Life Expectancy In Good Health Research Articles

A Review of Non-Alcoholic Fatty Liver Disease in HIV-Infected Patients: The Next Big Thing?

The burden of liver-related morbidity remains high among HIV-infected patients, despite advances in the treatment of HIV and viral hepatitis. Especially, the impact of non-alcoholic fatty liver disease (NAFLD) is significant with a prevalence of up to 50%. The pathogenesis of NAFLD and the reasons for progression to non-alcoholic steatohepatitis (NASH) are still not fully elucidated, but insulin resistance, mitochondrial dysfunction and dyslipidemia seem to be the main drivers. Both HIV-infection itself and combination antiretroviral therapy (cART) can contribute to the development of NAFLD/NASH in various ways. As ongoing HIV-related immune activation is associated with insulin resistance, early initiation of cART is needed to limit its duration. In addition, the use of early-generation nucleoside reverse transcriptase inhibitors and protease inhibitors is also associated with the development of NAFLD/NASH. Patients at risk should therefore receive antiretroviral drugs with a more favorable metabolic profile. Only weight reduction is considered to be an effective therapy for all patients with NAFLD/NASH, although certain drugs are available for specific subgroups. Since patients with NASH are at risk of developing liver cirrhosis and hepatocellular carcinoma, several non-antifibrotic and antifibrotic drugs are under investigation in clinical trials to broaden the therapeutic options. The epidemiology and etiology of NAFLD/NASH in HIV-positive patients is likely to change in the near future. Current guidelines recommend early initiation of cART that is less likely to induce insulin resistance, mitochondrial dysfunction and dyslipidemia. In contrast, as a result of increasing life expectancy in good health, this population will adopt the more traditional risk factors for NAFLD/NASH. HIV-treating physicians should be aware of the etiology, pathogenesis and treatment of NAFLD/NASH in order to identify and treat the patients at risk.

Traitement des grands collapsus de la colonne du pouce après trapézectomie à un recul minimum de 2 ans

Trapezectomy represents the gold standard for treatment of painful peritrapezial osteoarthritis resistant to the medical treatment. A well-know complication is the collapse of the space of trapeziectomy despite realization of a ligamentoplasty or suspensioplasty. It can causes at long term scaphometacarpal osteoarthritis, loss of strength, adductus deformation and pain. The aim is to report our experience of treatment the major collapse of the thumb after trapezectomy and the results at minimum follow-up of 2 years. We reviewed 15 patients operated by a senior surgeon after a minimum follow up of 2 years after the salvage procedure. Clinical assessment compare pain by EVA scale, joint amplitude, kapandji opposition score, QuickDash score, satisfaction, complications, revisions. Radiological assessment compares the proximal migration and subluxation of M1, the height of the trapezial void, osteoarthritis scaphometacarpal. The treatment consist of the release of the first metacarpal, ligamentoplasty by Brunelli associated tendon interposition, palmar capsulodesis and temporary intermetacarpal and metacarpophalangeal fixation by a Kirschner. Between January 2013 to January 2016 we treated 15 patients for major collapse of the thumb after trapezectomy concerning 14 women and 1 man with a mean age 58 years (47–93). The mean follow-up was 42 months (24–60). All of them were operated for osteoarthritis peritrapezal at mean 6 years ago (1–8) in another center by trapezectomy alone or PLA interposition. Fifteen patients had pain with a mean EVA at 4 10 (2–8). Grip strength and key pinch was mean 8 kg (3–14). The mean joint mobility sector was for the metacarpophalangeal 60° (50–70°) and 80° (70–90°) for the interphalangeal. The Kapandji score was for all 10 10. All patient did not forget this thumb and had an attitude of protection towards him. The mean QuickDash score was 35 (20–50). Concerning radiological assessment the mean space height was 1,2 mm (0,8–1,2). Trapezometacarpal arthroplasty have revolutionized postoperative rhizarthrosis for rapid recovery and shorter postoperative immobilization. The trapeziectomy stay an indication of choice in case of dysplasic trapezium, multidirectional laxity of the MPA and STT involvement. These poor clinical and radiographic results post-trapeziectomy with major collapse are not acceptable in our patients who have a longer life expectancy in good health. This procedure helps to treat pain significantly despite mixed radiographic results.

Determinants Of Healthy Ageing For Older People In European Countries – A Spatio-Temporal Approach

The European Commission (EC) has identified active and healthy ageing (AHA) as a major societal challenge mutual to European countries. This issue has increased in importance due to the progressive ageing observed in European societies, that force authorities to take initiatives for support the activity of the elderly. One of the initiatives, widely recognised is The European Innovation Partnership on Active and Healthy Ageing, which strive to enabling EU citizens to lead healthy, active and independent lives while ageing. The positive effect of actions for the AHA will be extension of the life in good health duration of EU citizens by two years by 2020. This is an important issue, as in 2013, women who have reached the age of 65 years in UE28 were facing on average 21.3 years of further life years and only 8.6 years (on average this amounted for 40.4 % of life expectancy) accounted for living in health, whereas for males, this ratio was estimated on 8.5 years in health of the anticipated further 17.9 years (47.5% of further life duration). Life expectancy in good health in older age is influenced by many different factors, i.e. cultural, social, economic and accessibility to health services and the quality of provided treatment. The last aspect is related to both the economic development of the country and the health care system management. The significant factor that has been increasingly emphasised in documentation of World Health Organisation or European Commission, concerns the investment in public and individual health. Taking into account the multivariate impact of objective and subjective factors on life expectancy in good health of elderly, the Authors decided to conduct the multidimensional comparative analysis for EU countries, including Norway, Switzerland and Iceland as well. Among the objective factors Authors distinguished: proportion of population (men and women) aged 65 years and more, economic development of the countries measured by GDP per capita, healthy life years expectancy in absolute values for males and females at 65 years, health care expenditures in PPS per inhabitant aged 65+, whereas the group of subjective characteristics consisted of: self-perceived health for people aged 65+ and self-reported unmet needs for medical services. The article aims to investigate the relationship between the length of the further life in healthy for men and women aged 65 years and selected factors in European countries in the period 2005–2012. For this purpose, following methods were used: 1/ spatial distribution of characteristics – rates of change in selected periods: 2005 and 2012, 2/ tests for dependencies using correlograms and Spearman’s rank correlation coefficients, 3/ cluster analysis: on the basis of Ward’s methods spatial similarities (among countries) were indicated. As the source of data the Eurostat database were used.

Adjusting prospective old-age thresholds by health status: empirical findings and implications. A case study of Italy

While traditional measures of population ageing are bound to the concept of chronological age, new indicators have been proposed that take into account the dramatic changes that have occurred in later life due to increasing longevity. In this paper, we re-evaluate demographic ageing in Italy using prospective oldage thresholds based on both total remaining life expectancy and remaining life expectancy in good health. We show that the proportion of individuals above the prospective thresholds has been increasing much more slowly than the proportion of people aged 65 years and older, and that the increase in the proportion of individuals above the prospective thresholds adjusted for health status has been more or less large depending on trends in health status at older ages. Given these results and the ongoing improvements in health conditions among older people, we think the consequences of population ageing for Italian society could be less severe than expected.

Use values: The value added for citizen inclusion

Whether we consider illness, disability or aging, we are or we will be all, at some point in our lives, affected by the theme of this conference. Acting to address these problems whatever they are, is not only do for but first and foremost do with and let it done. To succeed we must: – porpose to support a person throughout life irrespective of his age; – proceed to this necessary change by changing practices, the use of innovations, changes in professional cultures…; Many of our systems are built on an organization where supply dictates demand. Now, the user is the common point of all economic issues. His participation should not be limited to the listening of the needs alone. It is essential to involve the person from design to experiments in a living situation and provide an economic and medico-social assessment. This doesn’t mean to be inside but take his place in order to adapt the environment to the elderly, sick and/or disabled person. For this purpose, we are one of autonomic lab partners. There is a condition for this success: Make these networks work in complementary skills including different trades care, guidance, and research from the University, the public health and the industry, public authorities, elected officials. Co build increases the chances of success and distribution of solutions and devices proposed in this process. The heart of this new industry is: to highlight the person, to prioritize and simplify the care pathway, to highlight the desired route: from the choice of the necessary complementarities between human assistance and technical aids, to not confuse resource and compensation, gateways between trades of CARE and take CARE to make a real life course, to legitimate their respective competences. Finally, the desire to improve life expectancy in good health and living together.

Specyfika przemieszczeń wewnętrznych osób starszych w Polsce

The purpose of this study is to identify regularities in internal migration of elderly people in Poland. In the analysis we focus mainly on directions of migration (urban, rural), demographic structure of migrants, and spatial distribution (at voivodeship level) of senior migrants. The study is based on results of the 2002 and 2011 National Population and Housing Censuses and current reports of the Statistical Central Office.
 The results show that an increase in average life expectancy in good health leads to postponement of decisions to migrate to a later stage of life. It is reflected in a rise in the number of married persons amongst seniors changing a domicile. In case of persons in advanced age, who are usually single, less educated and of poor health, the migration is often a result of necessity rather than choice. The results of the 2011census indicate that current senior migrants are relatively younger than those who migrated a decade earlier. This suggests that the existing pattern of forced migration of seniors has changed to voluntary moves in Poland.

Population ageing and health implication. Thinking time trends in Emilia-Romagna Region

Ageing is doubtless a factor characterizing population in Europe, and particularly in Emilia-Romagna, a north-east Italian region of about 4,5 million people. From 1990 to 2010 life expectancy in Emilia-Romagna has grown by about 6 years for men and 5 for women. At the same time good health life expectancy has grown even more rapidly, particularly among women. While it is expected that in 2030 the number of over-65s will have exceeded one million people, the trends in good health life expectancy is not granted. Strengthen actions aimed at increasing good health conditions promotes ageing sustainability and can feed the positive trend observed for the life expectancy in good health. The Emilia-Romagna Region takes up the demographic challenge of the coming years in the European context and promotes strategies for active and healthy ageing, working on prevention in its broadest sense and for the entire life span, with the aim of actively contribute to the achievement of the EU2020 target of an increase of two years in life expectancy in good health of European citizens.

Local Role of Food Producers' Communities for a Global One-Health Framework: The Experience of Translational Research in an Italian Dairy Chain

Community is the foundation of public health: the present paper reports the approach and strategy for intervention on the dairy production community developed by the Italian project ALERT (www.alert2015.it), which implements the transfer of technical innovation and technological know-how from public research. Starting from the local role of primary producers, North-South and South-South networking (www.noodlesonlus.org) is needed to share solutions for transnational problems like climatic change, contaminated agro-farming sites and food waste and losses in the era of food crisis. Based on risk analysis, science-society dialogue and global health, the main drivers of this experience of translational research are One Health, i.e. the web of inter-relationships among environment, farm animals and human health, and sustainable food safety (prevention actions on diet of young women, today, to protect next generation’s health) to increase population life expectancy in good health.

Social inequalities in facing old-age dependency: a bi-generational perspective

Population ageing implies the ageing of family and kinship networks. Because the absolute number of the frail elderly is set to increase, notwithstanding the increase in life expectancy in good health, a top-heavy intergenerational chain is likely both to put stress on the middle generation, and result in the older and younger generations competing for their support. Thus, issues of the redistribution of financial and time resources become relevant in the middle and younger generations when frailty emerges in the older generation. This article adopts a bi-generational perspective in order to examine not only whether social inequality affects resources available to the dependent elderly, but also whether and how a frail elderly person’s demands impact differently on children’s resources and life chances across gender and social classes, as well as what the impact of specific patterns of public care provision (other than healthcare) is on these inequalities.

Turning life into life expectancy: the efficiency of life-saving interventions

A life-saving intervention, if truly it is to save life, should yield more life expectancy in good health than the amount of work time it takes to pay for it. Together with available cost-effectiveness data, this 'Time Principle' permits a separation of the efficient from the inefficient options among all life-saving interventions. The majority of known options for intervention are efficient according to the Time Principle.

Social and economic criteria of acceptable risk

Abstract A simple normative theory is proposed for the responsible management of risks to the public. A ‘lifesaving’ alternative, if it is truly to save lives, should return to the community more years of life expectancy in good health than the years of work consumed to pay for its cost. This common-sense time principle of risk management provides a criterion for acceptable risk that is applicable in connection with cost-utility analysis. The principle is a benchmark, providing a unified rationale for the assessment of risks in health care and technology. Integration of acceptable risk criteria with criteria for national performance can be achieved via applicable compound social indices such as the Life Quality Index or the Human Development Index.

Results of two methods to determine health expectancy in The Netherlands in 1981–1985

Health expectancy is a measure providing summarizing information on mortality on one hand and morbidity and/or disability on the other hand. In this article health expectancy is determined with two approaches: method 1 leads to life expectancy free of disability at birth and at other ages; method 2 leads to life expectancy in good health. Results of the various calculations show that according to method 1 life expectancy free of disability at birth for men in the Netherlands was 58.8 years and for women 57.3 years (based on data from the period 1981–1985). Results of method 2 are different from method 1; life expectancy in good health for men was 58.9 years and for women 60.7 years. Results of both methods are compared with studies which have been carried out in other countries. The comparison shows that method 1 leads to results which deviate from the other studies while results of method 2 are to a large extent similar to the other studies. Reasons are given which explain why the results of method 1 deviate from the other studies. In spite of the fact that the two methods lead to different outcomes, the conclusion is drawn that the difference in health expectancy between men and women is much smaller than the difference in total life expectancy between men and women. The difference in total life expectancy by sex in the period 1981–1985 was 6.7 years.