Salud física

  • 文章类型: Journal Article
    背景:面肌痉挛(HFS)是一种使人衰弱的疾病,其特征是由面神经支配的肌肉的不自主的强直和阵挛性收缩。肉毒杆菌毒素A(BTX-A)是HFS的一线选择和最有效的药物治疗。本研究的目的是评估BTX-A治疗对HFS患者身心健康的影响。
    方法:研究对象包括65名HFS患者和65名匹配的健康对照。采用康奈尔医学指数(CMI)自评问卷对所有参与者的心理健康状况进行检测。局部注射BTX-A,并采用科恩等级标准对痉挛程度进行分层,进一步评估BTX-A在HFS患者治疗前和治疗后两个月的疗效。采用CMI自评问卷对治疗后2个月的HFS患者进行再评价,并将这些患者的评估因素与治疗前的患者进行比较。
    结果:躯体化评分,抑郁症,焦虑,不适应,灵敏度,愤怒,紧张,M-R,HFS组总分明显高于对照组(均P<0.05)。治疗后两个月,在接受BTX-A治疗的65例HFS患者中,42人(64.6%)完全缓解,16人(24.6%)明显缓解,7人(10.8%)部分缓解,0(0%)例无效,总有效率为89.2%。BTX-A治疗后两个月,躯体化的分数,紧张,焦虑,抑郁症,灵敏度,HFS患者的M-R和总分均低于治疗前(均P<0.05)。
    结论:HFS患者常伴有躯体化,愤怒,不适应,灵敏度,焦虑,抑郁症,和紧张。BTX-A不仅可以缓解HFS的症状,而且还改善了躯体化,紧张,焦虑,抑郁症,和敏感性。
    BACKGROUND: Hemifacial spasm (HFS) is a debilitating disease characterized by involuntary tonic and clonic contractions of muscles innervated by the facial nerve. Botulinum toxin A (BTX-A) is the first-line option and the most effective medical treatment for HFS. The objective of this study was to evaluate the effect of BTX-A therapy on the physical and mental health of HFS patients.
    METHODS: Participants included 65 HFS patients and 65 matched healthy controls in the study. Cornell Medical Index (CMI) self-assessment questionnaire was used to detect the psychological health of all participants. Local injection of BTX-A was applied, and the Cohen hierarchical criteria were employed to stratify the degree of spasticity, further evaluating the efficacy of BTX-A before and two months after treatment in HFS patients. The HFS patients at two months post-treatment were re-evaluated by CMI self-assessment questionnaire, and the evaluated factors of these patients were compared with those of patients before treatment.
    RESULTS: The scores of somatization, depression, anxiety, inadaptation, sensitivity, anger, tension, M-R, and total scores in the HFS group were significantly higher than those in the control group (all P<0.05). Two months post-treatment, among 65 HFS patients who received with BTX-A treatment, 42 (64.6%) were completely relieved, 16 (24.6%) were significantly relieved, 7 (10.8%) were partially relieved, and 0 (0%) cases were invalid, and the total effective rate was 89.2%. Two months after BTX-A treatment, the scores of somatization, tension, anxiety, depression, sensitivity, M-R and total scores of patients with HFS were lower than those before treatment (all P<0.05).
    CONCLUSIONS: Patients with HFS are often accompanied by somatization, anger, inadaptation, sensitivity, anxiety, depression, and tension. BTX-A can not only alleviate the symptoms of HFS, but also improve the somatization, tension, anxiety, depression, and sensitivity.
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  • 文章类型: Journal Article
    随着患病率的增加,孤独和与隔离相关的结构是公共卫生问题。该保护伞的目的是整理和评分证据,以分析实际和主观的孤独感作为健康风险因素。在预期注册之后,在Pubmed进行了系统的搜索,Embase,Scopus,WebofSciences,psycoINFO和Cochrane图书馆,直到2023年8月。选择了评估实际和主观孤独感与不良健康结果之间关联的系统评价。使用AMSTAR-2工具评估偏倚风险。数据列表,综合叙述。共选择13篇系统评价(4篇纳入荟萃分析)。10篇综述的方法学质量极低(76.92%),3篇综述的方法学质量极低(23.08%)。结果表明,孤独感与不良幸福感有关,并增加了不良身心健康的风险。现有数据表明,但不允许因果关系的确认。大多数孤独感似乎与心理和身体健康状况有关。应该建议采取预防策略,特别是弱势群体。
    Loneliness and related constructs associated with isolation are public health problems with increasing prevalence. The aim of this umbrella was to collate and grade evidence analyzing actual and subjective loneliness as a health risk factor. Following prospective registration, a systematic search was conducted in Pubmed, Embase, Scopus, Web of Sciences, psycoINFO and Cochrane Library until August 2023. Systematic reviews assessing the association between actual and subjective loneliness with adverse health outcomes were selected. Risk of bias was evaluated using AMSTAR-2 tool. Data were tabulated and synthesis was narrative. A total of 13 systematic reviews was selected (four included meta-analysis). The methodological quality was critically low in 10 reviews (76.92%) and low in 3 (23.08%). Results showed that loneliness was related to poor well-being and increase the risk of negative mental and physical health. The available data suggested but did not allow the confirmation of a causal association. Most constructs of loneliness seem to be related to mental and physical health conditions. A preventive strategy ought to be recommended, especially for vulnerable populations.
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  • 文章类型: Editorial
    Due to the current pandemic situation, work from home, or telecommuting, has been implemented as part of public health measures to prevent the spread of SARS-CoV-2. Although this measure was introduced rapidly, it is likely to remain in effect for some time to prevent further outbreaks of COVID-19. Despite being few, various studies have addressed the relationship between telecommuting and workers\' health in the context of the current pandemic. Some aspects observed include fatigue, dietary changes, reduced levels of physical activity, and pain. Other conditions observed are associated with \"techno-stress,\" namely work overload, invasion of privacy, pace of information technology changes, decreased job autonomy, emotional exhaustion, and being constantly in electronic contact with work. Generally speaking, the COVID-19 pandemic has created a new environment for considering work and family life within the discussion on telecommuting. Likewise, a contextualized understanding of factors related to physical and mental well-being is essential to ensure positive impacts on workers. It is important to develop studies and discussions within organizations that allow knowing, analyzing and reformulating strategies and policies aimed at aspects such as changes in workers\' physical and mental well-being in the pandemic context and the way how occupational environments at home affect these components.
    Debido a la situación actual de la pandemia, el trabajo en casa, o home office, se ha implementado como parte de las medidas de salud pública para prevenir la propagación del SARS-CoV-2. Aunque esta medida se introdujo rápidamente, es probable que permanezca en vigor durante algún tiempo para evitar nuevos brotes de la COVID-19. A pesar de ser pocos, diversos estudios han abordado la relación entre el home office y la salud de los trabajadores en el contexto de la pandemia actual. Algunos aspectos observados incluyen fatiga, alteraciones en la dieta, reducción de la actividad física y dolor. Otras condiciones observadas se encuentran asociadas con el tecnoestrés, a saber: sobrecarga de trabajo, invasión de la privacidad, ritmo del cambio de las tecnologías de la información, menor autonomía laboral, agotamiento emocional y contacto electrónico constante con el trabajo. En términos generales, la pandemia de COVID-19 ha creado un nuevo entorno para considerar la vida laboral y familiar dentro de la discusión del home office. Así mismo, realizar una lectura en contexto de los factores que se relacionan con el bienestar físico y mental es fundamental para garantizar impactos positivos en los trabajadores. Es importante realizar estudios y discusiones al interior de las organizaciones que permitan conocer, analizar y reformular estrategias y políticas orientadas a aspectos como las alteraciones en el bienestar físico y mental de los trabajadores en el contexto de la pandemia y la forma en que los entornos ocupacionales en el hogar afectan estos componentes.
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  • 文章类型: Journal Article
    OBJECTIVE: To analyze by gender the relationship of forced displacements due to neglected housing insecurity with the physical and mental health of renters in Barcelona in 2019, distinguishing between economic (EHI) and legal (LHI) housing insecurity.
    METHODS: We conducted a cross-sectional study based on the Survey of the Living Conditions of Renters in the Barcelona Metropolitan Area 2019 (1021 women; 584 men). Self-reported health and mental well-being were the dependents variables; the main explanatory variable was neglected housing insecurity. We used adjusted robust Poisson regression models to compare health outcomes among people affected by neglected housing insecurity and those who were not affected.
    RESULTS: We observed that the probability of worse health outcomes are greater in those affected by EHI, followed by those affected by LHI, both compared to those who have not been affected by housing insecurity. This association are mainly observed in mental health of renters affected by EHI, even after adjusting for socioeconomic and other housing variables (in women PR: 1,17, CI95%: 1,03-1,33; in men PR: 1,21, CI95%: 1,01-1,43).
    CONCLUSIONS: Neglected housing insecurity is associated with worse mental health. Enhancing the visibility of neglected housing insecurity and raising awareness of its effects on health is urgently needed to tackle this massive but hidden problem.
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  • 文章类型: Journal Article
    During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social domains. Based on the theoretical framework in literature reviews and in quantitative studies, this paper aims to obtain evidence on the effects of financial fraud on health and on the family and social environments of those affected. An intentional sample of 32 people affected by abusive and multi-currency mortgages, preferred and swap stock in Madrid was approached. In-depth interviews were conducted, and the resulting data was analysed using content analysis. Fraud-affected individuals had conditions of age, sex, educational level and occupations that possibly allowed them to accumulate economic resources throughout the course of their lives and, predictably in many cases, to take out fraudulent financial products, based on trust in the financial institutions. Financial fraud has led to the emergence of various processes of anomia and adverse health effects. The consequences on health were physical ailments (symptoms and diseases in various systems and parts of the body) and mental disorders (anxiety, depression, suicidal ideation), all affecting lifestyles, behaviour and personal and social relationships, both in affected individuals and their families. The increase in the use of medical drugs and health services serves as a final corollary to the imbalances on the affected people\'s health. Individuals and the Spanish society demand public health policy measures to mitigate the effects on health and the recovery of their confidence in the banking and political system.
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  • 文章类型: Journal Article
    OBJECTIVE: To examine whether financial fraud is associated with poor health sleeping problems and poor quality of life.
    METHODS: Pilot study (n=188) conducted in 2015-2016 in Madrid and León (Spain) by recruiting subjects affected by two types of fraud (preferred shares and foreign currency mortgages) using venue-based sampling. Information on the monetary value of each case of fraud; the dates when subjects became aware of being swindled, lodged legal claim and received financial compensation were collected. Inter-group comparisons of the prevalence of poor physical and mental health, sleep and quality of life were carried according to type of fraud and the 2011-2012 National Health Survey.
    RESULTS: In this conventional sample, victims of financial fraud had poorer health, more mental health and sleeping problems, and poorer quality of life than comparable populations of a similar age. Those who had received financial compensation for preferred share losses had better health and quality of life than those who had not been compensated and those who had taken out foreign currency mortgages.
    CONCLUSIONS: The results suggest that financial fraud is detrimental to health. Further research should examine the mechanisms through which financial fraud impacts health. If our results are confirmed psychological and medical care should be provided, in addition to financial compensation.
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  • 文章类型: Journal Article
    BACKGROUND: Depression is a common and disabling psychiatric disorder in adulthood and is associated with higher mortality and functional disability.
    OBJECTIVE: To determine the association between clinical and sociodemographic variables with depression in a sample of people over 50 years old living in Spain, and compare the prevalence of depression with the other Survey of Health, Ageing and Retirement (SHARE) countries.
    METHODS: There were 5,830 participants in the Spanish sample of the Wave 5, 2013, of SHARE. Tools used: EURO-D (Depression) and CASP-12 (Quality of Life).
    METHODS: Bivariate, and binary logistic.
    RESULTS: The variables associated with depression in the binary logistic regression (EURO-D ≥4) were poor self-perceived physical health (OR=13.34; 95% CI: 9.74-18.27), having more than 2 difficulties in Activities of Daily Living (ADL) (OR=4.46; 95% CI: 3.13-6.34) and female gender (OR=2.16; 95% CI: 1.83-2.56). Depression was more common among participants with Alzheimer (76.4%), emotional disorders (73.9%), Parkinson (57.4%), hip fracture (55.4%), and rheumatism (50.9%). Compared with other European countries, Spain had a percentage of people with depression (29.3%) that was higher than the European average (27.9%).
    CONCLUSIONS: The most important variables associated with depression were poor perceived physical health, presence of difficulties in ADL, and female gender.
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  • 文章类型: Journal Article
    OBJECTIVE: This exploratory pilot study aimed to investigate the physical and mental disease burden of unaccompanied asylum-seeking adolescents arriving in Bielefeld, a medium-size city in Germany.
    METHODS: A cross-sectional survey with purposive sampling of 102 unaccompanied asylum-seeking adolescents aged 12-18 years was performed. Information on general health status, selected infectious and non-communicable diseases, iron deficiency anaemia and mental illness was collected during routine check-up medical examinations upon arrival in Bielefeld, Germany. The data were analysed using descriptive statistics.
    RESULTS: The analysis revealed a complex disease burden with a high prevalence of infections (58.8%), mental illness (13.7%) and iron deficiency anaemia (17.6%) and a very low prevalence of non-communicable diseases (<2.0%). One in five of the refugees were infected with parasites. Whilst sub-Saharan Africans showed the highest prevalence of infections (86.7%), including highest prevalences of parasites (46.7%), West Asians had the highest prevalence of mental disorders (20.0%). Overall, the disease burden in females was higher.
    CONCLUSIONS: A thorough medical and psychological screening after arrival is highly recommended to reduce the individual disease burden and the risk of infection for others. This promotes good physical and mental health, which is needed for successful integration into the receiving society. Barriers to health service access for unaccompanied asylum-seeking adolescents need to be lowered to allow need-specific health care and prevention.
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  • 文章类型: Consensus Development Conference
    Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient\'s recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.
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  • 文章类型: Journal Article
    This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends\' social support, and relatives\' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2)  = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (β = .38, p < .001), as did relatives\' social support, inversely (β = -.16, p < .001). Biobehavioral reactivity predicted disease activity (β = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.
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