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Abstract: Background: Independence in daily activities is defined as the ability to perform functions related to daily living, i.e. the capacity of living independently in the community with little or no help from others. Objective: We focused on non-attenders as a subgroup of patients whose health status is not well known to family practice teams. Our goal was to estimate the prevalence of dependence and its severity level in the daily activities of patients, and to determine the factors that are associated with the occurrence of dependence. Design: Cross-sectional observational study. Settings and participants: Data was obtained in family medicine settings. Participants in the study were adults living in the community (aged 18 or over) who had not visited their chosen family physician in the last 5 years (non-attenders) and who were able to participate in the study. Through the electronic system, we identified 2,025 non-attenders. Community nurses collected data in the participants' homes. The outcome measure was dependence in daily activities, assessed through eight items: personal hygiene; eating and drinking; mobility; dressing and undressing; urination and defecation; continence; avoiding hazards in the environment; and communication. Results: The final sample consisted of 1,999 patients (98.7% response rate). The mean age was 59.9 (range 20 to 99). Dependence in daily activities was determined in 466 or 23.3% (95% CI: [21.5, 25.2]) of the patients. Older patients (over 60 years), with at least one chronic disease, increased risk of falling, moderate feelings of loneliness and a lower self-assessment of health were statistically significantly more likely to be dependent in their daily activities, according to our multivariate model. Conclusions: A considerable proportion of family practice non-attenders were found to be dependent in daily activities, though at a low level. We identified several factors associated with this dependence. This could help to identify people at risk of being dependent in daily activities in the general adult population, and enable specific interventions that would improve their health status.
Keywords: family medicine, ability to perform functions, daily activities
Published in DKUM: 17.10.2024; Views: 0; Downloads: 1
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Abstract: Introduction: Not much is known about the fall risk among the adult population of those who rarely visit doctors. We wanted to determine the prevalence of increased fall risk in a population of family practice non-attenders and the factors associated with it. Methods: We included participants from family medicine practices in this cross-sectional study. To be included in the study, the participants had to be adults living in the community (home-dwelling people) who had not visited their chosen family physician in the last five years (non-attenders). The identification of the eligible persons was done through a search of electronic medical records, which yield 2,025 non-attenders. Community nurses collected data in the participants’ homes. The outcome measure was increased fall risk as assessed by the Morse fall scale: increased risk (≥25) vs. no risk. Results: The sample consisted of 1,945 patients (96.0% response rate) with a mean age of 60.4 years (range 20.5 to 99.7 years). An increased fall risk was determined in 482 or 24.8% (95% CI: [22.9, 26.8]) of the patients. The multivariate model showed a significant association of increased fall risk with higher age (p<0.001), lower systolic blood pressure (p=0.047), poor family function (p=0.016), increased risk of malnutrition (p=0.013), higher number of chronic diseases (p=0.027), higher pain intensity (p<0.001), lower self-assessment of current health (p=0.002), and higher dependence in daily activities (p<0.001). Conclusion: Non-attenders may have an increased risk of falling which depends on their health status and age. The inclusion of community nurses in primary healthcare teams could be of use not only to identify the non-attenders’ health needs, but also to better manage their health, especially the factors that were identified to be associated with greater fall risk.
Keywords: fall risk, primary healthcare, family practice, non-attenders, cross-sectional studies
Published in DKUM: 17.07.2024; Views: 125; Downloads: 4
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Abstract: In vitro studies have shown a link between the consumption of food rich in (poly)phenols, especially flavonoids, and reduced risk of coronary heart diseases. Several flavonoids have been reported to prevent low density lipoprotein cholesterol oxidation in vitro. The aim of our work was to determine antioxidant and radical scavenging activity of flavonoids myricetin,quercetin, rutin, luteolin, apigenin, kaempferol, catechin, epicatechin and epigallocatechin gallate and to study the influence of chemical structure and flavonoid interactions on the ability to inhibit oxidation and scavenge free radicals. Two in vitro methods, i.e. oxidation of â-carotene in an emulsion system and DPPH (1,1-Diphenyl-2-picrylhydrazyl) radical scavenging assay, were applied. In addition, a review of in vivo studies that investigate the effectiveness of food flavonoids in reducing oxidative damage in human body was done and their results were analyzed and compared to in vitro results obtained in our laboratory. Although all tested flavonoids except apigenin showed strong antioxidant and antiradical properties in vitro, these findings can not be completely confirmed from the reviewed in vivo human studies since those results are sometimes contradictoryand inconsistent.
Keywords: phenolics, flavonoids, antioxidant activity, antiradical activity
Published in DKUM: 10.07.2015; Views: 1488; Downloads: 85
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Abstract: Grapes and wine production residuals, containing grape skins, seeds and stems, represent important sources of phenolic compounds. Red wines are rich in phenolic antioxidants while white wines generally show lower (poly)phenolic content and antioxidant activity. The main difference in the production of white and red wines is the fermentation step. The fermentation of red grapes includes maceration, i.e. it takes place in both liquid and solid parts of the grape. In the case of white wines, the must is clarified before the fermentation starts, cultured yeasts are added to convert the must to wine and antioxidant sulfur dioxide is inserted to protect the wine. The objective of the PhD research was to study antioxidant potential of white grape phenolics both in raw material and fermentation products. First, the standards of phenolic compounds commonly found in white grapes and wines were tested for their antioxidant and antiradical activity. All tested compounds except apigenin showed strong antioxidant and antiradical properties. Afterwards, conventional solid-liquid extraction (CE) and pressurized liquid extraction (PLE) of phenolic compounds from grape seeds were performed. The optimal extraction conditions were investigated and extracts were analyzed in order to determine their total phenolic content, individual phenolic compounds and antiradical potential. Two different drying methods (hot air and freeze drying) were applied to the seeds. Solvent efficiencies of water, ethanol and water-ethanol mixtures were compared at different temperatures. In addition, supercritical fluid extraction (SFE) with CO2 was investigated as the technique for the recovery of phenolic compounds and for the pretreatment of white grape seed samples. Both CE and PLE gave extracts rich in phenolic compounds with good antiradical properties and, generally, the best results were obtained with PLE at 130°C. At the end, the influence of maceration process on the content and the activity of grape phenolic antioxidants in white wines was studied. For such a purpose, six commercially available macerated white wines from Italy and Croatia were analyzed. In addition, eight non-macerated wines from the same region and variety were studied and compared to macerated wines. The experiments have shown that the maceration process increases the total phenolic content and antiradical activity of the wine. It enables the production of white wines rich in phenolic compounds and with strong antiradical properties in completely natural way using only the grapes and without addition of any chemical agents.
Keywords: white grapes, white wine, maceration, antioxidant activity, polyphenols, extraction, PLE, SFE.
Published in DKUM: 05.04.2012; Views: 2968; Downloads: 190
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