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Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts 遭受性别暴力的难民妇女的性保健和生殖保健需求:在重新安置环境中提供以创伤为基础的护理
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-08 DOI: 10.3390/ijerph21081046
Cherra M. Mathis, Jordan J. Steiner, Andrea Kappas Mazzio, Meredith Bagwell-Gray, Karin Wachter, Crista Johnson-Agbakwu, Jill Messing, Jeanne Nizigiyimana
This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women’s experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women’s Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.
本文评估了有关经历过性别暴力(GBV)的重新安置难民妇女的性与生殖保健(SRH)需求以及性与生殖保健服务提供者采用的创伤知情护理(TIC)原则的文献。通过系统性检索,确定了2000年至2021年间发表的相关研究;但没有发现任何文章同时反映了难民妇女的性健康和生殖健康以及创伤知情护理原则。因此,检索分为两个目的:回顾有关重新安置国中经历过性别暴力的难民妇女的性健康和生殖健康需求的文献(目的1),以及研究在经历过性别暴力的妇女的性健康和生殖健康护理中使用TIC原则的情况(目的2)。文章的主题分析确定了关键主题。共有 26 篇文章被纳入这两个目标的分析(目标 1 = 8 篇,目标 2 = 18 篇)。目标1的文章分享了影响重新安置的难民妇女性健康和生殖健康需求的三个因素:暴力和创伤的中心地位;性健康和生殖健康护理的结构性障碍;以及服务提供者的行动、实践和资源。目标2的文章说明了在提供性健康和生殖健康服务时采用的七项关键性信息和通信技术原则,如赋权;针对创伤的服务和综合护理;联系;安全;协作;认同文化和背景;以及可信赖。重新安置的难民妇女遭受暴力的经历要求提供以创伤为基础的性健康和生殖健康保健服务。虽然有关为难民妇女提供创伤知情同意-性健康和生殖健康护理的同行评审文献有限,但有关难民妇女性健康和生殖健康需求的研究结果以及有关在性健康和生殖健康中实施创伤知情同意的研究结果共同构成了如何将创伤知情同意纳入性健康和生殖健康的建议。难民妇女健康诊所是一个实践范例,它体现了在性别暴力中幸存下来的重新安置难民妇女的健康问题上,"以人为本 "的性健康和生殖健康原则在行动中的示范作用。
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引用次数: 0
Neural Correlates of Mobility in Children with Cerebral Palsy: A Systematic Review 脑瘫儿童行动能力的神经相关性:系统回顾
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-07 DOI: 10.3390/ijerph21081039
Isabella Pessóta Sudati, Diane Damiano, Gabriela Rovai, Ana Carolina de Campos
Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children”with’CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.
脑图绘制工具的最新进展使人们能够研究功能性任务中的大脑活动,揭示早期脑损伤后和康复后的神经可塑性。了解活动受限的神经相关性对于治疗脑瘫(CP)患者至关重要。本研究旨在总结脑瘫儿童行动能力的神经相关性,并描述现有文献中使用的脑图谱绘制方法。本系统性综述根据 PRISMA 指南进行,并在 PROSPERO 上注册(编号 CRD42021240296)。文献检索在 PubMed 和 Embase 数据库中进行。纳入的观察性研究涉及平均年龄不超过 18 岁的 CP 患者,这些研究利用了脑图技术,并将脑图技术与行动能力结果相关联。研究结果从样本特征、脑图绘制方法、活动能力测量和主要结果等方面进行了分析。偏倚风险是根据 STROBE 指南、《科克伦手册》和 "批判性评估技能计划"(CASP),使用我们的研究小组之前创建的检查表进行评估的。共有 15 项研究符合纳入标准,其中包括 313 名患有小儿麻痹症的儿童和 229 名发育正常的儿童,研究同时采用了静态和移动技术。这些研究表明,与发育正常的儿童相比,罹患 "CP "的儿童在移动活动(如步态、安静站立、骑自行车和粗大运动任务)过程中的大脑活动增加,大脑重组的可变性更高。大脑活动和重组的改变强调了开展更多研究以调查脊髓灰质炎儿童在活动过程中的神经相关性的重要性。这些信息可以为针对大脑神经可塑性的神经康复策略提供指导,从而提高功能。
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引用次数: 0
Psychological Well-Being and Self-Efficacy for Self-Regulated Learning 心理健康与自我调节学习的自我效能感
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-07 DOI: 10.3390/ijerph21081037
Maria Luisa Pedditzi, Laura Francesca Scalas
This study explores psychological well-being in adolescence through a multidimensional perspective using the Adolescent Students’ Basic Psychological Needs at School Scale, derived from the Self-Determination Theory. The ASBPNSS focuses on three basic psychological needs (Competence, Autonomy, and Relatedness) in adolescence and has not yet been used within the school context in Italy. This study’s main objectives are: (1) to validate a preliminary Italian version of the ASBPNSS; (2) to analyze the association between well-being at school and self-efficacy for self-regulated learning; and (3) to verify whether there are differences by gender. A sample of 395 students (mean age = 17.5; SD = 0.75) completed the ASBPNSS and the Self-Efficacy for Self-Regulated Learning Scale. The factorial structure, composite reliability, and gender invariance of the ASBPNSS were examined. Associations between well-being at school and self-efficacy were tested with structural equation models (CFI = 0.935, TLI = 0.925; RMSEA = 0.054). Measures of well-being were associated with school self-efficacy for self-regulated learning, which predicted Competence (beta = 0.639), Relatedness (beta = 0.350), and Autonomy (beta = 0.309). These relationships were invariant over gender, although girls reported lower latent means in the Relatedness factor. This study highlights the importance of promoting school self-efficacy and well-being in adolescence.
本研究采用源自自我决定理论的 "青少年学生在校基本心理需求量表",从多维角度探讨青少年的心理健康问题。ASBPNSS 主要关注青少年的三种基本心理需求(能力、自主性和相关性),在意大利的学校环境中尚未使用过。本研究的主要目的是(1) 验证 ASBPNSS 的意大利语初步版本;(2) 分析在校幸福感与自我调节学习的自我效能感之间的关联;(3) 验证是否存在性别差异。395名学生(平均年龄=17.5;标准差=0.75)完成了ASBPNSS和自我调节学习的自我效能感量表。研究考察了 ASBPNSS 的因子结构、综合信度和性别不变性。通过结构方程模型(CFI = 0.935,TLI = 0.925;RMSEA = 0.054)检验了在校幸福感与自我效能感之间的关联。幸福感测量结果与学校自我调节学习的自我效能感相关,而学校自我调节学习的自我效能感预测能力(beta = 0.639)、相关性(beta = 0.350)和自主性(beta = 0.309)。虽然女生在 "相关性 "因子中的潜平均值较低,但这些关系在性别上是不变的。这项研究强调了在青春期提高学校自我效能感和幸福感的重要性。
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引用次数: 0
Ecosystem Barriers and Facilitators Linked to the Fear of Cancer Recurrence: An Umbrella Review 与癌症复发恐惧相关的生态系统障碍和促进因素:综述
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-07 DOI: 10.3390/ijerph21081041
Benjamin Caumeil, Nicolas Bazine, Axel Maugendre, Sarah Calvin
The fear of cancer recurrence is an important topic in the healthcare field. In general, approximately 40% of survivors experience high levels of fear of recurrence. This study aims to fill this gap by synthesizing the findings of systematic reviews studies investigating ecosystems, correlates or predictors, and barriers and facilitators of fear of cancer recurrence among cancer survivors. An umbrella meta-synthesis was conducted using the following databases: MEDLINE, PsycINFO, PsycARTICLES, CINAHL, Business source premier, and SOCindex, ending in April 2024 with PRISMA methods. A total of 24 systematic reviews, representing 729 articles, were included in the study. In total, six ecosystems were identified, including family, work, friends, the healthcare system, caregivers, and religion. As part of this umbrella review, 55 specific ecosystemic factors were identified that may contribute to fear of cancer recurrence. Furthermore, the umbrella review identified 12 facilitators and 12 barriers related to fear of cancer recurrence. This umbrella meta-synthesis contributed significantly to our review’s strength in synthesizing the main ecosystem and its influence on fears of cancer recurrence. Understanding the interdependence of ecosystems should enable future research on intervention effectiveness or the development of interventions that could reduce the fear of cancer recurrence.
对癌症复发的恐惧是医疗保健领域的一个重要话题。一般来说,约有 40% 的幸存者对癌症复发有高度恐惧。本研究旨在通过综合调查癌症幸存者对癌症复发恐惧的生态系统、相关因素或预测因素以及障碍和促进因素的系统综述研究结果来填补这一空白。我们使用以下数据库进行了总括荟萃:MEDLINE、PsycINFO、PsycARTICLES、CINAHL、Business source premier 和 SOCindex。本研究共收录了 24 篇系统综述,代表 729 篇文章。总共确定了六个生态系统,包括家庭、工作、朋友、医疗保健系统、护理人员和宗教。作为总综述的一部分,确定了 55 个可能导致癌症复发恐惧的具体生态系统因素。此外,总体综述还确定了与癌症复发恐惧相关的 12 个促进因素和 12 个障碍因素。这种总括性的元综述极大地增强了我们综述主要生态系统及其对癌症复发恐惧影响的实力。了解生态系统之间的相互依存关系有助于今后对干预效果进行研究或开发可降低癌症复发恐惧的干预措施。
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引用次数: 0
Energy-Dense and Low-Fiber Dietary Pattern May Be a Key Contributor to the Rising Obesity Rates in Brazil 高能量、低纤维饮食模式可能是巴西肥胖率上升的主要原因
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-07 DOI: 10.3390/ijerph21081038
Iuna Arruda Alves, Mahsa Jessri, Luana Silva Monteiro, Luiz Eduardo da Silva Gomes, Taís de Souza Lopes, Edna Massae Yokoo, Rosely Sichieri, Rosangela Alves Pereira
Hybrid methods are a suitable option for extracting dietary patterns associated with health outcomes. This study aimed to identify the dietary patterns of Brazilian adults (20–59 years old; n = 28,153) related to dietary components associated with the risk of obesity. Data from the 2017–2018 Brazilian National Dietary Survey were analyzed. Food consumption was obtained through 24 h recall. Dietary patterns were extracted using partial least squares regression, using energy density (ED), percentage of total fat (%TF), and fiber density (FD) as response variables. In addition, 32 food groups were established as predictor variables in the model. The first dietary pattern, named as energy-dense and low-fiber (ED-LF), included with the positive factor loadings solid fats, breads, added-sugar beverages, fast foods, sauces, pasta, and cheeses, and negative factor loadings rice, beans, vegetables, water, and fruits (≥|0.15|). Higher adherence to the ED-LF dietary pattern was observed for individuals >40 years old from urban areas, in the highest income level, who were not on a diet, reported away-from-home food consumption, and having ≥1 snack/day. The dietary pattern characterized by a low intake of fruits, vegetables, and staple foods and a high intake of fast foods and sugar-sweetened beverages may contribute to the obesity scenario in Brazil.
混合方法是提取与健康结果相关的膳食模式的合适选择。本研究旨在确定巴西成年人(20-59 岁;n = 28153)与肥胖风险相关的膳食成分有关的膳食模式。研究分析了 2017-2018 年巴西全国膳食调查的数据。食物消耗量通过 24 小时回忆获得。以能量密度(ED)、总脂肪百分比(%TF)和纤维密度(FD)作为响应变量,使用偏最小二乘法回归提取膳食模式。此外,还将 32 个食物组作为模型中的预测变量。第一种膳食模式被命名为能量密度和低纤维(ED-LF),包括固体脂肪、面包、添加糖的饮料、快餐、调味汁、面食和奶酪的正因子载荷,以及米饭、豆类、蔬菜、水和水果的负因子载荷(≥|0.15|)。年龄大于 40 岁、来自城市地区、收入水平最高、不节食、报告在家以外的食物消费和每天≥1 次零食的人对 ED-LF 饮食模式的依从性较高。饮食模式的特点是水果、蔬菜和主食摄入量低,而快餐和含糖饮料摄入量高,这可能是造成巴西肥胖的原因之一。
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引用次数: 0
The Association between Psychological and Behavioral Economic Factors and the Rapid Assessment Disuse Index (RADI) during the COVID-19 Pandemic COVID-19 大流行期间心理和行为经济因素与快速评估失效指数 (RADI) 之间的关系
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-07 DOI: 10.3390/ijerph21081040
Clare Meernik, Qing Li, Jeffrey Drope, Ce Shang, Tammy Leonard, Bob M. Fennis, Mahmoud Qadan, Carolyn E. Barlow, Laura F. DeFina, Reid Oetjen, Loretta DiPietro, Kerem Shuval
The deleterious health effects of prolonged sitting and physical inactivity are well-established, yet these behaviors are pervasive in modern culture. To inform interventions aimed at reducing sedentary behavior and increasing lifestyle activity, this study examined psychological and behavioral economic factors that may be associated with these behaviors. This cross-sectional study was conducted among 4072 adults in Israel. Participants completed a survey pertaining to lifestyle behaviors and economic preferences using an online platform in September 2020. The psychological and behavioral economic factors of interest were patience, self-control, risk-taking, grit, and general self-efficacy. Sedentary behavior and lifestyle activity (e.g., time spent moving about) was assessed using the Rapid Assessment Disuse Index (RADI) tool (higher score indicative of more sitting and less activity). Multivariable linear and logistic regression analyses examined the association between psychological and behavioral economic factors and RADI score. Among 4072 participants, those who were impatient (vs. patient, β: −1.13; 95% CI: −1.89, −0.38) had higher grit (β: −1.25, 95% CI: −1.73, −0.77), and those who were more risk-seeking (β: −0.23; 95% CI: −0.33, −0.13) had lower RADI scores (i.e., less sedentary, more active). Significant associations for grit and risk-taking were also observed when the RADI score was dichotomized, such that individuals who had higher grit or were more risk-seeking were more likely to be non-sedentary/active. No significant associations were observed for self-control or general self-efficacy. Higher grit and more risk-seeking were associated with a decreased propensity for sedentary behaviors and inactivity; these factors may provide targets for interventions aimed at reducing sedentary behavior and increasing lifestyle activity.
久坐和缺乏运动对健康的有害影响已得到公认,但这些行为在现代文化中却普遍存在。为了给旨在减少久坐行为和增加生活方式活动的干预措施提供信息,本研究调查了可能与这些行为相关的心理和行为经济因素。这项横断面研究在以色列 4072 名成年人中进行。参与者于 2020 年 9 月通过在线平台完成了一项有关生活方式行为和经济偏好的调查。心理和行为经济因素包括耐心、自控力、冒险精神、勇气和一般自我效能感。久坐行为和生活方式活动(如活动时间)通过快速评估失用指数(RADI)工具进行评估(得分越高,表明坐得越多,活动越少)。多变量线性和逻辑回归分析检验了心理和行为经济因素与 RADI 分数之间的关联。在 4072 名参与者中,急躁者(与耐心者相比,β:-1.13;95% CI:-1.89,-0.38)具有更高的勇气(β:-1.25,95% CI:-1.73,-0.77),而那些更喜欢冒险的人(β:-0.23;95% CI:-0.33,-0.13)具有更低的 RADI 分数(即更少久坐,更多活动)。如果对 RADI 分数进行二分法处理,还可以观察到勇气和冒险行为之间的显著关联,即勇气越高或越喜欢冒险的人越有可能不久坐/越活跃。在自我控制或一般自我效能感方面没有观察到明显的关联。较高的勇气和较高的冒险精神与久坐行为和不活动倾向的降低有关;这些因素可能为旨在减少久坐行为和增加生活方式活动的干预措施提供了目标。
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引用次数: 0
Health Status and COVID-19 Epidemiology in an Inland Region of Portugal: A Retrospective Study 葡萄牙内陆地区的健康状况和 COVID-19 流行病学:回顾性研究
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-06 DOI: 10.3390/ijerph21081033
Jorge Lindo, Patrícia Coelho, Catarina Gavinhos, Manuel Martins, Joana Liberal, António Jorge Ferreira, Teresa Gonçalves, Francisco Rodrigues
Multiple factors, from socioeconomic development to genetic background, can affect the regional impact of some diseases, and this has also been seen during the COVID-19 pandemic. The objective of this retrospective study was to characterize a population in the interior of Portugal regarding health status and COVID-19 epidemiology. Between October 2021 and January 2023, 1553 subjects residing in Beira Baixa, Portugal, were included. Using a self-report approach, demographic and clinical data were obtained. Blood group, blood pressure, peripheral oxygen saturation and anti-spike protein immunoglobulin concentration were also analyzed. Statistical analysis was performed using IBM SPSS Statistics. The average age of the participants was 48.95 (±14.43) years, with 64% being male and 36% being female. The most prevalent comorbidities were hypertension (19.2%), dyslipidemia (12.6%) and diabetes mellitus (6.6%). Half of the population was overweight, and more than half of the subjects had no history of tobacco consumption. Among the participants, 33% were infected with SARS-CoV-2: 70.1% had mild disease, 14.1% moderate disease and 1.4% severe disease. There was a very significant adherence to vaccination (97%). Previously infected or vaccinated people had higher anti-spike protein immunoglobulin values; this value depended on the vaccine administered (p < 0.001). Patients with autoimmune diseases and smokers had lower levels of anti-S IgG antibodies (p = 0.030 and p = 0.024, respectively). The severity of COVID-19 did not affect the concentration of anti-S IgG (p = 0.430). This study highlights the general health statuses and the impact of COVID-19 on a population in the Portuguese interior. Knowledge of the circulation and impact of the virus in this specific population can alert and assist in better interventions being conducted by health authorities.
从社会经济发展到遗传背景等多种因素都会影响某些疾病的地区影响,在 COVID-19 大流行期间也出现了这种情况。这项回顾性研究旨在了解葡萄牙内陆地区人口的健康状况和 COVID-19 流行病学特征。在 2021 年 10 月至 2023 年 1 月期间,共纳入了 1553 名居住在葡萄牙贝拉白沙的受试者。通过自我报告的方式,获得了人口统计学和临床数据。此外,还对血型、血压、外周血氧饱和度和抗尖峰蛋白免疫球蛋白浓度进行了分析。统计分析使用 IBM SPSS 统计软件进行。参与者的平均年龄为 48.95 (±14.43) 岁,其中 64% 为男性,36% 为女性。最常见的合并症是高血压(19.2%)、血脂异常(12.6%)和糖尿病(6.6%)。半数人超重,超过一半的受试者没有吸烟史。参与者中有 33% 感染了 SARS-CoV-2 病毒:70.1% 患有轻度疾病,14.1% 患有中度疾病,1.4% 患有重度疾病。接种疫苗的依从性非常高(97%)。以前感染过或接种过疫苗的人抗尖峰蛋白免疫球蛋白值较高;该值取决于接种的疫苗(p < 0.001)。自身免疫性疾病患者和吸烟者的抗S IgG抗体水平较低(分别为p = 0.030和p = 0.024)。COVID-19 的严重程度并不影响抗 S IgG 的浓度(p = 0.430)。这项研究强调了 COVID-19 对葡萄牙内陆人口的总体健康状况和影响。了解该病毒在这一特定人群中的传播和影响可以提醒和帮助卫生当局采取更好的干预措施。
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引用次数: 0
Cultural Adaptation and Validation of the Ambulatory Self-Confidence Questionnaire (ASCQ), Portuguese (European) Version 非卧床自信心问卷(ASCQ)葡萄牙语(欧洲版)的文化适应性与验证
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-04 DOI: 10.3390/ijerph21081026
Maria Teixeira, Mónica Luís, Magda Reis, Carlota Carvão, Anabela Correia Martins
In a world where physical activity and social participation are fundamental pillars of a full and healthy life, confidence in walking has emerged as a fundamental aspect to assess, especially for older adults. Therefore, the purpose of this study was to develop a Portuguese (European) version of the Ambulatory Self-Confidence Questionnaire (ASCQ) that was both linguistically and psychometrically adapted. To do so, a translation method was used, followed by an assessment of its validity and reliability. The Portuguese version was completed by 173 older adults. To assess reliability, Cronbach’s alpha and intraclass correlation coefficients (ICCs) were used. For sociodemographic and clinical characterization, as well as questionnaire scoring, descriptive statistical analysis was used. Pearson’s correlation (r), Student’s t-test, and one-way ANOVA were used to analyze criterion and construction validity. The Portuguese interactions with ASCQ were effectively translated and adjusted, revealing exceptional internal consistency and test–retest reliability, as reflected in Cronbach’s alpha and ICC values of 0.95. No floor effect was observed; however, a ceiling effect was identified (3.5%). The criterion and construct validity were verified as all the correlations established were statistically significant. The adaptation of the ASCQ to Portuguese culture is adequate, making it valid for use within the Portuguese population.
在体育锻炼和社会参与成为充实健康生活的基本支柱的今天,步行信心已成为需要评估的一个基本方面,尤其是对老年人而言。因此,本研究的目的是开发一个葡萄牙语(欧洲)版的行走自信心问卷(ASCQ),该问卷在语言和心理测量方面都进行了调整。为此,我们采用了一种翻译方法,然后对其有效性和可靠性进行了评估。葡萄牙语版本由 173 位老年人填写。为了评估可靠性,使用了克朗巴赫α和类内相关系数(ICC)。在社会人口学和临床特征以及问卷评分方面,采用了描述性统计分析。皮尔逊相关(r)、学生 t 检验和单向方差分析用于分析标准效度和构建效度。葡萄牙语与 ASCQ 的交互作用得到了有效的翻译和调整,显示出卓越的内部一致性和测试-再测可靠性,Cronbach's alpha 和 ICC 值均为 0.95。没有发现最低效应,但发现了最高效应(3.5%)。标准效度和建构效度都得到了验证,因为所有建立的相关关系都具有显著的统计学意义。根据葡萄牙文化对 ASCQ 进行了适当的调整,使其能够在葡萄牙人群中有效使用。
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引用次数: 0
Knowledge, Acceptance, and Uptake of Family Planning: A Cluster Randomized Controlled Trial of Group Antenatal Care in Ghana 计划生育的知识、接受度和采用率:加纳集体产前护理分组随机对照试验
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-03 DOI: 10.3390/ijerph21081025
Ruth Zielinski, Samia Abdelnabi, Georgina Amankwah, Vida A. Kukula, Veronica Apetorgbor, Elizabeth Awini, John Williams, Cheryl Moyer, Bidisha Ghosh, Jody R. Lori
The use of family planning (FP) methods significantly contributes to improved outcomes for mothers and their offspring. However, the use of FP remains low, particularly in low- and middle-income countries. A cluster randomized controlled clinical trial was implemented in Ghana, comparing group antenatal care (ANC) with routine care. The group ANC intervention included eight meetings where the seventh group meeting incorporated information and discussion regarding methods of FP. Data collection occurred at five time points: baseline (T0), 34 weeks’ gestation (T1), 6–12 weeks post birth (T2), 5–8 months post birth, and 11–14 months post birth (T4). At T1, there was a significantly greater increase in the knowledge of FP methods as well as the intention to use FP after the birth among the intervention group. The uptake of FP was significantly higher in the intervention group for all post-birth timepoints except for T4 where the control group had significantly higher rates. The reasons for the diminishing effect are unclear. An increasing uptake of FP methods requires a multifaceted approach that includes increasing accessibility, knowledge, and acceptability as well as addressing societal and cultural norms.
使用计划生育(FP)方法大大有助于改善母亲及其后代的生活质量。然而,计划生育方法的使用率仍然很低,尤其是在中低收入国家。加纳实施了一项分组随机对照临床试验,对集体产前保健(ANC)和常规护理进行了比较。小组产前保健干预包括八次会议,其中第七次小组会议纳入了有关计划生育方法的信息和讨论。数据收集在五个时间点进行:基线(T0)、妊娠 34 周(T1)、产后 6-12 周(T2)、产后 5-8 个月和产后 11-14 个月(T4)。在 T1 阶段,干预组对 FP 方法的了解程度以及产后使用 FP 的意愿都有明显提高。除 T4 外,干预组在产后所有时间点的使用率都明显高于对照组,对照组的使用率明显高于干预组。效果下降的原因尚不清楚。要提高计划生育方法的使用率,需要采取多方面的方法,包括提高可获得性、知识性和可接受性,以及解决社会和文化规范问题。
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引用次数: 0
Brain, Metabolic, and RPE Responses during a Free-Pace Marathon: A Preliminary Study 自由步伐马拉松比赛中的大脑、代谢和 RPE 反应:初步研究
3区 综合性期刊 Q1 Medicine Pub Date : 2024-08-03 DOI: 10.3390/ijerph21081024
Florent Palacin, Luc Poinsard, Julien Mattei, Christian Berthomier, Véronique Billat
The concept of the “central governor” in exercise physiology suggests the brain plays a key role in regulating exercise performance by continuously monitoring physiological and psychological factors. In this case report, we monitored, for the first time, a marathon runner using a metabolic portable system and an EEG wireless device during an entire marathon to understand the influence of brain activity on performance, particularly the phenomenon known as “hitting the wall”. The results showed significant early modification in brain activity between the 10th and 15th kilometers, while the RPE remained low and cardiorespiratory responses were in a steady state. Thereafter, EEG responses decreased after kilometer 15, increased briefly between kilometers 20 and 25, then continued at a slower pace. After kilometer 30, both speed and respiration values dropped, along with the respiratory exchange ratio, indicating a shift from carbohydrate to fat metabolism, reflecting glycogen depletion. The runner concluded the race with a lower speed, higher RPE (above 15/20 on the Borg RPE scale), and reduced brain activity, suggesting mental exhaustion. The findings suggest that training strategies focused on recognizing and responding to brain signals could allow runners to optimize performance and pacing strategies, preventing premature exhaustion and improving overall race outcomes.
运动生理学中的 "中央调速器 "概念表明,大脑通过持续监测生理和心理因素,在调节运动表现方面发挥着关键作用。在本病例报告中,我们首次使用便携式代谢系统和脑电图无线设备对一名马拉松运动员进行了全程监测,以了解大脑活动对运动成绩的影响,尤其是被称为 "撞墙 "的现象。结果表明,在第 10 至第 15 公里期间,大脑活动发生了明显的早期变化,而 RPE 保持在较低水平,心肺反应处于稳定状态。此后,脑电图反应在第 15 公里后下降,在第 20 至 25 公里之间短暂上升,然后继续以较慢的速度前进。30 公里后,速度和呼吸值以及呼吸交换比均下降,表明碳水化合物代谢转向脂肪代谢,反映出糖原耗竭。该选手在比赛结束时速度降低,RPE 升高(高于博格 RPE 表中的 15/20),大脑活动减少,表明精神疲惫。研究结果表明,以识别和响应大脑信号为重点的训练策略可以让跑步者优化成绩和步速策略,防止过早精疲力竭,并改善整体比赛结果。
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引用次数: 0
期刊
International Journal of Environmental Research and Public Health
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