Background and objective. Ultrasonic evaluation of carotid intima media thickness (IMT) has been widely used as a surrogate of atherosclerosis. Few studies have specifically examined risk factors related to subclinical atherosclerosis (SA) among early postmenopausal women, in particular in the Chinese population. There is also little information on the distribution of IMT in Asian midlife women. We described the prevalence of SA, as determined by IMT and carotid plaque, and the associated risk factors in early postmenopausal Chinese women in Hong Kong. / Conclusions. Our findings showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT, while age, LDL-C, and abdominal obesity were independent predictors of the presence of plaque. The optimal IMT cutoff of 0.783 mm was defined and that a prevalence of SA (IMT ≥ 0.783 mm) of 38.6% was found among 'healthy' early postmenopausal Chinese women in Hong Kong. / Methods. 518 women aged 50 to 64 years, and within 10 years since menopause were recruited from random telephone dialing. Women with surgical menopause, established cardiovascular diseases (CVD), and severe disease conditions such as cancer and renal failure were excluded. Sociodemographic, anthropometric and lifestyle factors were obtained based on standardized questionnaires. Fasting blood sample was also obtained. B-mode ultrasound was used for measuring IMT at 12 sites of the carotid arteries and plague index, which is the sum of the grades (ranged from 0 to 3) at the 6 segments. The relations between traditional risk factors, and other potential risk factors such as inflammatory markers, as well as lifestyle factors including physical activity, dietary intake, and psychological factors with SA were also assessed. / Results. The mean IMT +/- SD was 0.76 +/- 0.12 mm, with a range from 0.53 to 1.00 mm. IMT was higher on the far wall than on the near wall (P<0.01), and differ among segments (greatest at the bulb and least at the ICA) (P<0.01). One-fifth of women had at least 1 plaque in the carotid artery with most of the plaque occurred in the bulb area. IMT increased with age, and was positively associated with carotid plaque. With the use of receiver operating characteristic curve (ROC) analysis, the optimal cutoff IMT for diagnostic plaque was 0.783 mm, at which sensitivity and specificity was 80.5% and 75.1%, respectively. The prevalence of SA was 38.6%. Among the traditional risk factors, systolic blood pressure (SBP), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were associated with high IMT. Abdominal obesity assessed by waist circumference (WC) and waist hip ratio (WHR) was also found to be positively associated with IMT. Stepwise multiple regression showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT. Multiple logistic regression showed that women with LDL-C ≥ 130 mg/dL were associated with a 2.4-fold (95% CI 1.5-3.7) higher risk of having plaque compared to those with LDL-C < 130 mg/dL. In addition, women with abdominal obesity (WHR ≥ 0.85) had a 1.7-fold (95% CI 1.08-2.67) higher risk of having plaque than women with WHR < 0.85 after adjustment for age, and potential confounders including physical activity, dietary intakes etc. Significant inverse associations were observed between physical activity and indices of obesity, as well as fasting blood glucose, while psychological perceived stress and trait anxiety were independent risk factors for both total cholesterol and LDL-C. / Yu Ho-yan. / "February 2006." / Adviser: Suzanne C. Ho. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6350. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 220-256). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Orientador: Paulo Dalgalarrondo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-10-02T11:41:13Z (GMT). No. of bitstreams: 1 Vieira_SaraPonzini_M.pdf: 1302458 bytes, checksum: 64a4e82da3b76d287120db989a9c13f9 (MD5) Previous issue date: 2009 / Resumo: Em consideração do aumento populacional de indivíduos muito idosos no Brasil, bem como da carência de estudos qualitativos com esta faixa etária, este trabalho se propõe investigar a realidade subjetiva de pessoas nonagenárias, mentalmente e cognitivamente saudáveis, e em condições de se comunicar de forma adequada. Através de entrevistas semi-estruturadas, investigamos a percepção que pessoas muito idosas têm de suas histórias de vida, do processo de envelhecer, da morte e do sentido da vida, a presença de bem estar subjetivo e o processo da gerotranscendência, que prevê uma transição de uma perspectiva materialista para uma visão de vida mais cósmica e transcendente com o envelhecimento. As narrativas dos 20 sujeitos entrevistados foram subdividas em 3 níveis de Bem Estar Subjetivo. Os dados desta amostra revelaram que, na velhice avançada, podem ser encontradas condições de bem estar bastante heterogêneas, e que o maior bem estar subjetivo está associado a fatores de caráter psicológico (perceber a própria vida como significativa), afetivo (ter pessoas queridas com quem se relacionar) e espiritual (ter fé e esperança em relação à finitude), como também ao estado de saúde e a alguns fatores sociodemográficos. A dimensão da transcendência mostrou-se presente e positivamente relacionada ao maior bem estar, mas esta não mostrou estar associada ao processo de envelhecimento. / Abstract: Considering demographic increasing number of very old people in Brazil, as well as the lack of qualitative studies with this age group, this work purposes to investigate clearheaded, capable of verbal communication nonagenarians' subjective reality. Through half-structured interviews, we investigated the perception that the oldest old have on their life stories, aging process, death and meaning of life, presence of well-being and the gerotranscendent process, considered a transition from a materialistic perspective into a more cosmic and transcendent view of life, accompanying the process of aging. The narratives of the 20 individuals were divided into 3 levels of Subjective Well-being. Data of this group revealed that, in very old age, heterogenous conditions of SWB can be found, and that greater SWB is related to psychological factors (such as viewing one's life as meaningful), affective factors (having significant persons to count on), and spiritual (being faithful and hopeful about finitude), as well as the health state and some social-demografic factors. Transcendent dimension was met in some individuals and positively associated to greater well-being, but didn't show association with the aging process. / Mestrado / Mestre em Gerontologia

Made available in DSpace on 2014-12-17T15:43:49Z (GMT). No. of bitstreams: 1 LidianeMBMF_DISSERT.pdf: 3767124 bytes, checksum: cfd0a539259485f1e7035a06b32592ab (MD5) Previous issue date: 2013-03-25 / the institutionalized elderly presents for being more fragile a lot of body balance s changes, which can induce falls and health frailty. One of the consequences of it is the appearance of dizziness, vestibular or not. This study aims to identify the risk factors related to dizziness in institutionalized elderly, with and without vestibular disorders, in the city of Natal-RN. Method: a case-control study realized in 12 regulated by Health Surveillance Long Term Care Institutions for the elderly in Natal-RN. Elected seniors with good cognitive level and able to walk, totaling 115 individuals, and of these, 102 were selected according to the presence of dizziness in the last year (n = 51) and their controls (n = 51), paired by sex and age. The 51 elderly patients with dizziness were divided into 3 groups case: case one, for elderly with dizziness and without vestibulopathy (n=38); case two, for elderly with dizziness and vestibulopathy (n=13) and case three, for all the seniors with dizziness, or added to the case 1 case 2 (n=51). The 51 seniors who served as controls were also divided into three groups, according to the number of individuals of each case: control 1, n = 38, control 2, n = 13 control and 3 (sum of 1 control with control 2), n = 51. As possible risk factors were analyzed variables related to characteristics of the institution, to the habits of life of older people and those concerned with the health of the elderly. For statistical analysis, we used the chi-square or Fisher exact test for a significance level of 5% and calculating the association magnitude between variables by measuring the Odds Ratio. Results: as risk factors for dizziness without vestibular disorders were found the presence of hypertension and cardiovascular disease, as well as the presence of three or more disorders for elderly and use of gastric protector drugs. For the elderly group from case two were found no associated risk factor. For elderly patients with dizziness in the case group three, we observed the same risk factors found for the elderly in the case group one, plus the presence of osteoarthritis pathology, which was also significant for this group. Conclusion: dizziness in institutionalized elderly is associated with systemic common diseases in this age group and the vestibulopathy presents itself as pathology on an isolated way, not being possible, with our data, associate it with non-risk factors / O idoso institucionalizado apresenta, por ser mais fr?gil, v?rias altera??es do equil?brio corporal, podendo levar a quedas e debilidade de sua sa?de. Uma das consequ?ncias disto ? o surgimento do sintoma tontura, que pode ser de origem vestibular ou n?o. Este trabalho tem o objetivo de identificar os fatores de risco relacionados com tontura em idosos institucionalizados, vestibulopatas e n?o-vestibulopatas, na cidade do Natal-RN. M?todo: trata-se de um estudo caso-controle realizado nas 12 Institui??es de longa perman?ncia para idosos de Natal-RN, regulamentadas pela Vigil?ncia Sanit?ria. Foram eleitos os idosos com bom n?vel cognitivo e capazes de deambular, totalizando 115 indiv?duos, e destes, foram selecionados 102 de acordo com a presen?a da queixa de tontura no ?ltimo ano (n=51) e os respectivos controles (n=51), emparelhados por sexo e idade. Os 51 idosos com queixa de tontura foram divididos em 3 grupos caso: caso 1, para idosos com tontura e sem vestibulopatia (n=38); caso 2, para idosos com tontura e com vestibulopatia (n=13) e caso 3, para todos os idosos com tontura, ou seja, caso 1 somado ao caso 2 (n=51). Os 51 idosos que serviram de controle foram tamb?m divididos em tr?s grupos, seguindo o n?mero de indiv?duos de cada caso: controle 1, n=38; controle 2, n=13 e controle 3 (soma do controle 1 com o controle 2), n=51. Como poss?veis fatores de risco, foram analisadas vari?veis referentes a caracter?sticas da institui??o, aos h?bitos de vida dos idosos e as relacionadas com a sa?de dos idosos. Para a an?lise estat?stica, utilizou-se o teste do Qui-quadrado ou exato de Fisher para um n?vel de signific?ncia de 5% e c?lculo da magnitude da associa??o entre as vari?veis, atrav?s da medida da OddsRatio. Resultados: como fatores de risco para tontura sem vestibulopatia, foram achados a presen?a de hipertens?o arterial sist?mica e doen?a cardiovascular, assim como a presen?a de 3 ou mais patologias por idoso e o uso de medicamentos protetores g?stricos. Para os idosos do grupo caso 2, n?o foi encontrado nenhum fator de risco associado. Para os idosos com tontura pertencentes ao grupo caso 3, foram observados os mesmos fatores de risco encontrados para os idosos do grupo caso 1, acrescido da presen?a da patologia osteoartrose, que tamb?m se mostrou significativa para este grupo. Conclus?o: a tontura no idoso institucionalizado est? associada a doen?as sist?micas comuns nesta faixa et?ria, e a vestibulopatia apresenta-se como patologia de forma isolada, n?o sendo poss?vel com os dados deste estudo associ?-la a nenhum fator de risco

O conhecimento do paciente sobre seus medicamentos é o conjunto de informações sobre o medicamento necessárias para garantir seu uso correto. Este conhecimento é insuficiente nos idosos, que representam o segmento populacional que usa mais medicamentos e que mais cresce no Brasil. Este estudo identificou fatores relacionados ao conhecimento que pacientes muito idosos (≥80 anos), atendidos no Ambulatório de Fragilidade do Hospital Universitário da USP, possuíam sobre a medicação prescrita. As 11 perguntas do questionário espanhol \"Conocimiento del Paciente sobre su Medicamento\" foram adaptadas transculturalmente ao português brasileiro, processo que incluiu etapas de tradução, retradução, pré-teste e avaliação da confiabilidade e validade de construto da versão final. Esta foi usada para medir o conhecimento sobre todos os medicamentos prescritos pelo geriatra na última consulta médica por meio de uma entrevista face a face com o paciente ou seu cuidador. O conhecimento foi explicado por variáveis relacionadas ao entrevistado, ao atendimento médico e aos medicamentos, incluídas em um modelo misto linear. Foi construído um modelo para pacientes e outro para cuidadores. O questionário adaptado mostrou equivalência conceitual, de item, semântica, operacional, de mensuração e funcional com o original. A versão brasileira apresentou confiabilidade suficiente (α de Cronbach=0,736). Sua estrutura interna foi semelhante a do questionário espanhol e o conhecimento estimado esteve correlacionado à adesão ao tratamento anti-hipertensivo (rb=0,86), ao controle da pressão arterial (rb=0,46) e à complexidade da prescrição (r=-0,22). No grupo de pacientes, medicamentos usados de 0,1 a 6,0 meses (b=0,19, p=0,009), e a mais de 6 meses (b=0,12, p=0,025), foram mais conhecidos que medicamentos nunca usados. No grupo de cuidadores, medicamentos classificados como potencialmente perigosos em ambiente ambulatorial foram mais conhecidos que os outros medicamentos (b=0,16, p=0,004) e, quanto maior a categoria do nível de instrução, maior o conhecimento. Assim, recomenda-se o uso do instrumento adaptado para medir o conhecimento sobre medicamentos de uso crônico em qualquer paciente fluente na língua portuguesa. A equipe de saúde precisa prover programas contínuos de educação sobre medicamentos, os quais devem ser adaptados à rede de apoio do paciente, incluindo os medicamentos usados há muito tempo. Deve-se, também, estimular a participação ativa do paciente (empoderamento) no gerenciamento de seus medicamentos. / Patient drug knowledge is the set of drug information needed to guarantee correct drug use. This knowledge is poor in aged individuals, which is the most drug consuming and the fastest growing age group. Here, we identified factors related to the knowledge very old patients (≥80 years) attending the Frailty Ambulatory of the University Hospital of USP possessed on prescribed drugs. The 11 items of the Spanish questionnaire entitled \"Conocimiento del Paciente sobre su Medicamento\" were cross-culturally adapted into Brazilian Portuguese, which included translation, back-translation, pretest, and reliability and construct validity assessment of the final version. The latter was used to measure knowledge about all geriatrician prescribed drugs in the last appointment by means of a face-to-face interview with either patient or caregiver. Drug knowledge was explained by variables related to interviewee, medical appointment, and prescribed drugs, which were included in a linear mixed model. It was obtained one model for patients and another for caregivers. The adapted questionnaire possessed conceptual, item, semantic, operational, measurement, and functional equivalence with the original. Realiability of the Brazilian version was sufficient (Cronbach´s α=.736). Internal structure was similar to the Spanish questionnaire and estimated drug knowledge was correlated to adherence to antihypertensive treatment (rb=.86), blood pressure control (rb=.46), and medication regimen complexity (r=-.22). In the patient group, drugs used from 0.1 to 6.0 months (b=0.19, p=.009), and used longer than 6 months (b=0.12, p=.025) presented more knowledge than never used ones. In the caregiver group, medications classified as high-alert in ambulatory healthcare were associated with higher knowledge than other drugs (b=0.16, p=.004) and, higher the educational level category, the bigger the caregiver drug knowledge. Thus, this work recommends the utilization of adapted instrument in order to assess chronic drug knowledge of any patient fluent in Portuguese. Healthcare team have to provide continuous drug education programs, which should be tailored to the extent of patient support and cover even long time use drugs. Patients taking active part (empowerment) in the management of their medication should also be stimulated.

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

<p>The purpose of this study was to examine and describe how politicians and directors of care define and experience quality in aged care facilities. Further on we wanted to compare on which fundamental principles the participants base their opinion about quality and how they work with quality. To reach our aim we conducted five interviews with politicians and directors of care. The results show that it is hard to determine quality in an unambiguous and objective way. Quality in aged care appears to be about relations and encounters amongst people. The participants in our study agree that experiences are subjective and depending on individual expectations.</p><p>There are fundamental principles shared by both politicians and directors of care regarding safety and respect of human integrity. Directors of care point out the difficulties in having multiple perspectives to consider, residents and their relatives have other expectations on what services should be provided than the directors of care understand to be their assignment from the local government. It appears to be a gap between political goals and reality. The future will bring changes, regarding both needs and expectations. The participants see a challenge in developing aged care and meeting new generations of elderly.</p>

Thesis (Dr.P.H.)--University of Texas Health Science Center at Houston. School of Public Health, 1982. / Typescript. Dissertation Abstracts International Order No. 83-08,249. Includes bibliographical references (leaves 179-190).

The purpose of this study was to examine and describe how politicians and directors of care define and experience quality in aged care facilities. Further on we wanted to compare on which fundamental principles the participants base their opinion about quality and how they work with quality. To reach our aim we conducted five interviews with politicians and directors of care. The results show that it is hard to determine quality in an unambiguous and objective way. Quality in aged care appears to be about relations and encounters amongst people. The participants in our study agree that experiences are subjective and depending on individual expectations. There are fundamental principles shared by both politicians and directors of care regarding safety and respect of human integrity. Directors of care point out the difficulties in having multiple perspectives to consider, residents and their relatives have other expectations on what services should be provided than the directors of care understand to be their assignment from the local government. It appears to be a gap between political goals and reality. The future will bring changes, regarding both needs and expectations. The participants see a challenge in developing aged care and meeting new generations of elderly.

Tyrimo objektas -vidutinio ir pagyvenusio amžiaus žmonių fizinis aktyvumas (FA) ir fizinis pajėgumas (FPj). Tyrimo problema - Lietuvoje kaip ir daugelyje pasaulio šalių visuomenė sparčiai senėja, tačiau problema yra ne senstanti visuomenė, o problemos su kuriomis susiduria pagyvenę žmonės. Dėl milžiniškos mokslo, technikos ir medicinos pažangos XX a., beveik visiškai pakeitusios žmonių gyvenimą, įsivyravo fiziškai pasyvus gyvenimo būdas. Viena iš pagrindinių problemų yra fizinio pasyvumo didėjimas senėjant, dėl ko susiduriama su širdies ir kraujagyslių ligomis bei mirtimi. Moksliniais tyrimais įrodyta, kad fizinis pasyvumas yra viena iš trijų pagrindinių mirtingumo priežasčių pasaulyje. Tyrimo tikslas – nustatyti pagyvenusio ir vidutinio amžiaus žmonių fizinio aktyvumo apimties sąsają su fizinio pajėgumo rezultatų atsako dėsningumais. Tyrimo autoriaus iškelti uždaviniai: 1. Nustatyti brandaus amžiaus žmonių fizinį aktyvumą. 2. Nustatyti ir palyginti pagyvenusio amžiaus fiziškai aktyvių ir vidutinio amžiaus fiziškai pasyvių žmonių fizinį pajėgumą. 3. Nustatyti sąsajas tarp fizinio aktyvumo ir fizinio pajėgumo. 4. Nustatyti prie kokio fizinio aktyvumo dažnumo pasiekiami geriausi fizinio pajėgumo rezultatai. Tyrimo hipotezė – neatsižvelgiant į suaugusių žmonių amžiaus brandumą, egzistuoja fizinio aktyvumo apimties ir fizinio pajėgumo (judesių koordinacijos, raumenų pajėgumo, širdies kraujagyslių sistemos) rezultatų atsako sąsajos. Išvados 1. Dauguma, t.y. 28 %... [toliau žr. visą tekstą] / Object of research – physical activity and physical potency of middle and mature aged people. Problem of research – society grow old rapidly in Lithuania as in many countries in the world. However the problem is not the senescent society, but the problems faced by mature aged people. Because of huge progress of science, technology and medicine in 20 century, what almost totally changed people life, passive lifestyle settled. One of the main problems is the growth of physical passivity while senescent, which results heart and vessel diseases and even death. It was confirmed by scientific research that physical passivity is one of three main reasons of mortality in the world The purpose of research – to identify the connection between middle and mature aged people physical activity extent and consistent pattern of reaction of physical potency results. The goals proposed by the author of research: 1. To assess the physical activity of mature aged people 2. To assess and compare physical potency of physically active and passive people 3. To identify the connection between physical activity and potency. 4. To assess what physical activity rate provides best results of physical potency. The hypothesis of research – not considering the maturity of adults’ age, there exist the connection between physical activity extent and reaction of results of physical potency (movement coordination, muscle potency, heart vessel system). Conclusion 1. Most that is 28 percents of... [to full text]

This thesis project explores social constructions of aging women within Women’s Health magazine. There is limited scholarly literature on representations of aging women within popular health/fitness media, such as magazines. The limited current research which does exist suggests that aging women are subjected to negative stereotypes and gendered myths within our societal and cultural values with respect to aging (Vertinsky, 1994). Media representations are strong and pervasive reflections of societal norms and expectations and may impact the way women view themselves. I therefore undertook a Foucaultian discourse analysis of Women’s Health magazine to examine if/how gendered constructions of aging are functioning within representations of health directed to women of all ages. I found that Women’s Health reproduces aging women as useless, failures, problems to be managed, and other to normative femininity. Women’s Health reinforces that aging can and should be managed through the consumption of anti-aging products, procedures, and surgeries endorsed within the magazine. / v, 125 leaves ; 29 cm