Impact of dental caries on quality of life of adolescents according to access to oral health services: a cross sectional study

Aim: This study presents the prevalence of dental caries and its relation to the quality of life of adolescents according to the access to dental health services. Methods: Two hundred and fifty-six adolescents between 15 and 19 years of age participated in the study; they were all enrolled in public schools in a countryside municipality of the São Paulo State. Data related to dental caries were evaluated by the DMFT Index, and OHIP-14 was used for evaluating the quality of life. Mann Whitney and Spearmann correlation tests were also used (p<0.05). Results: A DMFT of 3.09 (±3.30) was found with a higher prevalence among the adolescents who used public dental services (3.43±3.34) compared with those who used private services (2.94±3.28). A statistically significant relationship between the decay component of DMFT with physical pain (0.020), physical disability (0.002) and quality of life (0.017) was verified. Conclusions: A low prevalence of dental caries was observed, and it was higher in adolescents who used public oral health services rather than private ones, evidencing the low influence of oral health on the quality of life of the participants.

The domiciliary support in the vision of the informal care provider

The home support services are a social response in order to improve the quality of life directed predominantly for the elderly and for people with varying degrees of disability and dependence. Examples of those services are hygiene and personal comfort, medication, housekeeping and cleaning, preparation and monitoring of the meals; the dressing, etc. It is necessary to make society aware of the importance of these services to all those who need them. The general objective was to understand the most important relationships among informal caregivers, those who are care and home support services providers. Material and Methods. Data were collected through a questionnaire, using the various dimensions of the construct Quality SERVPERF model of service that matches the 22 items of SERVQUAL model. The various items used to assess the perception of care individuals and informal caregivers about the quality of home care services. 82 individuals participated providers of informal care, to receive home support services, and exclusion criteria, the fact of having a diagnosed psychiatric illness or psychological factors that prevent them from responding. The analysis was performed with SPSS and SEM-PLS for the estimation of the proposed structural model. Written consent was obtained, free and clear of each subject. Results and Conclusions. The results showed that the relationships with healthcare professionals are the most important positive effects on satisfaction. This research emphasizes the need to work closely with health professionals to improve the relationship between technicians and patients. Although current constructs appear to explain much of the satisfaction, it is recommended that the future researches exploit new variables, to get a better understanding of the effects of public health policies on the quality of life of these patients.

Quality of life and chronic disease in patients receiving primary health care

Problem Statement: Chronic disease entails physical, psychological and social issues with a decrease in the quality of life. The assessment of QoL has been applied as indicator in patients with chronic diseases. Research Questions: What is the quality of life in patients with chronic disease? What are the socio-demographic variables that influence the quality of life in patients? Purpose: To assess the quality of life in patients suffering from chronic disease and identify socio-demographic variables which influence the quality of life of patients suffering from chronic disease. Research Methods: We conducted a cross-sectional analytical study using a sample composed of 228 users (134 females) from a Family Health Unit in the municipality of Viseu. Data collection was made by means of a questionnaire, consisting of sociodemographic variables, the SF-12 scale and the existence of chronic disease was assessed through the questions – “Do you currently suffer from any chronic disease?”; “If so, which one(s)?”. Findings: The most common chronic diseases were hypertension (59.9%). Female patients with a chronic disease reported worse physical functioning, role-physical and role-emotional; increased bodily pain and better quality of life regarding general health. Male patients showed worse role-physical, increased bodily pain and vitality. Sociodemographic variables which were associated with quality of life were area of residence, academic qualifications and work situation. Conclusion: Chronic disease affects quality of life negatively. Quality of life in both patients groups was associated with socio-demographic variables. Health-related quality of life is an essential issue and should be considered as a priority in health policies.

Sporting activities and quality of life in children with hemophilia: An observational study

Sports activities are part of multidisciplinary treatments in people with hemophilia. Aim: The objective of this study was to assess the incidence of sports activities in the quality of life as perceived by children with hemophilia. Methods: A total of 53 children with hemophilia aged 7 to 13 years and 51 children without hemophilia were evaluated. The perception of quality of life, clinical variables, and the frequency of sports activities were registered. The joint condition of patients with hemophilia was measured with the Spanish version of the Haemophilia Joint Health Score. Results: There were no significant differences in the perception of quality of life between children with hemophilia and children without hemophilia. Sports activities in people with hemophilia promoted a greater health satisfaction. Conclusions: Sports activity in children with hemophilia is associated with an improved quality of life and joint health. It is also associated with improved psychosocial wellness. Copyright © 2016 Wolters Kluwer Health, Inc. and Academy of Pediatric Physical Therapy of the American Physical Therapy Association.

Different forms of life satisfaction and their relation to affectivity

Aims: The present study is aimed at studying the research question whether high satisfaction levels achieved through either (1) the fact that one's quality of life is truly satisfactory (i.e., stabilized life satisfaction) or through (2) adapting a more favorable perception of one's quality of life by lowering standards (i.e., resigned life satisfaction) are associated with different levels of positive affect (PA) and negative affect (NA) when compared to each other but also when compared to dissatisfied individuals. Case Report: A sample of 104 adults completed measures assessing stabilized and resigned life satisfaction, PA and NA, and global life satisfaction (i.e., no explicit consideration of differences in standards) in an online survey. Participants were not paid for participation but received feedback on results of the study if interest was expressed. Results: Stabilized life satisfaction and global life satisfaction showed highly similar correlation pattern with PA and NA. Resigned satisfaction was negatively associated with PA and positively correlated with NA. Stabilized and resigned satisfied individuals showed more favorable levels of PA and NA compared with dissatisfied individuals, but did not differ from each other with regard to their levels of PA and NA. Conclusion: Although showing a less favorable correlation pattern with PA and NA, adopting a resigned form of satisfaction (i.e., taking a more favorable view of one's quality of life by lowering individual standards) seemed to prevent individuals from experiencing the same high levels of NA like dissatisfied ones. This has not been studied in detail so far, and therefore, the present paper opens a further area of research within the context of life satisfaction.

Quality of life in children and adolescents with congenital heart disease. A new challenge for parents, professionals and community

The Quality of life is currently a major topic discussed in our society. The World Health Organization (WHO) has been developing a unifying and transcultural definition of QOL. They considered it as 'the individual's perception of his or her position in life, within the cultural context and value system he or she lives in, and in relation to his or her goals, expectations, parameters and social relations. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships and their relationship to salient features of their environment (WHOQOL, 1997, p. 1). Congenital heart disease is the most prevalent congenital disease in Portugal. Despite the advances in cardiac treatment and an early correct diagnosis that could increase the survival of children with congenital heart disease, this condition influences the quality of life of children, adolescents and their parents. Knowing the perception of quality of life could help healthcare professionals, nurses in particular, providing suited care to the needs of these families, establishing priorities in their interventions, sensing predictors of a poor quality of life, promoting adherence to treatment and boosting compliance with treatment, and fostering greater satisfaction for these children, adolescents and their parents. Purpose As part of broader research and with the awareness that the chronic conditions could impact the quality of life and considering that all advances on treating congenital cardiac diseases we have defined this main objective: To determine the quality of life in children and adolescents with congenital heart disease (CHD) and the perception of their parents, as well as factors that influence it. Methods It is a quantitative, descriptive and correlational research. The data collection tool was a questionnaire, which consisted of four parts: socio-demographic and educational characteristics, clinical characteristics, and quality of life, obtained using the Pediatric Cardiac Quality of Life Inventory - PCQLI - (Marino, Tomlinson, Wernovsky, Drotar , Newburger, Mahony et al., 2010) translated into Portuguese. Data collection took place between February and July 2014, in compliance with ethical research guidelines. The sample comprised 59 children, 59 parents of children, 80 adolescents and 80 parents of adolescents. Results The results indicated that children, adolescents, and their parents have high level of perceived health. The results are similar in all groups: children and parents and adolescents and parents. In the group of children, we observed the classification of "Good" in 66.10%, followed by the "Very Good" at 18.65% and "fair" in 15.25% of cases. The parents of the children responded in about half the cases that the health of their children was "good" (50.85%), "very good" in 30.51% "fair" in 11.86% and "Excellent "in 6.78%. In turn, the group of adolescents can be seen that 46.25% rate their health as "good", 32.50% as "very good", 16.25% as "Average" and 5% as "Excellent". Parents of teenagers classify the health of their children mostly as "good" in 42.50%, 31.25% as "very good", 20% as "fair" and 6.25% as "excellent". To point out that none of the respondents pointed out the option of a health status "Bad". About the quality of life, in general the results indicated that children, adolescents and their parents have high levels of quality of life, and that perceptions of parents and children are similar. Only in the children's group (8 to 12 years old), was no influence of socio-demographic, school or clinical variables on quality of life observed. For adolescents (13 to 18 years old), school, special education, school retention, the age of diagnosis of congenital heart disease, cardiac catheterization and surgical intervention influenced their quality of life. Perception of quality of life of parents of children and of adolescents was influenced by socio-demographic and clinical variables. The results partly agree with the literature in this field. About the influence of some variables: - The perception of quality of life expressed by children and adolescents with congenital heart disease and parents are related, with statistical significance. - There were no statistically significant relationships between the quality of life of children and adolescents and their age, gender or socioeconomic status. - Adolescents differ statistically significant between their quality of life and their education, the frequency of special education and the existence of grade retention. The severity of heart disease, the number of cardiac catheterizations or surgery and the presence of other health disorders are unrelated to the quality of life of children and adolescents. - Adolescents revealed that the level of quality of life is influenced by the age of diagnosis of CHD by cardiac catheterization and surgery. - For parents of children and adolescents gender and their education don´t influence their perception of quality of life. Only the socioeconomic status of parents of teens has statistically significant difference to quality of life. - Parents of children and adolescents do not show statistically significant relationship between the perceived level of quality of life and severity of disease, age at diagnosis, the number of surgical interventions and the existence of other health disorders. - There is a relationship of statistical significance between cardiac catheterization and the perceived quality of life by parents of adolescents; between the number of cardiac catheterizations and the perception of quality of life of parents of children; and between performing surgery and the perception of parents of children and adolescents. Conclusion To analyze the quality of life of children and adolescents with CHD must be a key focus of attention in caring for this population, allowing the identification of individual differences, interests, preferences, and prevent potential problems. The knowledge acquired along with clinical experience contributes to improve the quality of life of children and families, facilitating their growth, psycho-emotional development and social integration. Nevertheless, the reading and interpretation of these results must be prudent and cautious, there are limitations to this research, including: the use of a range of specific quality of life for the Congenital heart disease in children, adolescents, and parents but whose validation process could not be completed in this study; the low prevalence of severe conditions in our sample; the absence of national studies to enable comparison with the results obtained. We intend to continue the process of validation of instrument and enlarge the research to Lisbon and Oporto, other major centers where the cardiac conditions can be treated

Quality of life in children and adolescents with congenital heart disease

Purpose: The Quality of life is currently a major topic discussed in our society. The World Health Organization (WHO) has been developing a unifying and transcultural definition of QOL. They considered it as 'the individual's perception of his or her position in life, within the cultural context and value system he or she lives in, and in relation to his or her goals, expectations, parameters and social relations. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships and their relationship to salient features of their environment (WHOQOL, 1997, p. 1). Congenital heart disease is the most prevalent congenital disease in Portugal. Despite the advances in cardiac treatment and an early correct diagnosis that could increase the survival of children with congenital heart disease, this condition influences the quality of life of children, adolescents and their parents. Knowing the perception of quality of life could help healthcare professionals, nurses in particular, providing suited care to the needs of these families, establishing priorities in their interventions, sensing predictors of a poor quality of life, promoting adherence to treatment and boosting compliance with treatment, and fostering greater satisfaction for these children, adolescents and their parents. 'As part of broader research and with the awareness that the chronic conditions could impact the quality of life and considering that all advances on treating congenital cardiac diseases we have defined this main objective: To determine the quality of life in children and adolescents with congenital heart disease (CHD) and the perception of their parents, as well as factors that influence it. Methods: It is a quantitative, descriptive and correlational research. The data collection tool was a questionnaire, which consisted of four parts: socio-demographic and educational characteristics, clinical characteristics, and quality of life, obtained using the Pediatric Cardiac Quality of Life Inventory ? PCQLI - (Marino, Tomlinson, Wernovsky, Drotar , Newburger, Mahony et al., 2010) translated into Portuguese. Data collection took place between February and July 2014, in compliance with ethical research guidelines. The sample comprised 59 children, 59 parents of children, 80 adolescents and 80 parents of adolescents. Results: The results indicated that children, adolescents, and their parents have high level of perceived health. The results are similar in all groups: children and parents and adolescents and parents. In the group of children, we observed the classification of "Good" in 66.10%, followed by the "Very Good" at 18.65% and "fair" in 15.25% of cases. The parents of the children responded in about half the cases that the health of their children was "good" (50.85%), "very good" in 30.51% "fair" in 11.86% and "Excellent "in 6.78%. In turn, the group of adolescents can be seen that 46.25% rate their health as "good", 32.50% as "very good", 16.25% as "Average" and 5% as "Excellent". Parents of teenagers classify the health of their children mostly as "good" in 42.50%, 31.25% as "very good", 20% as "fair" and 6.25% as "excellent". To point out that none of the respondents pointed out the option of a health status "Bad". About the quality of life, in general the results indicated that children, adolescents and their parents have high levels of quality of life, and that perceptions of parents and children are similar. Only in the children?s group (8 to 12 years old), was no influence of socio-demographic, school or clinical variables on quality of life observed. For adolescents (13 to 18 years old), school, special education, school retention, the age of diagnosis of congenital heart disease, cardiac catheterization and surgical intervention influenced their quality of life. Perception of quality of life of parents of children and of adolescents was influenced by socio-demographic and clinical variables. The results partly agree with the literature in this field. About the influence of some variables: The perception of quality of life expressed by children and adolescents with congenital heart disease and parents are related, with statistical significance. There were no statistically significant relationships between the quality of life of children and adolescents and their age, gender or socioeconomic status. Adolescents differ statistically significant between their quality of life and their education, the frequency of special education and the existence of grade retention. The severity of heart disease, the number of cardiac catheterizations or surgery and the presence of other health disorders are unrelated to the quality of life of children and adolescents. Adolescents revealed that the level of quality of life is influenced by the age of diagnosis of CHD by cardiac catheterization and surgery. For parents of children and adolescents gender and their education don?t influence their perception of quality of life. Only the socioeconomic status of parents of teens has statistically significant difference to quality of life. Parents of children and adolescents do not show statistically significant relationship between the perceived level of quality of life and severity of disease, age at diagnosis, the number of surgical interventions and the existence of other health disorders. There is a relationship of statistical significance between cardiac catheterization and the perceived quality of life by parents of adolescents; between the number of cardiac catheterizations and the perception of quality of life of parents of children; and between performing surgery and the perception of parents of children and adolescents. Conclusion: To analyze the quality of life of children and adolescents with CHD must be a key focus of attention in caring for this population, allowing the identification of individual differences, interests, preferences, and prevent potential problems. The knowledge acquired along with clinical experience contributes to improve the quality of life of children and families, facilitating their growth, psycho-emotional development and social integration. Nevertheless, the reading and interpretation of these results must be prudent and cautious, there are limitations to this research, including: the use of a range of specific quality of life for the Congenital heart disease in children, adolescents, and parents but whose validation process could not be completed in this study; the low prevalence of severe conditions in our sample; the absence of national studies to enable comparison with the results obtained. We intend to continue the process of validation of instrument and enlarge the research to Lisbon and Oporto, other major centers where the cardiac conditions can be treated.

AD-HOC principles of minimum energy expenditure as corollaries of the constructal law the cases of river basins and human vascular systems

In a recent paper [1] Reis showed that both the principles of extremum of entropy production rate, which are often used in the study of complex systems, are corollaries of the Constructal Law. In fact, both follow from the maximization of overall system conductivities, under appropriate constraints. In this way, the maximum rate of entropy production (MEP) occurs when all the forces in the system are kept constant. On the other hand, the minimum rate of entropy production (mEP) occurs when all the currents that cross the system are kept constant. In this paper it is shown how the so-called principle of "minimum energy expenditure" which is often used as the basis for explaining many morphologic features in biologic systems, and also in inanimate systems, is also a corollary of Bejan's Constructal Law [2]. Following the general proof some cases namely, the scaling laws of human vascular systems and river basins are discussed as illustrations from the side of life, and inanimate systems, respectively.

Aspects Related to Venous Ulcer Healing and its Influence on Quality of Life

Nowadays, the varicose ulcers (VUs) are one of the most worrying leg ulcers and are an important problem in global public health, with high costs related to the treatment and its complications. Moreover, the quality of life (QOL) of the patient could be affected by pain, sleep disorders, functional impairment, depression and isolation. The VUs patient care is complex and it is necessary to know the aspects that contribute to the healing process for developing effective strategies. The members of the multidisciplinary health team should identify sociodemographic, clinical and care aspects that interfere in tissue repair and therefore impacting the QOL. Self-efficacy, adherence to treatment and self-esteem are other important aspects also related to healing and QOL, with implications for health care and the multidisciplinary team. To sum up, the use of multidisciplinary protocols allows the systematization of care for people with VUs in order to standardize therapeutic interventions with the aim to decrease the healing process time and, as a consequence, to improve the QOL.

Quality of Life Profile, Overweight-Obesity and Sedentary Behavior in Elementary and High School Children of Guanacaste

The purpose of this study was to identify the quality of life profile, overweight-obesity and sedentary behavior in a group of elementary and high school children of Guanacaste. 635 students participated in the study. The participants completed a protocol by which they were anthropometrically evaluated, and also filled up a questionnaire related to sedentary behavior and quality of life. In general, the findings reflected a prevalence of overweight and obesity of 13, 9%. The most important sedentary activities were, in descending order, the small screen (watching TV, video games, computer), and certain social and cultural activities. The self-reported quality of life index was within acceptable limits but not exceeding 80 points on a scale of 1-100. There was no significant relationship between the rate of the overall quality of life, overweight, obesity and some sedentary behaviors, although some anthropometric parameters like percentage of body fat and body weight showed significant correlation with sedentary behavior and specific aspects belonging to quality of life. The study provides valuable information to health authorities, directors of educational institutions and parents about key issues related to child development.

Role of Shiga toxins in the pathogenesis of hemolytic uremic syndrome

During the pathogenesis of hemolytic uremic syndrome (HUS), a severe sequela of Shiga toxin (Stx)-producing Escherichia coli (STEC) gastrointestinal infections, before the toxin acts on the target endothelial cells of the kidney and brain, several Stx forms are transported in the bloodstream: free Stx; Stx bound to circulating cells through Gb3Cer and TLR4 receptors; and Stx associated to blood cell-derived microvesicles. The latter form is mainly responsible for the development of life-threatening HUS in 15% of STEC-infected patients. Stx consist of five B subunits non-covalently bound to a single A subunit (uncleaved Stx) which can be cleaved in two fragments (A1 and A2) held by a disulfide bond (cleaved Stx). After reduction, the enzymatically active A1 fragment responsible for toxicity is released. Cleaved and uncleaved Stx are biologically active but functionally different, thus their presence in patients’ blood could affect the onset of HUS. Currently, there are no effective therapies for the treatment of STEC-infected patients and the gold standard strategies available for the diagnosis are very expensive and time-consuming. In this thesis, by exploiting the resolving power of SERS technology (Amplified Raman Spectroscopy on Surfaces), a plasmonic biosensor was developed as effective diagnostic tool for early detection of Stx in patients’ sera. An acellular protein synthesis system for detecting cleaved Stx2a in human serum based on its greater translation inhibition after treatment with reducing agents was developed and used to identify cleaved Stx in STEC-infected patients’ sera. Pathogenic microvesicles from Stx2a-challenged blood from healthy donors were isolated and characterized. The antibiotic NAB815, acting as inhibitor of toxin binding to TLR4 expressed by circulating cells, was found to be effective in impairing the formation of blood cell-derived microvesicles containing Stx2a, also having a protective effect in cellular models. This approach could be proposed as an innovative treatment for HUS prevention.

Climate change effects on animal and plant phylogenetic diversity in southern Africa

Much attention has been paid to the effects of climate change on species' range reductions and extinctions. There is however surprisingly little information on how climate change driven threat may impact the tree of life and result in loss of phylogenetic diversity (PD). Some plant families and mammalian orders reveal nonrandom extinction patterns, but many other plant families do not. Do these discrepancies reflect different speciation histories and does climate induced extinction result in the same discrepancies among different groups? Answers to these questions require representative taxon sampling. Here, we combine phylogenetic analyses, species distribution modeling, and climate change projections on two of the largest plant families in the Cape Floristic Region (Proteaceae and Restionaceae), as well as the second most diverse mammalian order in Southern Africa (Chiroptera), and an herbivorous insect genus (Platypleura) in the family Cicadidae to answer this question. We model current and future species distributions to assess species threat levels over the next 70years, and then compare projected with random PD survival. Results for these animal and plant clades reveal congruence. PD losses are not significantly higher under predicted extinction than under random extinction simulations. So far the evidence suggests that focusing resources on climate threatened species alone may not result in disproportionate benefits for the preservation of evolutionary history.