875 resultados para Hospitalized Adults


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Purpose: To examine age-related differences in the physical activity behaviors of young adults. Methods: We examined rates of participation in vigorous- and moderate-intensity leisure-time activity and walking, as well as an index of physical activity sufficient for health benefits in three Australian cross-sectional samples, for the age ranges of 18-19, 20-24, and 25-29 yr. Data were collected in 1991, 1996, and 1997/8. Results: There was at least a 15% difference in vigorous-intensity leisure-time physical activity from the 18-19 yr to the 25-29 yr age groups, and at least a 10% difference in moderate-intensity leisure-time physical activity. For the index of sufficient activity there was a difference between 9 and 21% across age groups. Differences in rates of walking were less than 8%. For all age groups, males had higher rates of participation for vigorous and moderate-intensity activity than did females, bur females had much higher rates of participation in walking than males. Age-associated differences in activity levels were more apparent for males. Conclusions: Promoting walking and various forms of moderate-intensity physical activities to young adult males, and encouraging young adult females to adopt other forms of moderate-intensity activity to complement walking may help to ameliorate decreases in physical activity over the adult lifespan.

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Physical inactivity continues to be a significant public health issue for middle-aged and older adults. This review focuses on physical activity interventions targeting older adults in health care settings. The literature in this area is limited and the results to date disappointing. Much remains to be done to develop effective interventions targeting older adults, especially those from underserved groups. Attention also needs to be paid to maintenance of initial treatment gains and to linking primary-care-based physical activity interventions to community-based resources. Recognition in the social and behavioral sciences of the importance of social-environmental influences on health and health behaviors mandates both a multidisciplinary and a multilevel intervention approach to the problem of physical inactivity.

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A representative sample (n = 10 641) of Australian adults completed a structured diagnostic interview assessing the prevalence of mental and substance use disorders in the last year. The prevalence of DSM-IV (1.5%) and ICD-10 (1.7%) cannabis dependence was similar. DSM-IV and ICD-10 dependence criteria comprised unidimensional syndromes. The most common symptoms among dependent and non-dependent users were difficulties with controlling use and withdrawal, although there were marked differences in symptom prevalence. Dependent users reported a median of four symptoms. There was good to excellent diagnostic concordance (kappas = 0.7-0.9) between systems for dependence but not for abuse/harmful use (Y = 0.4). These findings provide some support for the validity of cannabis dependence. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

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Background. This study aimed to investigate relationships between environmental aesthetics, convenience, and walking companions and walking for exercise or recreation and to investigate differences in these relationships by sex and by reported physical and mental health. Methods. Analyses of cross-sectional self-report data from a statewide population survey of 3,392 Australian adults were used. Results. Men and women reporting a less aesthetically pleasing or less convenient environment were less likely to report walking for exercise or recreation in the past 2 weeks. Those respondents, particularly women, reporting no company or pet to walk with were also less likely to walk for exercise or recreation. Associations with environmental and social influences were observed for men and women reporting both good and poor physical and mental health. Conclusions. Perceived environmental aesthetics and convenience and walking companions are important correlates of walking for exercise among urban Australians. Acknowledging the cross-sectional nature of these data, findings support a case for evaluation of environmental policies to promote physical activity. (C) 2001 American Health Foundation and Academic Press.

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Objective To determine the accuracy of the whispered voice test in detecting hearing impairment in adults and children. Design Systematic review of studies of test accuracy. Data sources Medline, Embase, Science Citation Index, unpublished theses, manual searching of bibliographies of known primary and review articles, and contact with authors. Study selection Two reviewers independently selected and extracted data on study characteristics, quality, and accuracy of studies. Studies were included if they had cross sectional designs, at least one of the index tests was the whispered voice test, and the reference test (audiometry) was performed on at least 80% of the participants. Data extraction Data were used to form 2x2 contingency tables with hearing impairment by audiometry as the reference standard. Data synthesis The eight studies that were found used six different techniques. The sensitivity in the four adult studies was 90% or 100% and the specificity was 70% to 87%. The sensitivity in the four childhood studies ranged from 80% to 96% and specificity ranged from 90% to 98%. Conclusion The whispered voice test is a simple and accurate test for detecting hearing impairment. There is some concern regarding the lower sensitivity in children and the overall reproducibility of the test, particularly in primary care settings. Further studies should be conducted in primary care settings to explore the influence of components of the testing procedure to optimise test sensitivity and to promote standardisation of the testing procedure.

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The distribution and density of a population of the narrowback mud crab Panopeus americanus were evaluated, with emphasis on the different developmental stages (juveniles and adults) and sexes. Specimens were collected in a remnant human-impacted mangrove at Araca on the northern coast of Sao Paulo, Brazil, at two-month intervals from January through July 2006, using 1m x 1m sample plots randomly distributed in the intertidal zone. The population was abundant, with a mean density of 14.3 +/- 9.3 individuals/m(2). Larger individuals were more abundant in the upper and middle intertidal zones, whereas smaller crabs were predominant in the lower intertidal and thus remained submerged longer. Males and juveniles were homogeneously distributed. Females preferred regions farther from the waterline. A clustered distribution pattern suggested gregarious behaviour and settling of juveniles in the vicinity of the adults` habitats, in an adaptive process as a function of tidal rhythms.

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There is emerging evidence to support the effectiveness of cognitive behavior therapy (CBT) for older adults. However, there are a number of clinical difficulties that practitioners often encounter when using homework assignments with the older adult population. In this article, we provide a brief summary of the research findings on homework in CBT, review common obstacles to the use of homework, and provide concrete suggestions for the adaptation of homework assignments to increase their potential effectiveness with older adults. We also describe several types of homework assignments that may be most helpful, augmenting these suggestions with clinical examples.

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Two experiments were conducted to investigate the effect of a threatening stimulus in human adults in a temporal bisection task. In Experiment I. for two anchor duration conditions (400/800 vs. 800/1600 ms), the participants completed trials in which the probe duration was followed by an aversive stimulus or a nonaversive stimulus. The results showed that the duration was judged longer when the participants expected an aversive rather than a nonaversive stimulus. In Experiment 2, the effect of the temporal localization of the aversive stimulus was also tested, with the aversive stimulus being presented at the beginning or at the end of the probe duration. The results revealed a temporal overestimation in each condition compared to the trials in which no aversive stimulus was presented. Furthermore, the temporal overestimation was greater when the expectation for the forthcoming threatening stimulus was longer. This temporal overestimation is explained in terms of a speeding-up of the neural timing system in response to the increase in the arousal level produced by the expectation of a threatening stimulus.

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Objective. To examine the link between tooth loss and multilevel factors in a national sample of middle-aged adults in Brazil. Material and methods. Analyses were based on the 2003 cross-sectional national epidemiological survey of the oral health of the Brazilian population, which covered 13 431 individuals (age 35-44 years). Multistage cluster sampling was used. The dependent variable was tooth loss and the independent variables were classified according to the individual or contextual level. A multilevel negative binomial regression model was adopted. Results. The average tooth loss was 14 (standard deviation 9.5) teeth. Half of the individuals had lost 12 teeth. The contextual variables showed independent effects on tooth loss. It was found that having 9 years or more of schooling was associated with protection against tooth loss (means ratio range 0.68-0.76). Not having visited the dentist and not having visited in the last >= 3 years accounted for increases of 33.5% and 21.3%, respectively, in the risk of tooth loss (P < 0.05). The increase in tooth extraction ratio showed a strong contextual effect on increased risk of tooth loss, besides changing the effect of protective variables. Conclusions. Tooth loss in middle-aged adults has important associations with social determinants of health. This study points to the importance of the social context as the main cause of oral health injuries suffered by most middle-aged Brazilian adults.

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A measure of dimensional anxiety specifically designed for use in older people is urgently needed. Such a measure could be used in a variety of settings to screen for anxiety disorders and to measure response to treatment in older people with established anxiety disorders. We have developed a new instrument to measure generalized anxiety symptoms in older people, the Geriatric Anxiety Inventory (GAI). This new instrument uses plain language, minimises somatic items and has a dichotomous response scale. Although it is a self-report measure, it may readily be administered to frail and mildly cognitively impaired older people by nursing staff. The development and initial validation of the GAI will be described. The scale was administered to community samples as well as patients with anxiety, depression, and mild cognitive impairment. Reliability was high and validity sound when compared to a range of standard anxiety instruments, and the instrument was well-tolerated among these cohorts. Sensitivity, specificity and cut-off scores for community and impatient samples will be presented.