is a main factor in health for its improvement, allowing the individuals to have a greater capacity to engage and participate in collective health promotion actions. The assessment of functional health literacy to determine the ability that each individual has to understand basic health information is essential. The aim of the present study was to translate and perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry (REALD-30) to Portuguese language and test the reliability and validity of this version. Methods The REALD-30 in the Portuguese language (REALD-29 PT) was applied to a group of individuals that participate in the program Atividade Senior, developed by the municipality of Viseu, Portugal. The final sample was composed by 206 participants that accepted responding to the questionnaire and to the REALD-30 Portuguese version (REALD-29 PT). Translation and cultural adaptation of the questionnaire and the statistical validation was accomplished in order to complete the process and obtain the REALD-29 PT. Results The REALD-29 PT presented good internal reliability. Cronbach’s alpha ranged from 0.89 to 0.90 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility. We can verify that the REALD-30 scale for assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach´s alpha of 0.894. Conclusions The REALD-29 PT scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to assess oral health literacy and is crucial in epidemiological studies.


2022 ◽  
Vol 11 (1) ◽  
pp. e3211124481
Author(s):  
Karen Miyamoto Moriya ◽  
Tatiana Ikeda Condo ◽  
José Maria Montiel ◽  
Gisele Garcia Zanca

Objetivo: Investigar possíveis diferenças na qualidade de vida, percepção de dificuldade de acesso a serviços de saúde e presença de doenças crônicas em idosos com letramento em saúde (LS) adequado e inadequado. Métodos: Foram avaliados 30 idosos e coletados dados de escolaridade, percepção de dificuldade de acesso a serviços de saúde, ter plano de saúde suplementar, relato de quedas e de doenças crônicas. O LS foi avaliado por meio do Short Test of Functional Health Literacy in Adults e a qualidade de vida por meio do 12-Item Short-Form Health Survey (SF-12). Os dados foram comparados entre grupos de idosos com LS adequado (n=15) e inadequado (n=15) utilizando testes t para amostras independentes, teste de Mann-Whitney e teste exato de Fisher, considerando significância de 5%. Resultados: Não houve diferença entre grupos quanto à escolaridade, escores físico e mental do SF-12. O grupo com LS inadequado apresentou percepção de menor limitação no trabalho ou outras atividades devido à saúde física; percepção de menor dificuldade de acesso a serviços de saúde; e maior proporção não sabia informar se apresentava doenças crônicas. Considerações finais: Não houve diferença na qualidade de vida, avaliada a partir das percepções de limitações e dificuldades devido à saúde física e mental, entre idosos com LS adequado e inadequado. No entanto, idosos com LS inadequado parecem apresentar percepção de menor dificuldade relacionada ao trabalho e acesso a serviços de saúde e menor conhecimento sobre a presença de doenças crônicas.


2021 ◽  
Vol 2 (1) ◽  
pp. 1-11
Author(s):  
Naif H. Al Anazi ◽  
Rene P. Carsula ◽  
Regie B. Tumala

The increasing population of Saudi elderly demands adequate assessment of their functional health status and mental status to improve their health and quality of life. This study aimed to determine the functional status of older Saudi people in performing basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and its influencing factors. This quantitative, descriptive-correlational study surveyed a total of 203 participants using the Mini-Mental State Examination, Katz Index of ADL, and Lawton IADL. Overall, the participants had moderate cognitive impairment and were able to perform basic ADLs and IADLs independently, but they needed assistance in doing housework. Functional status was sensitive to their sociodemographic characteristics, presence of health problems, and mental status. Mental status, education, employment, marital status, and source of support were significantly associated with their ability to perform basic ADLs and IADLs. This study suggests that more efforts are needed to understand the sociodemographic characteristics, presence of health problems, and mental status that support the development of evidence-based public health policy on the functional status among older Saudi people. The findings can be utilized by hospital and nursing administrators to initiate educational and training programs for healthcare professionals including nurses and to create healthcare policies so that the health concerns and functional difficulties of older patients are adequately addressed.


Author(s):  
Elham Amiri ◽  
Negin Zargar ◽  
Mansour Zahiri ◽  
Farzad Faraji-Khiavi

Background: Enhancing health literacy may improve health-related quality of life. Given the more educational programs in nursing homes, this study aimed to determine the relationship between health literacy and the quality of life among the elderly living in nursing homes and those living with their families in Ahvaz, Iran. Methods: This descriptive-analytical cross-sectional study was conducted in 2017. The research population was the elderly in Ahvaz city, Iran. This population consisted of two groups, those living in nursing homes and those who do not. There were 62 samples. Random cluster sampling was used to select the participants. The data collection tools included a demographic questionnaire as well as Test of Functional Health Literacy in Adults (TOFHLA) and LEIPAD questionnaires. The data were analyzed by independent t-test, Mann-Whitney test, Spearman correlation, and Chi-square test using SPSS 19. Results: The mean health literacy of the elderly living in nursing homes estimated to be relatively desirable (3.60 ± 0.77) and the mean health literacy of the elderly not living in nursing homes was estimated to be relatively undesirable (2.30 ± 0.83). The quality of life was estimated to be moderate for both groups, the mean score for nursing homes was 2.65 ± 0.37 and for the community was 2.98 ± 0.52. Simple regression indicated that appraisal and decision, among the subscales of health literacy, are predicting factors for quality of life in the elderly. Conclusion: Using self-help groups and the participation of the elderly in decision making as well as designing educational programs for identifying the accuracy of health information of the media and encouraging them to share health knowledge with others can ultimately improve quality of life in the elderly.


Author(s):  
Jennifer A Margrett ◽  
Thomas Schofield ◽  
Peter Martin ◽  
Leonard W Poon ◽  
Kamal Masaki ◽  
...  

Abstract To investigate inter-individual differences in cognitive terminal decline and identify determinants including functional, health, and genetic risk and protective factors, data from the Honolulu Heart Program/Honolulu-Asia Aging Study, a prospective cohort study of Japanese American men, were analyzed. The sample was recruited in 1965-68 (ages 45-68 years). Longitudinal performance of cognitive abilities and mortality status were assessed from Exam 4 (1991-1994) through June 2014. Latent class analysis revealed two groups: maintainers retained relatively high levels of cognitive functioning until death and decliners demonstrated significant cognitive waning several years prior to death. Maintainers were more likely to have greater education, diagnosed coronary heart disease, and presence of the apolipoprotein E (APOE) ε2 allele and FOXO3 G allele (SNP rs2802292). Decliners were more likely to be older and have prior stroke, Parkinson’s disease, dementia, and greater depressive symptoms at Exam 4, and the APOE ε4 allele. Findings support terminal decline using distance to death as the basis for modeling change. Significant differences were observed between maintainers and decliners 15 years prior to death, a finding much earlier compared to the majority of previous investigations.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Siqing Chen ◽  
Xingwei Zhang ◽  
Meijuan Cao ◽  
Bingyu Zhao ◽  
Jie Fang

A suitable health literacy assessment instrument for patients with chronic pain (HLCP) in China with good instrument’s psychometric properties is required. A theoretical framework for the HLCP was developed by adopting the hierarchical model of health literacy proposed by Nutbeam. The reliability and validity of the HLCP were tested in a cross-sectional survey of 237 chronic pain patients from three pain clinics and wards of Grade-3A hospitals in Zhejiang Province, China. The discriminant degree method, correlation analysis method, factor analysis method (exploratory factor analysis), half reliability, and other methods were utilized to screen items for inclusion in the final version of HLCP, and the fitness of the model was subsequently evaluated by confirmatory factor analysis. Cronbach’s alpha value and test-retest with two-week intervals were used to test the internal consistency and retest reliability of the HLCP. In the exploratory factor analysis, three domains, functional health literacy (10 items), interactive health literacy (14 items), and critical health literacy (7 items), comprising 31 items in total, were finally loaded; the model was determined to explain 70.9% of the total variance. HLCP’s effective assessment of the health literacy level of patients with chronic pain and its acceptable reliability and validity were revealed through the results.


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