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American Journal of Orthodontics and... Mar 2024Understanding the rationale for adult patients undertaking orthodontic treatment and the impact of appliances on their quality of life has become increasingly important...
INTRODUCTION
Understanding the rationale for adult patients undertaking orthodontic treatment and the impact of appliances on their quality of life has become increasingly important to research efforts and clinical care. This study aimed to understand why adult patients undergo orthodontic treatment and their overall experience with the choice of appliance.
METHODS
A cross-sectional qualitative study using semistructured interviews with adult patients from 4 private specialist orthodontic practices in the London region involving a purposive homogeneous sampling technique to obtain variation regarding gender, treatment modalities (fixed ceramic [FC], removable aligner [RA], and fixed lingual [FL] appliances), and stages of treatment (early, late, and posttreatment stage) was undertaken. A piloted topic guide was used to standardize data collection. Interviews were audio recorded, and field notes were taken. Data were transcribed verbatim and analyzed using framework methodology until data saturation was reached.
RESULTS
A total of 22 participants (FC, 8; RA, 8; and FL, 6), with a mean age of 38.9 ± 11.7 years, with the majority being female (n = 13; 59.1%), were interviewed. Psychosocial and dental health-related factors were reported as the main reasons to seek orthodontic treatment. Social factors and appliance features influence an adult's decision-making in selecting a specific orthodontic appliance. Wearing FC, RA, and FL was seen to have both positive and negative impacts on an adult's quality of life. Functional and psychological factors were the strong influencers on patients' treatment experience.
CONCLUSIONS
The study highlighted the influence of psychosocial factors and dental health concerns in the decision-making processes of adults seeking orthodontic treatment. FC, RA, and FL appear to affect an adult's quality of life, with functional and psychosocial factors being commonly reported.
PubMed: 38520415
DOI: 10.1016/j.ajodo.2024.02.009 -
Frontiers in Public Health 2021This study examined the association between storey of building and fall risk in older adults' residences and residents' level of fear of falling. The National Health...
This study examined the association between storey of building and fall risk in older adults' residences and residents' level of fear of falling. The National Health and Ageing Trends Study (NHATS) collected information that would provide an understanding of basic trends people aged 65 years and older. Using a longitudinal survey, the present study employed the first round of NHATS data that was collected in 2011. In the first round, 12,411 participants were enrolled, and 8,077 interviews were completed. The study sample sizes for falling and worry about falling are 6,153 and 6,142, respectively. Unadjusted analysis revealed that storey of building was a risk factor for fall and worry about falling. There was a higher prevalence for fall and worry about falling when subjects lived in single storey of building compared with the subjects live in multi-storey. Logistic regression analysis showed no highly significant between storey of building and the fall/fear of falling. Several clinical factors independently were indicated pertaining to the fall and worry about falling in older adult's residences.
Topics: Accidental Falls; Aged; Aging; Fear; Humans; Risk Factors
PubMed: 34869135
DOI: 10.3389/fpubh.2021.665985 -
Journal of Applied Gerontology : the... Jul 2016Informal older adult caregiving allows older adults to stay in their homes or live with loved ones, but decisions surrounding older adult care are fraught with...
Informal older adult caregiving allows older adults to stay in their homes or live with loved ones, but decisions surrounding older adult care are fraught with complexities. Related research and case law suggest that an older adult's need for and refusal of help are important considerations; the current study is the first to examine these factors experimentally. Two samples (potential caregivers and care recipients) provided responses regarding anticipated emotions, caregiver abilities, and allocation of daily caregiving decision making based on a vignette portraying an older adult who had a high or low level of autonomy and who accepted or refused help. Study findings suggest differing views about caregiving; potential caregivers may not be as well prepared to take on caregiving as the potential care recipients anticipate and potential caregivers may allocate more decisional responsibility to older adults than the care recipients expect. Implications for older adult abuse are discussed.
Topics: Adult; Aged; Caregivers; Decision Making; Emotions; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Paternalism; Patient Acceptance of Health Care; Personal Autonomy
PubMed: 24652926
DOI: 10.1177/0733464813517506 -
Sensors (Basel, Switzerland) Apr 2021Ubiquity (devices becoming part of the context) and transparency (devices not interfering with daily activities) are very significant in healthcare monitoring... (Review)
Review
Ubiquity (devices becoming part of the context) and transparency (devices not interfering with daily activities) are very significant in healthcare monitoring applications for elders. The present study undertakes a scoping review to map the literature on sensor-based unobtrusive monitoring of older adults' frailty. We aim to determine what types of devices comply with unobtrusiveness requirements, which frailty markers have been unobtrusively assessed, which unsupervised devices have been tested, the relationships between sensor outcomes and frailty markers, and which devices can assess multiple markers. SCOPUS, PUBMED, and Web of Science were used to identify papers published 2010-2020. We selected 67 documents involving non-hospitalized older adults (65+ y.o.) and assessing frailty level or some specific frailty-marker with some sensor. Among the nine types of body worn sensors, only inertial measurement units (IMUs) on the waist and wrist-worn sensors comply with ubiquity. The former can transparently assess all variables but weight loss. Wrist-worn devices have not been tested in unsupervised conditions. Unsupervised presence detectors can predict frailty, slowness, performance, and physical activity. Waist IMUs and presence detectors are the most promising candidates for unobtrusive and unsupervised monitoring of frailty. Further research is necessary to give specific predictions of frailty level with unsupervised waist IMUs.
Topics: Aged; Exercise; Frailty; Humans; Wrist
PubMed: 33922852
DOI: 10.3390/s21092983 -
Frontiers in Public Health 2022In the US agriculture (including ranching) is among the most dangerous industries and it is the only one where children of any age are permitted in the worksite. Whether...
In the US agriculture (including ranching) is among the most dangerous industries and it is the only one where children of any age are permitted in the worksite. Whether working or not, children are at risk of serious injury or death when present among the many hazards associated with agricultural work. In most cases the proximate cause of a traumatic incident involving a child (<18 years) is an adult's choice to allow the child's presence in a high-risk situation. Yet, little is known about the legal repercussions for a responsible adult when such events occur. With an overarching goal to enhance the culture of safety for children in agricultural settings, this project includes three phases: (1) identification and collection of public records and news reports regarding legal action following a childhood agricultural injury or fatality; (2) analysis of the proposed or imposed legal responses following these agricultural injuries and fatalities; and (3) development of recommendations for public agencies responding to events that lead to a criminal complaint or the imposition of non-criminal child welfare or other civil measures. This paper describes the project's mixed methods study design that yielded extensive details on 12 legal cases as well as perspectives from key informants on the strengths and limitations of legal responses to child endangerment on farms. Integration and analyses of data from quantitative and qualitative sources will be used to generate recommendations, including guidelines and protocols, for key stakeholder groups.
Topics: Child; Adult; Humans; Farms; Agriculture; Family; Workplace
PubMed: 36438288
DOI: 10.3389/fpubh.2022.1015600 -
Prevention Science : the Official... Feb 2015Risk factors for marijuana use in older adolescents and young adults have focused primarily on family environment and peer affiliation. A growing body of work has... (Randomized Controlled Trial)
Randomized Controlled Trial
Risk factors for marijuana use in older adolescents and young adults have focused primarily on family environment and peer affiliation. A growing body of work has examined the relationship between environmental context and young adult substance use. This study builds on previous research linking neighborhood environment to young adult marijuana use by exploring two distinct features of neighborhoods, namely the physical (e.g., broken windows) and social environment (e.g., adults watching youth). Data were obtained from a longitudinal sample of 398 predominately African American young adults living in an urban environment. The data also included observational measures of physical and social order and disorder collected on the young adult's residential block. Exploratory structural equation modeling (ESEM) was utilized to test hypothesized relationships between these two features of the neighborhood environment and past year young adult marijuana use. A two-factor model of neighborhood environment with good fit indices was selected (CFI = 0.97, RMSEA = 0.037). There was a positive and significant direct effect from neighborhood physical disorder to marijuana use (0.219, p < 0.05) controlling for gender, race, and free and reduced price meal (FARPM) status. The direct effect from neighborhood social environment to marijuana use was not significant. These results converge with previous research linking vacant housing with young adult marijuana use but do not provide empirical support for the neighborhood social environment as a determinant of drug taking. Better explication of the social environment is needed to understand its relationship to drug use.
Topics: Adolescent; Adult; Baltimore; Female; Humans; Male; Marijuana Smoking; Models, Statistical; Residence Characteristics; Risk Factors; Urban Population; Young Adult
PubMed: 25005818
DOI: 10.1007/s11121-014-0497-8 -
Frontiers in Psychology 2022Research about decision-making capacity has been growing in the last decades. That relates to more concerns regarding patients' autonomy, and an increase in diseases...
OBJECTIVES
Research about decision-making capacity has been growing in the last decades. That relates to more concerns regarding patients' autonomy, and an increase in diseases that can negatively impact capacity. This research aims to: explore perceptions, legal aspects, and assessment procedures related to healthcare decision-making capacity in older adults with cognitive impairment; and study the first version of a new assessment instrument of this capacity.
METHOD
Nine focus groups were conducted, including healthcare, law and justice, nursing home professionals, institutionalized older adults, and dwelling older adults. Focus group discussions followed semi-structured interview scripts, specifically developed for each group. After group discussions, the assessment instrument was presented, and participants were asked to evaluate each item relevance and comprehensibility. Qualitative coding of the transcriptions was performed with resource to MAXQDA, using direct content analysis.
RESULTS
Six primary themes emerged from the qualitative analysis: Decision-making capacity features; Abilities implied in decision-making; Factors influencing decision-making; Obstacles to decision-making; Legal aspects; and Assessment procedures.
DISCUSSION
Results corroborate previous theoretical formulations of capacity. Generally, research results have implications for clinical and assessment practices, as well as preventive strategies that can improve older adult's decision-making capacity. Assessment procedures of capacity should include a thorough protocol for the assessment of cognition, functionality, depressive symptoms, and decision-making abilities. In this respect, the need for an assessment tool that can provide valid information during evaluation processes is highlighted. Concerning the strategies to promote decision-making capacity, these rely on improving older adult's health literacy and healthcare providers communication skills, as well as conduct actions to reduce stigma toward people with dementia.
PubMed: 36353088
DOI: 10.3389/fpsyg.2022.1024967 -
Skin Research and Technology : Official... Jan 2022In adults ageing is accompanied by changes in limb volume and skin biomechanical properties.
BACKGROUND
In adults ageing is accompanied by changes in limb volume and skin biomechanical properties.
OBJECTIVES
To explore the relationship between body size, aging, skin biomechanics, and leg volume, V and to define predictive equations linking leg volume with these properties.
METHODS
Sixty-two healthy adults (Age 18-80 years, M:F 45:55) were recruited. Anthropomorphic measures were recorded along with V (via circumferential method) and skin tone, stiffness, and elastance (via tonometry). Regression analysis was performed to define relationship between the measured parameters.
RESULTS
In healthy adults bilateral V were the same regardless of leg or sex, 5791 ± 1363 for females and 6151 ± 1203 mls for males. V was positively correlated to body weight, where V (mls) = 1058 + 69 × Wt (kg) for females and V (mls) = 539 + 65 × Wt (Kg) of body weight for males. Skin surface biomechanical properties varied with sex, leg volume, and location on the leg with the malleolus exhibiting the stiffest surface.
CONCLUSION
The study shows that anthropometric measures change with sex and leg size are multifactorial and body weight, sex, and skin condition as important determinant factors of leg volume.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Biomechanical Phenomena; Female; Humans; Leg; Male; Middle Aged; Skin; Young Adult
PubMed: 34455636
DOI: 10.1111/srt.13087 -
Critical Care (London, England) Nov 2022Sepsis is a life-threatening complication of the body's response to infection. The financial, medical, and psychological costs of sepsis to individuals and to the...
BACKGROUND
Sepsis is a life-threatening complication of the body's response to infection. The financial, medical, and psychological costs of sepsis to individuals and to the healthcare system are high. Most sepsis cases originate in the community, making public awareness of sepsis essential to early diagnosis and treatment. There has been no comprehensive examination of adult's sepsis knowledge in Canada.
METHODS
We administered an online structured survey to English- or French-literate adults in Canada. The questionnaire comprised 28 questions in three domains: awareness, knowledge, and information access. Sampling was stratified by age, sex, and geography and weighted to 2016 census data. We used descriptive statistics to summarize responses; demographic differences were tested using the Rao-Scott correction for weighted chi-squared tests and associations using multiple variable regression.
RESULTS
Sixty-one percent of 3200 adults sampled had heard of sepsis. Awareness differed by respondent's residential region, sex, education, and ethnic group (p < 0.001, all). The odds of having heard of sepsis were higher for females, older adults, respondents with some or completed college/university education, and respondents who self-identified as Black, White, or of mixed ethnicity (p < 0.01, all). Respondent's knowledge of sepsis definitions, symptoms, risk factors, and prevention measures was generally low (53.0%, 31.5%, 16.5%, and 36.3%, respectively). Only 25% of respondents recognized vaccination as a preventive strategy. The strongest predictors of sepsis knowledge were previous exposure to sepsis, healthcare employment, female sex, and a college/university education (p < 0.001, all). Respondents most frequently reported hearing about sepsis through television (27.7%) and preferred to learn about sepsis from healthcare providers (53.1%).
CONCLUSIONS
Sepsis can quickly cause life-altering physical and psychological effects and 39% of adults sampled in Canada have not heard of it. Critically, a minority (32%) knew about signs, risk factors, and strategies to lower risk. Education initiatives should focus messaging on infection prevention, employ broad media strategies, and use primary healthcare providers to disseminate evidence-based information. Future work could explore whether efforts to raise public awareness of sepsis might be bolstered or hindered by current discourse around COVID-19, particularly those centered on vaccination.
Topics: Female; Humans; Aged; Cross-Sectional Studies; COVID-19; Surveys and Questionnaires; Health Personnel; Health Knowledge, Attitudes, Practice; Sepsis
PubMed: 36329489
DOI: 10.1186/s13054-022-04215-6 -
Journal of the American Geriatrics... Dec 2019Geriatricians are often confronted with unexpected health outcomes in older adults with complex multimorbidity. Aging researchers have recently called for a focus on... (Review)
Review
BACKGROUND
Geriatricians are often confronted with unexpected health outcomes in older adults with complex multimorbidity. Aging researchers have recently called for a focus on physical resilience as a new approach to explaining such outcomes. Physical resilience, defined as the ability to resist functional decline or recover health following a stressor, is an emerging construct.
METHODS
Based on an outline of the state-of-the-art in research on the measurement of physical resilience, this article describes what tests to predict resilience can already be used in clinical practice and which innovations are to be expected soon.
RESULTS
An older adult's recovery potential is currently predicted by static tests of physiological reserves. Although geriatric medicine typically adopts a multidisciplinary view of the patient and implicitly performs resilience management to a certain extent, clinical management of older adults can benefit from explicitly applying the dynamical concept of resilience. Two crucial leads for advancing our capacity to measure and manage the resilience of individual patients are advocated: first, performing multiple repeated measurements around a stressor can provide insight about the patient's dynamic responses to stressors; and, second, linking psychological and physiological subsystems, as proposed by network studies on resilience, can provide insight into dynamic interactions involved in a resilient response.
CONCLUSION
A big challenge still lies ahead in translating the dynamical concept of resilience into clinical tools and guidelines. As a first step in bridging this gap, this article outlines what opportunities clinicians and researchers can already exploit to improve prediction, understanding, and management of resilience of older adults. J Am Geriatr Soc 67:2650-2657, 2019.
Topics: Adaptation, Psychological; Aged; Aging; Humans; Multimorbidity; Precision Medicine; Recovery of Function; Resilience, Psychological
PubMed: 31498881
DOI: 10.1111/jgs.16149