Decline In Health Status Research Articles

Declining Health Status of Young Women in India: A Cause of Concern

Health is important in every stage of life but the foundation of quality of old age majorly lies in the young age. Now a days due to modernisation and westernisation a major shift in lifestyles of young generation has been observed globally. Young women health status has shifted to a great extent towards deterioration as per recent researches in India. Many studies conducted on young women and college going females have concluded high percentages of subjects under the risk of obesity, diabetes, hypertension and poly cystic ovary syndrome. These chronic diseases are well known for other serious medical complications. The presence of risk of such diseases in the young females is really a cause of concern as to build a healthy and progressive nation, it is essential to preserve the health of the youth. The decline in health of young women can be a threat to their future health. Realising the importance of well- being of young women, present review article presents data on health status and prevalence of diseases among them.

Embodiment of structural vulnerability: illness experiences among Somali refugee women in urban displacement

ABSTRACT Objectives Forced migration and its subsequent sequelae have caused refugees to face significant adversities throughout the displacement process, making them susceptible to significant health issues. Refugees displaced in Africa are a group especially vulnerable to poor health outcomes, experiencing a documented decline in overall physical and mental health status and rise in mortality from non-communicable diseases (NCDs). Despite the heightened health risks experienced by Somali refugees, particularly women, research into their complex illness experiences and co-/multimorbid health conditions is scarce, leaving a gap in our understanding of the multifaceted health challenges of this population. Design Using structural vulnerability theory, this study explores how the broader host context shapes illness experiences for Somali refugee women in Kenya. Specifically, we describe the factors associated with illness experiences of urban Somali refugee women and how this compares with women with other similarly situated identities, such as Somali Kenyan women, other/non-Somali refugees, and Kenyan women. In-depth interviews were conducted with 43 women in Eastleigh, Kenya. Results Using hybrid thematic analysis, the emergent themes were grouped into three distinct domains: (1) multimorbid, complex illness experiences, (2) embodiment of structural vulnerability, and (3) distinct/shared vulnerability among refugee/non-refugee women. Results suggest that illness experiences of displaced refugee women are inextricably linked to traumatic experiences before displacement, as well as the experiences of transmigration stressors and the hostile socio-legal dynamics encountered post-displacement. Conclusions Our findings also have implications for the need to consider intersectional identities when examining for differential exposure to structural risks and the susceptibility to poor health experiences as well as supports the need for urgent change and improvement in systems of social protection and basic care for refugees experiencing prolonged displacement.

The Impact of the COVID-19 Pandemic on Older Adults Who Participate in Group Physical Exercise Program.

The COVID pandemic exposed the vulnerability of older adults in myriad ways and social service organizations faced unprecedented challenges in safely providing support for older adults. Since 2007, Hawai'i Healthy Aging Partnership (HHAP) has offered Enhance®Fitness, an evidence-based program to reduce the risk of falls and promote health among older adults. Due to the pandemic, all the Enhance®Fitness sites had to close and stop offering the program. The HHAP started to provide alternative activities remotely in May 2020. To explore the pandemic's impact, the feasibility of online exercise programs, and the support needed among older adults to stay physically active, HHAP surveyed existing Enhance®Fitness participants and received 291 responses (59% response rate). The study used frequency distributions, comparison of means, and chi-square to analyze the survey data. Findings showed that the shutdown of the group exercise program during the pandemic led to a health status decline, a reduction in physical activities, and a shift from group to individual physical activities among older adult participants. Most respondents tried the remote exercise opportunities during the pandemic and would consider joining the remote programs in the future. However, about one-fourth of the respondents did not participate in remote exercise activities due to the lack of electronic devices, internet access, or interest in remote activity formats. To ensure equitable access to physical exercise programs for older adults in the post-pandemic era, it is critical to address the access challenges and resources needed for providing multiple programming options.

Living beyond borders: the international legal framework to protecting rights to health of Indonesian illegal migrant workers in Malaysia

PurposeThis study aims to analyse in the health access of Indonesian illegal migrant workers in Malaysia, during which time they were not covered by Indonesia’s national social health insurance.Design/methodology/approachThis study adopted a sociolegal approach, the research approach is conducted to understand the effect of a law, policy and regulation on access to health-care access among Indonesian migrant workers working illegally in Malaysia. This research involved 110 respondents who work illegally in Malaysia. The research explored the perceptions of respondents concerning to health access services of illegal migrant workers.FindingsThe study demonstrated the weakness of provisions intended to guarantee the health access to health care of migrant workers from Indonesia illegally working in Malaysia. A decline in health status was observed, but it was not significant. Bilateral cooperation between Indonesia and Malaysia is necessary to provide a framework for Indonesia providing health care to its citizens working in Malaysia, regardless of their legal status.Originality/valueThis paper concerns on the Indonesia illegal migrant workers experiencing illness and the access to the health service in Malaysia, and also the implementation of international regulation to protect Indonesian illegal migrant workers in Malaysia under ASEAN Consensus on the Protection and Promotion of the Rights of Migrant Workers.

Ageing with spinal cord injury: a longitudinal study

Abstract Limited studies have evaluated the impact of recreation on successful ageing (SA) for individuals with spinal cord injury (SCI) in a longitudinal manner. Most existing SA models emphasise biomedical-based dimensions of physical functioning, which has been criticised as unrealistic and limited, especially for people with disabilities. Various researchers and organisations have proposed that SA needs to be reassessed using more self-perceived, self-reported measurements. Understanding long-term life satisfaction predictors for individuals ageing with SCI is still limited, particularly when including longitudinal recreation participation data. This study, based on Rowe and Kahn's SA model and utilising self-reported measurements, observes the long-term changes in self-reported health status, recreation participation time and social integration levels, and evaluates the long-term impacts of these predictors on life satisfaction among individuals with SCI. The sample comprises individuals with SCI (N = 11,450) who are at least 45 years old at the time of injury or have lived with their injury for over 15 years. Results indicate that when ageing with SCI, life satisfaction increases over time, but their recreation time, social interactions and self-perceived health status decline. Moreover, regular participation in recreational activities, engagement in and maintenance of certain levels of social relationships, and high self-evaluation of health can positively impact life satisfaction during ageing. The study explores the feasibility of using self-perceived measurements to replace biomedical-based variables in Rowe and Kahn's SA model and examines their impacts on life satisfaction among people ageing with disabilities. In the future development of SA models, researchers can incorporate more self-reported, self-evaluated assessment variables to better capture the ageing experience, especially for people with disabilities.

Integrated Analysis of the Transcriptome and Microbial Diversity in the Intestine of Miniature Pig Obesity Model.

Obesity, a key contributor to metabolic disorders, necessitates an in-depth understanding of its pathogenesis and prerequisites for prevention. Guangxi Bama miniature pig (GBM) offers an apt model for obesity-related studies. In this research, we used transcriptomics and 16S rRNA gene sequencing to discern the differentially expressed genes (DEGs) within intestinal (jejunum, ileum, and colon) tissues and variations in microbial communities in intestinal contents of GBM subjected to normal diets (ND) and high-fat, high-carbohydrate diets (HFHCD). After a feeding duration of 26 weeks, the HFHCD-fed experimental group demonstrated notable increases in backfat thickness, BMI, abnormal blood glucose metabolism, and blood lipid levels alongside the escalated serum expression of pro-inflammatory factors and a marked decline in intestinal health status when compared to the ND group. Transcriptomic analysis revealed a total of 1669 DEGs, of which 27 had similar differences in three intestinal segments across different groups, including five immune related genes: COL6A6, CYP1A1, EIF2AK2, NMI, and LGALS3B. Further, we found significant changes in the microbiota composition, with a significant decrease in beneficial bacterial populations within the HFHCD group. Finally, the results of integrated analysis of microbial diversity with transcriptomics show a positive link between certain microbial abundance (Solibacillus, norank_f__Saccharimonadaceae, Candidatus_Saccharimonas, and unclassified_f__Butyricicoccaceae) and changes in gene expression (COL6A6 and NMI). Overall, HFHCD appears to co-contribute to the initiation and progression of obesity in GBM by aggravating inflammatory responses, disrupting immune homeostasis, and creating imbalances in intestinal flora.

The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Background A better understanding of how chronic physical health conditions affect long-term outcomes following injury is essential for quantifying the burden of serious orthopaedic injuries. We aimed to describe the association between the presence of post-injury chronic physical health conditions and (i) the change in health status from before injury to six different follow-up time points after injury; and (ii) survival time. Methods A cohort study was conducted using linked data from the REcovery after Serious Trauma: Outcomes, Resource Use, and Patient Experiences study, the Victorian Registry of Births, Deaths and Marriages (BDM) (2009–2017), the victorian admitted episodes dataset (2009–2017) and the victorian emergency minimum dataset (2009–2017). Adults (≥ 18 years old) with serious orthopaedic injuries who survived to discharge from their trauma admission were included. Multivariable linear regression analysis was conducted to evaluate the association between post-injury chronic physical health conditions and the mean change in health status (EuroQol-Visual Analogue Scale) from before injury to six follow-up time points post-injury. Survival analysis was conducted to estimate the probability of survival for people with and without chronic physical health conditions following injury. Results Out of 894 participants, 177 (19.8%) had at least one chronic physical health condition recorded up to five years post-injury. People with post-injury conditions reported a greater mean decline in health status than people without post-injury conditions (difference, (95% CI): −6.9 (−9.7, −4.2), p = 0.01). Over the study period, almost six times as many people with chronic physical health conditions post-injury died as people without these conditions (AHR (95% CI): 5.7 (2.9, 11.3), p < 0.01). Conclusions Chronic physical conditions after serious orthopaedic injuries were associated with a lower survival probability and a deteriorating health status. Orthopaedic injury survivors may benefit from early detection and treatment of chronic conditions.

Geodetector analysis of individual and joint impacts of natural and human factors on maternal and child health at the provincial scale

This ecological study examined the individual and joint impacts of natural–human factors on the spatial patterns of maternal and child health status in China at the provincial scale in 2020. We considered natural factors (forest coverage, average temperature, and total sulfur dioxide and particulate matter emissions) and human factors (economic development, urbanization, healthcare access, and education level). We combined maternal, infant, and under-five mortality rates into a composite maternal and child health index using the entropy method. The spatial autocorrelation analysis of this index highlighted distinct health patterns across provinces, whereas the geodetector method assessed the effects of natural–human factors on the patterns. A notable east–central–west stepwise decline in health status was observed. Global Moran’s I showed positive spatial clustering, with high–high clustering areas in the Yangtze River Delta and low–low clustering areas in western regions. Factor detection identified eight significant natural–human factors impacting maternal and child health, with total sulfur dioxide emission density having the greatest impact. The interaction between average schooling years and total sulfur dioxide emission notably affected maternal and child health patterns. The study concludes that natural–human factors critically affect the spatial distribution of maternal and child health.

New markers in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD), a global healthcare and socioeconomic burden, is a multifaceted respiratory disorder that results in substantial decline in health status and life quality. Acute exacerbations of the disease contribute significantly to increased morbidity and mortality. Consequently, the identification of reliable and effective biomarkers for rapid diagnosis, prediction, and prognosis of exacerbations is imperative. In addition, biomarkers play a crucial role in monitoring responses to therapeutic interventions and exploring innovative treatment strategies. Although established markers such as CRP, fibrinogen and neutrophil count are routinely used, a universal marker is lacking. Fortunately, an increasing number of studies based on next generation analytics have explored potential biomarkers in COPD. Here we review those advances and the need for standardized validation studies in the appropriate clinical setting.

Assessment of frailty and its predictors in chronic obstructive pulmonary disease.

Frailty represents a state of risk in which a relatively small stressor results in a disproportionate decline in health status. This study aims to determine the prevalence of frailty among patients with COPD in the Indian population and its associated risk factors. A descriptive cross-sectional study was conducted in 150 COPD patients. Frailty was assessed using the frailty phenotype method. The mean age (SD) of the study population was 60.59 (5.9) years with 88.67% males and 53.33% ex-smokers. The prevalence of frailty was 51.33% (n = 77). Most of the frail patients belonged to GOLD group D (66.23%) (P < 0.0001). Post-bronchodilator FEV1(%) was lowest in the frail group (40 [36-47]%) (P < 0.0001). Risk of frailty significantly correlated with smoking pack years (1.036; 1.001-1.074), history of 1 exacerbation in last year (6.810; 2.036-22.779), post-bronchodilator FVC(%) (0.955; 0.926-0.985), post-bronchodilator FEV1(%) (0.940; 0.913-0.968), distance covered in 6-minute walk test [0.975; 0.965-0.986] and dyspnoea severity [1.044; 1.024-1.063]. In multivariate regression, 6-minute walk distance and GOLD group B were the independent predictors of frailty in COPD. The prevalence of frailty in Indian patients with COPD was 51.33%. Six-minute walk distance is an important predictor of frailty. Early identification of frailty will lead to prompt intervention and rehabilitation.

Exploring patient perspectives on electronic patient-reported outcome measures in home-based cancer palliative care: A qualitative study.

Electronic patient-reported outcomes (ePROMs) enhance symptom management and patients' engagement in palliative cancer care. However, integrating them into this setting brings challenges, including patients' familiarity with technological devices and declining health status. Prioritizing the patient's acceptability and feasibility is crucial for their adoption. However, more knowledge is needed about patients' perspectives on the adoption of ePROMs in the community, especially for home-based palliative care. Explore patient viewpoints on utilizing ePROMs for symptom reporting in home-based oncology palliative care. A qualitative interpretative approach was used to evaluate patients' points of view on using ePROMs in this specific care setting. Semistructured interviews were carried out. Data were analyzed using a reflexive thematic analysis. A total of 25 patients receiving oncological home palliative care from the advanced palliative care unit of the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy, were invited to participate. Twenty interviews were conducted, as five patients declined due to deteriorating health. Four themes were identified: (1) strategic value of ePROMs and subjective appreciation; (2) enhancing patient centeredness through ePROMs; (3) exploring and addressing concerns about the use of ePROMs and (4) intersecting factors influencing the efficacy of ePROMs. Despite initial reticence, home palliative care patients consider ePROMs as potentially valuable allies monitoring symptoms, enhancing their quality of life, and amplifying their voices on less explored aspects of care. Continuous dialog between healthcare professionals and patients is crucial for addressing patient skepticism about ePROMs and their impact on the human aspect of care.

PENINGKATAN KESEJAHTERAAN LANSIA MELALUI PEMERIKSAAN KESEHATAN

The elderly is a human age group entering the final stages of life. From the health aspect, the elderly group experiences a decline in health status, both naturally and as a result of disease, and a special approach and efforts are needed for the elderly to improve the quality of health on an ongoing basis. The elderly should receive attention to their health, so that they are healthy and live long, are not dependent on the family, and can live independently, it is necessary to carry out regular health checks for the elderly. The aim of this community service activity was to improve the health welfare of the elderly and provide basic health information to the public, especially the elderly regarding blood pressure, blood sugar levels and uric acid, as well as providing education on the results of health examinations carried out so as to realize improvements in the health of the elderly. The method used in carrying out this activity was accidental, namely carrying out health checks on elderly people who come during the activity, then the elderly took turns having their health checked, starting with blood pressure, blood sugar and uric acid. The results of this community service activity showed that of the 24 elderly people, 14 people had hypertension, 12 people had hyperglycemia, and 11 people had hyperuremia. For this reason, it was concluded that the elderly in Aboek Jaloh Village experienced more hypertension (58%), so appropriate follow-up programs were needed to deal with elderly problems, especially degenerative diseases, so that the health of the elderly continued to improve.

Pemantauan dan Deteksi Dini Risiko Anemia pada Ibu Hamil dan Stunting Balita melalui Pemeriksaan Antropometri di Puskesmas Kuranji Kota Padang

Stunting and anaemia in pregnant women are global conditions that are interrelated with the risk of declining health status in children and pregnant women. Anaemia in pregnant women poses a risk of stunting in children, impacting growth and development, brain function, immune system, and learning abilities. For this reason, the purpose of community service is to detect the early risk of stunting in children and anaemia in pregnant women. The method used is an anthropometric examination of toddlers and pregnant women using weight, height, upper arm circumference, and haemoglobin examination to detect the risk of stunting and anaemia. Inspection and measurement data were processed using KMS online and SPSS and presented descriptively in frequency distribution tables and central tendency values. This activity was carried out at the Durian Tiga Batang Posyandu, Kuranji Health Center, Padang City, on 10 August 2023. Data was collected on 50 infants/toddlers and nine pregnant women who visited the Posyandu. The examination revealed that 48% of infants and toddlers were at risk of stunting (short and very short stature), and 11.1% of pregnant women had anaemia. Thus, early detection of stunting through the online KMS application facilitates data interpretation so that it can provide information quickly and recommend further treatment to mothers to achieve ideal child height growth. In addition, early detection of anaemia can prevent stunting in children.

Effects of a Physical Exercise Program on Quality of Life and Physical Fitness of Breast Cancer Survivors: the MAMA_MOVE Gaia After Treatment Trial

ABSTRACT To assess the effects of a group class physical exercise program on health-related quality of life (HRQOL), physical fitness and activity, and safety in early breast cancer women after treatment, a double-phase trial [16-week control phase (CP) followed by a 16-week intervention phase (IP)] was designed. Outcomes were evaluated at baseline (T1), 8 (T2) and 16 (T3) weeks (CP), and 24 (T4) and 32 (T5) weeks (IP). The primary endpoint was global health status. Out of 82 enrolled patients, 37 completed the IP. Global health status decreased (−10,1; 95% CI −19.8 to −0.4; p = 0.040) during the CP and stabilized during the IP. Physical and sexual functioning increased during the IP (p = 0.008; p = 0.017), while cardiorespiratory fitness increased in the CP (p = 0.004). Upper limb strength and lower limb functionality increased during both phases [CP: p < 0.0001, p = 0.001 (surgical and nonsurgical arm), p = 0.028; IP: p < 0.0001, p = 0.002, p = 0.009]. Body mass index decreased in the IP (p = 0.026). Waist circumference increased in the CP (p = 0.001) and decreased in the IP (p = 0.010); sedentary behaviours and moderate and vigorous physical activity did not change. Adherence to 70% of the sessions was reported in 54% of patients. No serious adverse events related to the intervention were reported. In conclusion, the physical exercise program was able to prevent the decline in global health status and to improve other domains of HRQOL and physical fitness. As physical exercise is not the standard of care in many countries, the implementation of group class programs might be an option.

Novel Diabetic Nephropathy-Based Hypertension Treatment for Type-2 Diabetes Mellitus and CKD Patients: A Mini Review

Diabetes mellitus is known to result in persistent renal impairment among individuals with the condition and is presently the primary aetiology of terminal-stage renal disease, with more than fifty percent of dialysis patients being affected. The prevalence of diabetes continues to rise, resulting in a decline in individuals' health status and imposing significant financial burdens on healthcare systems. Accurately distinguishing between the various types of diabetes is crucial in order to provide appropriate treatment that mitigates the severity of associated complications and their significant consequences. The co-occurrence of diabetes and renal disease has been found to be linked with a significant fourfold rise in both the frequency and fatality of cardiovascular disease. Pharmacological interventions aimed at reducing blood pressure have been a crucial component in the management of diabetic nephropathy for several decades. The past decade has witnessed a decline in the occurrence of end-stage renal disease, owing to enhanced care measures such as the administration of hypertension medication. It is assumed in clinical practice recommendations that angiotensin-converting enzyme inhibitors and angiotensin-receptor antagonists hold an equivalent status. The efficacy of low doses of ACEI and ARB in reducing proteinuria was found to be superior to that of high doses. The co-administration of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has been observed to elicit a more pronounced reduction in 24-hour proteinuria and urinary albumin excretion rate (UAER) in comparison to the singular administration of either ACEI or ARB.

Capturing the variety of clinical pathways in patients with schizophrenic disorders through state sequences analysis

BackgroundCare pathways are increasingly being used to enhance the quality of care and optimize the use of resources for health care. Nevertheless, recommendations regarding the sequence of care are mostly based on consensus-based decisions as there is a lack of evidence on effective treatment sequences. In a real-world setting, classical statistical tools were insufficient to consider a phenomenon with such high variability adequately and have to be integrated with novel data mining techniques suitable for identifying patterns in complex data structures. Data-driven techniques can potentially support empirically identifying effective care sequences by extracting them from data collected routinely. The purpose of this study is to perform a state sequence analysis (SSA) to identify different patterns of treatment and to asses whether sequence analysis may be a useful tool for profiling patients according to the treatment pattern.MethodsThe clinical application that motivated the study of this method concerns the mental health field. In fact, the care pathways of patients affected by severe mental disorders often do not correspond to the standards required by the guidelines in this field. In particular, we analyzed patients with schizophrenic disorders (i.e., schizophrenia, schizotypal or delusional disorders) using administrative data from 2015 to 2018 from Lombardy Region. This methodology considers the patient’s therapeutic path as a conceptual unit, composed of a succession of different states, and we show how SSA can be used to describe longitudinal patient status.ResultsWe define the states to be the weekly coverage of different treatments (psychiatric visits, psychosocial interventions, and anti-psychotic drugs), and we use the longest common subsequences (dis)similarity measure to compare and cluster the sequences. We obtained three different clusters with very different patterns of treatments.ConclusionsThis kind of information, such as common patterns of care that allowed us to risk profile patients, can provide health policymakers an opportunity to plan optimum and individualized patient care by allocating appropriate resources, analyzing trends in the health status of a population, and finding the risk factors that can be leveraged to prevent the decline of mental health status at the population level.

Assessment of nutritional status of elderly in rural field practice area of Jhalawar medical college, Jhalawar, India

Background: Worldwide, the population of elderly people is constantly increasing. Elderly population is at risk of under nutrition due to age related physical, cognitive, functional decline and lack of financial support. Malnutrition contributes to decline in health status, increased utilization of healthcare services and increased mortality. Aim of this study was to assess nutritional status of the elderly by MNA and to find association between nutritional status and socio- demographic profile of elderly. Methods: After ethical approval, a community based cross sectional study was conducted among elderly people residing at Mandawar village, rural field practice area of JMC, Jhalawar during August to October 2022. Complete enumeration technique was used to enrolled participants in study. Door to door household survey was conducted using predesigned questionnaire. Nutritional status was assessed by using standard mini nutritional assessment questionnaire. The data was analyzed through SPSS28.0 (trail version). Results: Out of 287 elderlies, 139 (48.4%) were male and 148 (51.6%) were female. According to MNA, 73 (25.4%) were found malnourished while 119 (41.4%) were at risk of malnutrition and 95 (33.1%) were well nourished. A statistically significant (p&lt;0.05) association was found between nutritional status with increasing age, gender, marital status, education, occupation, morbidity, financial dependance and substance abuse. Conclusions: This study showed that malnutrition has multidimensional background. So, to improve nutritional status of elderly approach should be focus on those who are older, illiterate or low educational status, female gender and financially dependance.

Improving Health Status in The Elderly Through Health Checks and Education at Nuriah Nursing Homes in Karimun.

Background. Elderly is the final stage of development in human life. Everyone who goes through old age will experience various changes. Purpose. From the results of data collection for the elderly at the Nuriah Nursing Home, Kec.Sei Lakam, Kab. Karimun can identify the main problem in the elderly, namely the risk of declining health status of the elderly as evidenced by the existence of health problems such as CKD, high blood pressure, heart disease, rheumatism, paralysis and diabetes mellitus. Method. The method used is by conducting health checks and counseling followed by 5 elderly people. Results. The results of this activity showed that from 5 elderly people, 1 elderly had hypertension because the elderly underwent dialysis 2 times a week. 1 elderly suffers from malnutrition. 1 elderly had dementia, and one elderly experienced long bed rest. Conclusion. The conclusion is that 70% are all carried out / assisted by orphanage officers. Starting from bathing, clothes, chapters and tubs. The elderly seem to understand how to improve health status.

Improving the Degree of Health in the Elderly Through Health Checks and Education

Background. The thesis focuses on the elderly as the final stage of human development and acknowledges that individuals in old age undergo various changes. The research is conducted at the Nuriah Nursing Home, located in Kecamatan Sei Lakam, Kabupaten Karimun. The purpose of the research is to identify the main health problems faced by the elderly in the nursing home, specifically the risk of declining health status. The thesis mentions specific health problems prevalent among the elderly, such as chronic kidney disease (CKD), high blood pressure, heart disease, rheumatism, paralysis, and diabetes mellitus. Purpose. This activity aims to determine the health status. Method. The method used is by conducting health checks and counseling followed by 5 elderly people.. Results. The results of this activity showed that from 5 elderly people, 1 elderly had hypertension because the elderly underwent dialysis 2 times a week. 1 elderly suffers from malnutrition. 1 elderly had dementia, and one elderly experienced long bed rest. Conclusion. . The conclusion is that 70% are all carried out / assisted by orphanage officers. Starting from bathing, clothes, chapters, and tubs. The elderly seem to understand how to improve their health status. instructional approaches to meet the specific needs of their students.

Longitudinal Health Status and Quality of Life in Congenital Diaphragmatic Hernia.

To longitudinally evaluate self-reported health status (HS) and quality of life (QoL) in 8- and 12-year-old survivors of congenital diaphragmatic hernia (CDH). We hypothesized that HS would improve with age-as associated health problems tend to decline-whereas QoL would decrease, as the children start to compare themselves with peers. Self-reported HS and QoL of 133 children born between 1999 and 2013 who had joined our standardized follow-up program were routinely assessed at the ages of 8 and 12 with generic, internationally validated, standardized instruments. Longitudinal evaluation of total and subscale scores was performed using general linear model analyses. In addition, we compared these scores to sex- and age-specific normative data. Between ages 8 and 12, boys born with CDH perceived a decline in HS (mean difference -7.15, P < .001). Self-reported QoL did not change over time in both boys and girls. At both ages, HS was significantly lower than that of healthy peers (effect size = 0.71, P = .001 for boys, and effect size = 0.69, P = .003 for girls), whereas differences in QoL were small. Children born with CDH are at risk for declining HS between 8 and 12 years, but not QoL, compared with healthy peers. Given that children born with CDH tend to grow into deficits, our findings highlight the need for continued somatic and psychological assessments in adolescent and adult CDH survivors.