Current Issue : July - September Volume : 2015 Issue Number : 3 Articles : 5 Articles
Background: The Lapinlahti 2005ââ?¬â??2010 study was carried out to explore cardiovascular disease risk factors and\nchanges in lifestyle in Lapinlahti residents in eastern Finland. Our aim was to analyse factors influencing the level of\ncholesterol in the community.\nMethods: In 2005, 480 subjects aged 30ââ?¬â??65 years underwent a complete health survey (baseline study) that\nconsisted of a structured questionnaire and a health examination. The follow-up was carried out five years later in\n2010. The present study population included 326 individuals who did not use lipid-lowering medication at the\nbaseline. A trained research nurse measured weight, height, waist circumference and blood pressure at the\nbaseline and follow-up. Respectively, lifestyle factors (nutrition, exercise, smoking and alcohol use) were examined\nwith a structured questionnaire. Each lifestyle item was valued as ?1, 0 or 1, depending on how closely it fitted to\nthe recommendations. Cholesterol level analyses at the baseline and follow-up were performed according to the\nprotocol of the Kuopio University Hospitalââ?¬â?¢s medical laboratory. Based on their baseline cholesterol levels, the\nparticipants were divided into tertiles. The age- and sex-adjusted linear trend between the tertiles was tested.\nResults: The change in cholesterol level was associated with lipid-lowering medication (P < 0.001). Lifestyle\nimprovement was associated with the cholesterol level change but did not reach statistical significance (P = 0.061),\nalthough the interaction of lipid-lowering medication and lifestyle change was associated with the change in\ncholesterol level (P = 0.018). In multivariate analysis, a favourable change in fat consumption (P = 0.007) and\nlipid-lowering medication (P < 0.001) were associated with decreasing cholesterol levels.\nConclusions: At the population level, dyslipidaemia is one of the most easily modifiable risk factors of CHD.\nLipid-lowering medication may have the most significant impact on cholesterol level in communities with primary\nhealth care with good coverage. On the other hand, the potential of health-promoting and population-based\nprevention strategies may be underused....
Background: Healthy aging includes physical, psychological, social, and spiritual well-being in later years. The\npurpose of this study is to identify the psychosocial factors influencing healthy aging and examining their\nsocio-demographic characteristics. Perceived health status, depression, self-esteem, self-achievement, ego-integrity,\nparticipation in leisure activities, and loneliness were identified as influential factors in healthy aging.\nMethods: 171 Korean adults aged between 45 and 77 years-old participated in the study. Self-reporting questionnaires\nwere used, followed by descriptive statistics and multiple regressions as inferential statistical analyses.\nResults: There were significant differences between participants� general characteristics: age, education, religion,\nhousing, hobby, and economic status. The factors related to healthy aging had positive correlation with perceived\nhealth status, self-esteem, self-achievements, and leisure activities, and negative correlation with depression and\nloneliness. The factors influencing healthy aging were depression, leisure activities, perceived health status, ego\nintegrity, and self-achievements. These factors were able to explain 51.9%.\nConclusions: According to the results, depression is the factor with the greatest influence on healthy aging. Perceived\nhealth status, ego integrity, self-achievement, self-esteem, participation of leisure activities were also influential on\nhealthy aging as beneficial factors....
Background: Quality of life (QoL) is increasingly recognized as central to the broad construct of recovery in\npatients with substance use disorders (SUD). However, few longitudinal studies have evaluated changes in QoL\nafter SUD treatment and included patients with SUD that were compulsorily hospitalized. This study aimed to\ndescribe QoL among in-patients admitted either voluntarily or compulsorily to hospitalization and to examine\npatterns and predictors of QoL at admission and at 6 months post treatment.\nMethods: This prospective study followed 202 hospitalized patients with SUD that were admitted voluntarily\n(N=137) or compulsorily (N=65). A generic QoL questionnaire (QoL-5) was used to assess QoL domains.\nRegression analysis was conducted to identify associations with QoL at baseline and to examine predictors of\nchange in QoL at a 6-month follow-up.\nResults: The majority of patients had seriously impaired QoL. Low QoL at baseline was associated with a high\npsychiatric symptom burden. Fifty-eight percent of patients experienced a positive QoL change at follow-up. Although\nthe improvement in QoL was significant, it was considered modest (a mean 0.06 improvement in QoL-5 scores at\nfollow-up; 95% confidence interval: 0.03 - 0.09; p<0.001). Patients admitted voluntarily and compulsorily showed QoL\nimprovements of similar magnitude. Female gender was associated with a large, clinically relevant improvement in\nQoL at follow-up.\nConclusions: In-patient SUD treatment improved QoL at six month follow-up. These findings showed that QoL\nmeasurements were useful for providing evidence of therapeutic benefit in the SUD field....
Background: The impact of physical inactivity and unhealthy diet on health is increasingly profound. Lifestyle\ninterventions targeting both behaviors simultaneously might decrease the prevalence of overweight and comorbidities.\nThe Dutch ââ?¬Ë?BeweegKuurââ?¬â?¢ is a combined lifestyle intervention (CLI) in primary care, to improve physical activity and dietary\nbehavior in overweight people. In a cluster randomized controlled trial, the (cost-) effectiveness of an intensively guided\nprogram has been compared to a less intensively guided program. This process evaluation aimed to assess protocol\nadherence and potential differences between clusters. In addition, sustainability (i.e. continuation of the CLI in practice\nafter study termination) was evaluated.\nMethods: Existing frameworks were combined to design the process evaluation for our intervention and setting specifically.\nWe assessed reach, fidelity, dose delivered and received, context and implementation strategy. Both qualitative and\nquantitative data were used for a comprehensive evaluation. Data were collected in semi-structured interviews with\nhealth care providers (HCPs, n = 25), drop-out registration by HCPs, regular questionnaires among participants (n = 411)\nand logbooks kept by researchers during the trial.\nResults: Protocol adherence by professionals and participants varied between the programs and clusters. In both\nprograms the number of meetings with all HCPs was lower than planned in the protocol. Participants of the supervised\nprogram attended, compared to participants of the start-up program, more meetings with physiotherapists, but fewer\nwith lifestyle advisors and dieticians. The ââ?¬Ë?BeweegKuurââ?¬â?¢ was not sustained, but intervention aspects, networks and\nexperiences were still utilized after finalization of the project. Whether clusters continued to offer a CLI seemed\ndependent on funding opportunities and collaborations.\nConclusions: Protocol adherence in a CLI was problematic in both HCPs and participants. Mainly the amount of\ndietary guidance was lower than planned, and decreased with increasing guidance by PT. Thus, feasibility of changing\nphysical activity and dietary habits simultaneously by one intervention in one year was not as high as expected. Also\nthe sustainability of CLI was poor. When a CLI program is started, re-invention should be allowed and maximum effort\nshould be taken to guarantee long term continuation, by planning both implementation and sustainability carefully....
Background: Quality in healthcare has many potential meanings and interpretations. The case has been made for\nconceptualisations of quality that place more emphasis on describing quality and less on measuring it through\nstructured, vertically oriented metrics. Through discussion of an interdisciplinary community arts project we explore\nand challenge the dominant reductionist meanings of quality in healthcare.\nDiscussion: The model for structured participatory arts workshops such as ours is ââ?¬Ë?art as conversationââ?¬â?¢. In creating\ntextile art works, women involved in the sewing workshops engaged at a personal level, developing confidence\nthrough sharing ideas, experiences and humour. Group discussions built on the self-assurance gained from doing\ncraft work together and talking in a relaxed way with a common purpose, exploring the health themes which were\nthe focus of the art. For example, working on a textile about vitamin D created a framework which stimulated the\nemergence of a common discourse about different cultural practices around ââ?¬Ë?going out in the sunââ?¬â?¢. These conversations\nhave value as ââ?¬Ë?bridging workââ?¬â?¢, between the culture of medicine, with its current emphasis on lifestyle change to prevent\nillness, and patientsââ?¬â?¢ life worlds. Such bridges allow for innovation and flexibility to reflect local public health needs and\ncommunity concerns. They also enable us to view care from a horizontally oriented perspective, so that the interface in\nwhich social worlds and the biomedical model meet and interpenetrate is made visible.\nSummary: Through this interdisciplinary art project involving academics, health professionals and the local community\nwe have become more sensitised to conceptualising one aspect of health care quality as ensuring a ââ?¬Ë?space for the\nstoryââ?¬â?¢ in health care encounters. This space gives precedence to the patient narratives, but acknowledges the\nimportance of enabling clinicians to have time to share stories about care....
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