scholarly journals Effect of Practicing Health Behaviors on Unmet Needs among Patients with Chronic Diseases: A Longitudinal Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7977
Author(s):  
Bich-Na Jang ◽  
Hwi-Jun Kim ◽  
Bo-Ram Kim ◽  
Seon-Yeong Woo ◽  
Woo-Jin Lee ◽  
...  
Keyword(s):  
Health Behaviors ◽  
Chronic Diseases ◽  
Unmet Needs ◽  
Estimating Equation ◽  
Correlated Data ◽  
Equation Analysis ◽  
Using Data ◽  
High Risk Drinking ◽  
The Impact

With the growing prevalence of chronic diseases, the proportion of unmet needs is increasing. In this study, we investigated the effect of practicing health behaviors on unmet needs among patients with chronic diseases, using data from the Korea Health Panel Survey conducted between 2014–2017. Participants (n = 4069) aged 19 or older, with at least one chronic disease (hypertension, diabetes mellitus, dyslipidemia, or arthrosis) and with existing follow up data were selected. Health behaviors combined three variables: not presently smoking, not belonging to high-risk drinking group, and indulging in moderate- or high-intensity exercise. Those who met all three criteria were classified as the practicing health behaviors group. Generalized Estimating Equation analysis was performed to consider correlated data within a subject. Of the participants, 23.9% practiced health behaviors. Participants who did not practice health behaviors were significantly more likely to have unmet needs compared with those who did (OR: 1.24, 95% CI: 1.10–1.39). Further research would be needed to verify the impact of practicing health behavior on unmet needs.

Trends of Obesity in 10-Years of Follow-up among Tehranian Children and Adolescents: Tehran Lipid and Glucose Study (TLGS)

2020 ◽  
Author(s):  
Farhad HOSSEINPANAH ◽  
Sara SERAHATI ◽  
Maryam BARZIN ◽  
Shayan ARYANNEZHAD ◽  
Maryam REZAIE ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Parental Education ◽  
Estimating Equation ◽  
Phase Iii ◽  
Total Prevalence ◽  
Equation Analysis ◽  
Using Data ◽  
Phase Iv

Background: We aimed to investigate the trend of childhood obesity in Tehranian population during a median follow-up of 10 years. Methods: Within a prospective cohort study, using data collected from Tehran Lipid and Glucose Study (TLGS), 1406 participants, aged 3-11 yr were selected and monitored in 4 phases: phase I (1999-2001), phase II (2002–2005), phase III (2006–2008) and phase IV (2009–2011). Results: Total prevalence of obesity in children increased from 5.5% to 9.4% from phase I to IV. Performing GEE (Generalized Estimating Equation) analysis, relative risk of obesity was calculated, comparing each phase to its previous phase: phase II in reference to phase I (RR=1.06, CI=1.04-1.08), phase III in reference to phase II (RR=1.01, CI=1.00-1.03) and phase IV in reference to phase III (RR=0.96, CI=0.94-0.98). Between group difference was significant in all subgroups (age, gender, parental obesity) except parental education. Test of interaction for effect of time was insignificant in all subgroups except for the age group. For children younger than 7 yr old at phase I, trend of obesity throughout the study was higher compared to those with 7 yr of age and older at phase I. Conclusion: During a decade of follow-up, trend of obesity was rising in this Tehranian children in both genders, especially in younger children. Any preventive interventions for stopping this trend should focus on early stages of childhood.

Colorectal cancer survivors’ quality of life: a qualitative study of unmet need

2020 ◽  
pp. bmjspcare-2020-002190
Author(s):  
Amanda Drury ◽  
Sheila Payne ◽  
Anne-Marie Brady
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Unmet Need ◽  
Safety Net ◽  
The Impact

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.

Psychological Well-Being, Health Behaviors, and Weight Loss Among Participants in a Residential, Kripalu Yoga-Based Weight Loss Program

2012 ◽  
Vol 22 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Tosca Braun ◽  
Crystal Park ◽  
Lisa Ann Conboy
Keyword(s):  
Weight Loss ◽  
Health Behaviors ◽  
Well Being ◽  
The United States ◽  
Overweight And Obesity ◽  
Weight Loss Program ◽  
Health Concern ◽  
Psychological Well Being ◽  
The Impact

The increasing prevalence of overweight and obesity in humans is a growing public health concern in the United States. Concomitants include poor health behaviors and reduced psychological well-being. Preliminary evidence suggests yoga and treatment paradigms incorporating mindfulness, self-compassion (SC), acceptance, non-dieting, and intuitive eating may improve these ancillary correlates, which may promote long-term weight loss. Methods: We explored the impact of a 5-day residential weight loss program, which was multifaceted and based on Kripalu yoga, on health behaviors, weight loss, and psychological well-being in overweight/obese individuals. Thirty-seven overweight/obese program participants (age 32-65, BMI<25) completed validated mind-fulness, SC, lifestyle behavior, and mood questionnaires at baseline, post-program, and 3-month follow-up and reported their weight 1 year after program completion. Results: Significant improvements in nutrition behaviors, SC, mindfulness, stress management, and spiritual growth were observed immediately post-program (n = 31, 84% retention), with medium to large effect sizes. At 3-month follow-up (n = 18, 49% retention), most changes persisted. Physical activity and mood disturbance had improved significantly post-program but failed to reach significance at 3-month follow-up. Self-report weight loss at 1 year (n = 19, 51% retention) was significant. Conclusion: These findings suggest a Kripalu yoga-based, residential weight loss program may foster psychological well-being, improved nutrition behaviors, and weight loss. Given the exploratory nature of this investigation, more rigorous work in this area is warranted.

scholarly journals Prognostic value of 8F-Florbetapir scan: a 36-month follow up analysis using ADNI data

2015 ◽  
Vol 42 (S1) ◽  
pp. S30-S30
Author(s):  
M Lu ◽  
M Pontecorvo ◽  
A Siderowf ◽  
AD Joshi ◽  
MD Devous ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Standard Uptake Value ◽  
Estimating Equation ◽  
Cognitive Change ◽  
Amyloid Deposition ◽  
Function Change ◽  
Equation Analysis ◽  
Β Amyloid ◽  
Clinically Significant

Background: The Alzheimer’s Disease Neuroimaging Initiative (ADNI) provides an opportunity to investigate the relationship between β-Amyloid neuropathology and patients’ long-term cognitive function change. We examined baseline 18F-florbetapir PET amyloid imaging status and 36-months’ change from baseline in cognitive performance in subjects with mild cognitive impairment (MCI). Method: The study included all ADNI subjects who underwent PET-imaging with 18F-florbetapir and had a clinical diagnosis of MCI at the visit closest to florbetapir imaging. β-Amyloid deposition was measured by florbetapir standard uptake value ratio (SUVR), and dichotomized as Aβ+(SUVR>1.1) or Aβ–(SUVR≤1.1). Cognitive scores, including ADAS11, MMSE and CDR sum of boxes (CDR-SB), were evaluated for up to 36 months. Results: Of 478 MCI-subjects who had at least one florbetapir scan, 153 had a cognitive evaluation at 36-month follow-up. Of those, 79 were Aβ– and 74 Aβ+. At 36-months, the Aβ+ vs. Aβ– group scores changed from baseline (LS means 4.03 vs. 0.26 for ADAS11; -2.61 vs.-0.40 for MMSE; 1.53 vs. -0.11 for CDR-SB [p< 0.0001 all comparisons]). Generalised estimating equation analysis on clinically significant cognitive change showed a marginal Odds Ratio=2.18 (95% CI: 1.47–3.21) for Aβ+ vs. Aβ– groups. Conclusion: MCI subjects with higher β-Amyloid deposition had greater deterioration in cognitive function over 36 months while subjects with no β-Amyloid accumulation tended to be stable.

scholarly journals The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study (Preprint)

2018 ◽  
Author(s):  
Amani S Alqahtani ◽  
Saeed A Alsharif ◽  
Mohammad A Garnan ◽  
Mohamed Tashani ◽  
Nasser F BinDhim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Behaviors ◽  
General Practitioners ◽  
Preventive Measures ◽  
Disease Risk ◽  
Travel Agents ◽  
Travel Health ◽  
Health Advice ◽  
The Impact

BACKGROUND Pretravel health advice can play a crucial role in improving both travelers’ awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non–mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims’ health behaviors. OBJECTIVE The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims’ awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. METHODS A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015. RESULTS A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; <i>P</i>=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; <i>P</i>=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; <i>P</i>=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; <i>P</i>=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. CONCLUSIONS Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.

scholarly journals TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort

2017 ◽  
Vol 77 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Christoph Molnar ◽  
Almut Scherer ◽  
Xenofon Baraliakos ◽  
Manouk de Hooge ◽  
Raphael Micheroli ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Quality Management ◽  
Disease Activity ◽  
Missing Values ◽  
Radiographic Progression ◽  
Multivariable Analysis ◽  
Estimating Equation ◽  
Clinical Quality ◽  
The Impact

ObjectivesTo analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS).MethodsPatients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis.ResultsA total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97).ConclusionTNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity.

The Impact of Medical Marijuana Laws and Dispensaries on Self-Reported Health

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Elena Andreyeva ◽  
Benjamin Ukert
Keyword(s):  
Health Behaviors ◽  
Medical Marijuana ◽  
Behavioral Risk ◽  
Demographic Groups ◽  
Risky Health Behaviors ◽  
High School Degree ◽  
Reported Health ◽  
Using Data ◽  
Medical Marijuana Laws ◽  
The Impact

Abstract Growing evidence suggests that medical marijuana laws have harm reduction effects across a variety of outcomes related to risky health behaviors. This study investigates the impact of medical marijuana laws on self-reported health using data from the Behavioral Risk Factor Surveillance System from 1993 to 2013. In our analyses we separately identify the effect of a medical marijuana law and the impact of subsequent active and legally protected dispensaries. Our main results show surprisingly limited improvements in self-reported health after the legalization of medical marijuana and legally protected dispensaries. Subsample analyses reveal strong improvements in health among non-white individuals, those reporting chronic pain, and those with a high school degree, driven predominately by whether or not the state had active and legally protected dispensaries. We also complement the analysis by evaluating the impact on risky health behaviors and find that the aforementioned demographic groups experience large reductions in alcohol consumption after the implementation of a medical marijuana law.

FC08-04 - Trajectories of depressive episodes and hypertension over 24 years: the whitehall II prospective cohort study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1855-1855
Author(s):  
H. Nabi ◽  
J.-F. Chanstang ◽  
T. Lefèvre ◽  
A. Dugravot ◽  
M. Melchior ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Health Questionnaire ◽  
Antidepressant Medication ◽  
Estimating Equation ◽  
Depression Subscale ◽  
Medical Examinations ◽  
Depressive Episodes ◽  
The Impact ◽  
Over Time

IntroductionProspective data on depressive symptoms and blood pressure (BP) are scarce, and the impact of age on this association is poorly understood.ObjectivesThe present study examines longitudinal trajectories of depressive episodes and the probability of hypertension associated with these trajectories over time.MethodsParticipants were 6,889 men and 3,413 women London based civil servants followed for 24 years between 1985 and 2009. The age of participants over the follow-up ranged from 35 to 80 years. Depressive episode (defined as scoring 4 or more on the General Health Questionnaire-Depression subscale or using prescribed antidepressant medication) and hypertension (systolic/diastolic blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication) were assessed concurrently at five medical examinations.ResultsIn longitudinal logistic regression analyses based on Generalized-Estimating-Equation using age as the time scale, participants with depression trajectory characterised by increasing depressive episodes overtime had a greater increase in the likelihood for hypertension with advancing age; an adjusted-excess increase of 7% (95% CI 3-12, p < 0.001) for each five-year increase in age compared to those with a low/stable depression trajectory. In a model adjusted for relevant confounders, a higher risk of hypertension in the first group of participants did not become evident before age 55. A similar pattern of association was observed in men and women although the association was stronger in men.ConclusionsThis study suggests that the risk of hypertension increases with repeated experience of depressive episodes over time and materializes in later adulthood.

scholarly journals To Include, or Not Include, that is the Question: An Empirical Analysis of Dealing with Patients who are Lost to Follow-up when Developing Prognostic Models Using a Cohort Design

2020 ◽  
Author(s):  
Jenna M Reps ◽  
Peter Rijnbeek ◽  
Alana Cuthbert ◽  
Patrick B Ryan ◽  
Nicole Pratt ◽  
...  
Keyword(s):  
At Risk ◽  
Synthetic Data ◽  
Model Performance ◽  
Test Set ◽  
Loss To Follow Up ◽  
Using Data ◽  
Lost To Follow Up ◽  
The Impact ◽  
Prediction Problems

Abstract Background: Researchers developing prediction models are faced with numerous design choices that may impact model performance. One of the main decisions is how to include patients who are lost to follow-up. In this paper we perform a large-scale empirical evaluation investigating the impact of this decision. In addition, we aim to provide guidelines for how to deal with loss to follow-up. Methods: We generate a synthetic dataset with complete follow-up and simulate loss to follow-up based either on random selection or on selection based on comorbidity. We investigate four simple strategies for developing models using data containing some patients with loss to follow-up. Three strategies employ a binary classifier with data that: i) include all patients (including those lost to follow-up), ii) exclude all patients lost to follow-up or iii) only exclude patients lost to follow-up who do not have the outcome before being lost to follow-up. The fourth strategy uses a survival model with data that include all patients. In addition to our synthetic data study, we empirically evaluate the discrimination and calibration performance of these strategies across 21 prediction problems using real-world data. Results: The synthetic data study results show that excluding patients lost to follow-up can introduce bias when loss to follow-up is common and does not occur at random. However, when loss to follow-up was completely at random, the choice of addressing it had negligible impact on the model performance. Our empirical results showed that the four design choices investigated to deal with loss to follow-up resulted in comparable performance when the time-at-risk was 1-year, but demonstrated differential bias when we looking into 3-year time-at-risk. Removing patients who are lost to follow-up before the outcome but keeping patients who are loss to follow-up after the outcome can bias a model and should be avoided. Conclusion: Based on this study we therefore recommend i) developing models using data that includes patients that are lost to follow-up and ii) evaluate the discrimination and calibration of models twice: on a test set including patients lost to follow-up and a test set excluding patients lost to follow-up.

scholarly journals A One-Year Prospective Follow-Up Study on the Health Profile of Hikikomori Living in Hong Kong

2019 ◽  
Author(s):  
John Yuen ◽  
Victor Wong ◽  
Wilson Tam ◽  
Ka-Wing So ◽  
Wai-Tong Chien
Keyword(s):  
Estimating Equation ◽  
Moderate Intensity ◽  
Health Profile ◽  
Equation Analysis ◽  
The Social ◽  
Work Intervention ◽  
One Year ◽  
A Prospective Study ◽  
Mental And Physical Health

Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.

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