El temps del mal: l’experiència i la gestió de la cronicitat en adults

El temps del mal. L’experiència i la gestió de la cronicitat en adults. El principal objectiu d’aquesta recerca és l’estudi de l’experiència i la gestió diària de la cronicitat, entenent-la com a categoria analítica que engloba els processos de malalties i/o malestars crònics, biomèdicament diagnosticats o no, que perduren en el temps. La recerca es centra en adults entre 30 i 50 anys amb problemes crònics de salut que impliquin algun tipus de discapacitat i/o dependència (a nivell moderat), i s’ubica en l’àmbit urbà i en la comunitat autònoma de Catalunya (dins del context de l’estat Espanyol). L’estudi analitzarà la gestió individual i social de la cronicitat a través dels itineraris terapèutics i pràctiques assistencials dels processos de salut/malaltia/atenció prenent l’autoatenció com a principal categoria analítica. Per altra banda, es descriurà el rol dels serveis assistencials de la sanitat pública i dels serveis socials, per veure com es duu a terme la gestió – polítiques públiques - de la cronicitat en un país amb estat del benestar com Espanya. L’experiència de la cronicitat s’explorarà a través de les narratives de la vivència de la malaltia/malestar tan com a representació cultural – que dóna compte de les relacions, interaccions i respostes socials – i des d’una perspectiva fenomenològica que ens permet comprendre la naturalesa del patiment en l’experiència viscuda del cos malalt. Aquesta recerca espera poder fer aportacions pertinents que contribueixin des de l’antropologia però amb la intenció d’obrir un diàleg públic i interdisciplinar – professionals de la salut, experts en polítiques públiques i públic en general - a la resolució de l’actual problema de salut pública d’increment de cronicitat. El model públic d’atenció a la salut espanyol es va dissenyar per resoldre problemes de salut aguts, malgrat la major part dels usuaris actuals presentes problemes de salut crònics. L’actual crisi econòmica que amenaça aquest pilar de l’estat del benestar és, alhora, una oportunitat per replantejar-ho.

A comparison of the spatial dependence of body mass index among adults and children in a Swiss general population.

BACKGROUND: Body mass index (BMI) may cluster in space among adults and be spatially dependent. Whether BMI clusters among children and how age-specific BMI clusters are related remains unknown. We aimed to identify and compare the spatial dependence of BMI in adults and children in a Swiss general population, taking into account the area's income level. METHODS: Geo-referenced data from the Bus Santé study (adults, n=6663) and Geneva School Health Service (children, n=3601) were used. We implemented global (Moran's I) and local (local indicators of spatial association (LISA)) indices of spatial autocorrelation to investigate the spatial dependence of BMI in adults (35-74 years) and children (6-7 years). Weight and height were measured using standardized procedures. Five spatial autocorrelation classes (LISA clusters) were defined including the high-high BMI class (high BMI participant's BMI value correlated with high BMI-neighbors' mean BMI values). The spatial distributions of clusters were compared between adults and children with and without adjustment for area's income level. RESULTS: In both adults and children, BMI was clearly not distributed at random across the State of Geneva. Both adults' and children's BMIs were associated with the mean BMI of their neighborhood. We found that the clusters of higher BMI in adults and children are located in close, yet different, areas of the state. Significant clusters of high versus low BMIs were clearly identified in both adults and children. Area's income level was associated with children's BMI clusters. CONCLUSIONS: BMI clusters show a specific spatial dependence in adults and children from the general population. Using a fine-scale spatial analytic approach, we identified life course-specific clusters that could guide tailored interventions.

Framingham risk score and alternatives for prediction of coronary heart disease in older adults.

BACKGROUND: Guidelines for the prevention of coronary heart disease (CHD) recommend use of Framingham-based risk scores that were developed in white middle-aged populations. It remains unclear whether and how CHD risk prediction might be improved among older adults. We aimed to compare the prognostic performance of the Framingham risk score (FRS), directly and after recalibration, with refit functions derived from the present cohort, as well as to assess the utility of adding other routinely available risk parameters to FRS.¦METHODS: Among 2193 black and white older adults (mean age, 73.5 years) without pre-existing cardiovascular disease from the Health ABC cohort, we examined adjudicated CHD events, defined as incident myocardial infarction, CHD death, and hospitalization for angina or coronary revascularization.¦RESULTS: During 8-year follow-up, 351 participants experienced CHD events. The FRS poorly discriminated between persons who experienced CHD events vs. not (C-index: 0.577 in women; 0.583 in men) and underestimated absolute risk prediction by 51% in women and 8% in men. Recalibration of the FRS improved absolute risk prediction, particulary for women. For both genders, refitting these functions substantially improved absolute risk prediction, with similar discrimination to the FRS. Results did not differ between whites and blacks. The addition of lifestyle variables, waist circumference and creatinine did not improve risk prediction beyond risk factors of the FRS.¦CONCLUSIONS: The FRS underestimates CHD risk in older adults, particularly in women, although traditional risk factors remain the best predictors of CHD. Re-estimated risk functions using these factors improve accurate estimation of absolute risk.

lmplementació i avaluació d'un programa dirigit a I'alfabetització de les mares amb infants estrangers en la seva llengua i en català

Teixint Cultures és un projecte de recerca-acció comunitari que intenta promoure des de I'educació d'adults, I'aprenentatge de la llengua catalana a partir dels recursos Iingüístics que les mares d'origen africà tenen en la seva llengua familiar. El programa atén a mares d'origen immigrat amb fills menors de tres anys no escolaritzats al seu càrrec (la majoria de les quals té altres fills en edat escolar que assisteixen a la tarda a la biblioteca per fer els deures escolars). Tot el projecte esta vehiculat a partir dels contes infantils. De fet, intenta recuperar els contes de tradició oral provinents del continent africà per posteriorment elaborar materials educatius bilingües (en català i en les seves llengües) que es puguin utilitzar com a llibres educatius de consulta, tant per les biblioteques públiques com pels centres educatius. El programa es realitza de forma setmanal, al llarg de dues hores, a la biblioteca pública infantil d'en Massagran de Salt. Les mares expliquen contes i llegendes rellevants de la seva infància en la seva llengua i, a partir de diferents activitats de narració, traducció i dramatització de les històries basades en una metodologia de a dual-language D, elaboren textos escrits i narracions orals en català i en la seva llengua. Posteriorment són les mateixes participants les que editen els contes a I'ordinador i elaboren digitalment un llibre de contes bilingüe. Les sessions s'han registrat en àudio i vídeo i hem estudiat el procés d'implementació del programa i les estratègies multilingües utilitzades per les participants, els educadors i voluntaris. Els resultats evidencien el progrés de les dones en I'aprenentatge del català, la modificació de les seves actituds lingüístiques i de la seva autoimatge, així com I ‘impacte positiu del programa a la comunitat pel que fa al reconeixement dels recursos lingüístics i culturals de les minories ètniques.

Association between self-reported health and sociodemographic characteristics with cardiovascular diseases in adults

OBJECTIVE To assess the association of sociodemographic and self-rated health in the presence of cardiovascular diseases and the association of this perception with the type of disease. METHODS A cross-sectional population survey study carried out with 1,232 individuals aged between 20 and 59 years of both genders living in the metropolitan region of Maringá-PR. Data were analyzed using multiple and simple logistic regression. RESULTS In multivariate analysis, the age range and self-rated health were associated with cardiovascular disease, and in the univariate analysis self-rated regular health was associated with arterial hypertension, while self-rated poor health was associated to heart failure, stroke, and to acute myocardial infarction (heart attack). CONCLUSION The differences in association of self-rated health with these diseases can indicate how individuals with certain characteristics cope with the disease, allowing for more individualized and specific health care.

How feeding on young and old leaves affects the performance of Ascia monuste orseis (Godart) (Lepidoptera, Pieridae)

In the field, immature individuals of Ascia monuste orseis (Godart), the kale caterpillars, migrate in great proportion to other regions of the host in order to complete their development; there, they find leaves of different ages and are exposed to the nutritional variation of these leaves. The objective of this study was to find out how the change to leaves of different ages affects the A. monuste orseis performance. The experiments were carried out providing one kind of leaf during the three first instars, and afterwards providing leaves of different ages during the fourth and fifth instars, since it is in these two instars that the changing movement prevails in that species. The parameters to measure performance were time of development (both to complete the three first instars and the fourth and fifth instars), ingestion of food, incorporated biomass, digestive indices that evaluated efficiency in food utilization, relative growth and intake rates, percentage of emergence, weight and size of the adults. In general, the caterpillars which were first fed on new leaves presented a better performance, but this study concluded that the A. monuste orseis caterpillars have shown skills to compensate food with lower nutritional value or less abundant in nature.

RAGBRAI Learn about the Land; Day 1, July 2008

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RAGBRAI Learn about the Land; Day 1, July 2010

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RAGBRAI Learn about the Land; Day 1, July 2009

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RAGBRAI Learn about the Land; Day 2, July 2009

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RAGBRAI Learn about the Land; Day 3, July 2009

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RAGBRAI Learn about the Land; Day 4, July 2009

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RAGBRAI Learn about the Land; Day 5, July 2009

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RAGBRAI Learn about the Land; Day 6, July 2009

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RAGBRAI Learn about the Land; Day 7, July 2009

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