Occupational Class Research Articles

Dual trajectories of short-term and long-term sickness absence and their social- and health-related determinants among women in the public sector.

Short- and long-term sickness absence (SA) vary in their determinants. We examined short- and long-term SA contemporaneously as two interconnected phenomena to characterize their temporal development, and to identify employees with increasing SA at an early stage. We extracted 46- to 55-year-old employed women from the Helsinki Health Study occupational cohort during 2000-17 (N = 3206) and examined the development of short- (1-14 days) and long-term (>14 days) SA using group-based dual trajectory modelling. In addition, we investigated the associations of social-, work- and health-related factors with trajectory group membership. For short-term SA, we selected a three-group solution: 'no short-term SA' (50%), 'low frequency short-term SA' (40%), and 'high frequency short-term SA' (10%) (7 spells/year). For long-term SA, we also selected three trajectory groups: 'no long-term SA' (65%), 'low long-term SA' (27%), and 'high long-term SA' (8%). No SA in the short-term SA model, indicated a high probability of no SA in the long-term model and vice versa. The developmental pattern was far less certain if participant was assigned to a trajectory of high SA in either one of the models (short- or long-term SA model). Low occupational class and poor health behaviours were associated with the trajectory groups with more SA. SA does not increase with age among most employees. If either SA rate was high, the developmental patterns were heterogenous. Employers' attention to health behaviours might aid in reducing both short- and long-term SA.

Opinion polarization of immigration and EU attitudes between social classes – the limiting role of working class dissensus

ABSTRACT This study examines polarization in political opinions toward immigration and the European Union between occupational classes, i.e. structural polarization. We maintain that two conditions must hold to indicate structural opinion polarization: high between-class divergence and high within-class consensus. Our main contribution is to study these two conditions systematically for a wide variety of immigration and EU-related topics. Using data from four high-quality German surveys spanning three decades, we document three main findings. First, we find substantial between-class divergence: respondents in typical working class occupations express substantially more unfavorable opinions about immigration and the EU than the upper classes across the majority of survey indicators. Second, however, we also observe considerable opinion heterogeneity within the working class. This lack of within-class consensus limits the potential of mobilizing the working class as a group on the basis of anti-immigration and anti-EU sentiments. Third, while we do not document durable increases in structural opinion polarization over time across most of our opinion indicators, we do draw attention to those individual indicators that show relatively high polarization. Overall, our results suggest limited opinion polarization between occupational classes on immigration and EU issues in Germany.

Work-family conflicts and sickness absence-a register-linked cohort study among young and early midlife employees.

Work-family conflicts (WFC) have been associated with poor mental health, poor self-rated health and sickness absence. However, studies on short sickness absence are lacking and more information is needed also about long sickness absence regarding the direction of WFC, and potential explaining factors particularly among young and early middle-aged employees. The Helsinki Health Study baseline survey (2017) among 19- to 39-year-old municipal employees (N = 3683, 80% women, response rate 51.5%) was linked to employer's sickness absence data. The associations of work-to-family conflicts (WTFC) and family-to-work conflicts (FTWC) with short (1-7 days) and long (over 7 days) sickness absence were analyzed using negative binomial regression analysis. Covariates were age, gender, family-related factors and work-related factors. Stratified analyses by occupational class were performed. The results are presented as rate ratios and their 95% confidence intervals. High WTFC were associated with short (1.25, 1.12-1.40) and long (1.37, 1.11-1.70) sickness absence. High FTWC were also associated with short (1.12, 1.03-1.22) and long (1.24, 1.06-1.45) sickness absence. Adjustment for family-related factors strengthened the associations, whereas adjustment for work-related factors abolished the associations between WTFC and sickness absence. Associations between WFC and sickness absence were observed among two lowest occupational classes only. WFC are associated with both short and long sickness absence. Work-related factors including the quality of supervisory work and shift work play a role in the association. Intervention studies could determine if improvements in combining work and family life lead to a reduction in sickness absence.

Trust in COVID-19 information sources and vaccination status: Exploring social inequalities and differences within the four United Kingdom nations using a representative survey.

To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status. We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination. Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust. This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust.

How Far Can Interventions to Increase Income Improve Adolescent Mental Health? Evidence From the UK Millennium Cohort Study and Next Steps

UK adolescents and young adults are facing increasing rates of mental health problems and extremely difficult economic circumstances. There is strong evidence that interventions to increase income during adolescence can mitigate conditions such as anxiety and depression. However, policymakers lack quantified risk differences in the probability of mental illness between different income groups by which to establish the prospective scale of mitigation. Here, we estimate risk differences using two longitudinal cohort studies: Millennium Cohort Study (cohort members born between 2000 and 2002) and Next Steps (born 1989–1990). We quantify the association between income and risk of depression at age 14, serious mental illness at age 17, and non-psychotic mental illness at age 25. We also conduct sensitivity analysis using numerous other markers of socioeconomic (SES) status. We estimate that those living in the poorest quintile group of households have a greater probability of mental health problems than the richest at ages 14, 17, and 25. We find that other markers of SES status—subjective financial strain, cohort member assessed wealth relative to friends, occupational class, and education—display steeper associations with mental health symptoms relative to associations between mental health symptoms and income. Our findings are likely to be conservative underestimates since they are likely to be attenuated by well-known and large measurement errors in both mental health problems and living standards during adolescence.

Geriatric Health Care Utilization in Selected Rural Area of Assam

Health care utilization is a critical aspect reflecting the effectiveness and accessibility of services, shaped by factors such as proximity, waiting times, privacy, affordability, and treatment efficacy. To delve into this realm, a community-based cross-sectional survey was undertaken, focusing on the geriatric population. Employing a multi-stage random sampling technique, 350 individuals aged 60 years and above were selected from two Community Development Blocks in Kamrup district, Assam. Data collection involved a structured interview schedule, incorporating socio-demographic profiles through Pareek and Trivedi's socio-economic Rural scale and an additional 25 items to assess health care service utilization among the elderly. The results highlighted a higher percentage of females (61.28%) compared to males (48.63%), with a significant portion being widows, illiterate, and unemployed. Socio-economic class-IV accounted for the majority (62.57%) of the participants. Notably, 65.71% of the elderly moderately utilized health care services, while 24.57% inadequately accessed them. Marital status, family type, occupation, and socio-economic class exhibited varying impacts on health care service utilization. The study underscores the pressing need to enhance the overall wellbeing of rural elderly individuals. Proposing community-based geriatric health care services, leveraging existing rural health infrastructure, emerges as a viable solution to address the needs of this demographic group.

Estimating the Reduction of Socioeconomic Inequalities for a More Physically Active Society: A Cross-Sectional Study of the European Union Country Members.

Socioeconomic inequalities significantly impact the accessibility of resources necessary for physical activity, thereby influencing overall physical activity levels and contributing to broader health disparities. Nevertheless, evidence is lacking on quantifying the increase of people who would be physically active through reducing inequalities by a higher socioeconomic position. We conducted secondary data analysis on the 2017 cross-sectional survey of the European Union's population aged ≥18years (n = 27,538). By estimating socioeconomic status percentages and odds ratios between socioeconomic status (education, occupational social class, and economic issues) and physical activity, we calculated age-standardized Prevented Fraction for Population and the total number of individuals that would meet physical activity guidelines by a higher socioeconomic status (eg,from low to middle or high socioeconomic status), along with scenarios of reduced socioeconomic disparities, controlling for age, gender, place of residence, and marital status. A higher socioeconomic status could promote physical activity for a total of 93.0 (84.5-101.8) million people through university education, 28.5 million via high-ranked occupations (24.6-32.8), and 137.9 (129.5-146.2) million by less economic issues (compared with primary education, low-manual occupations, and having economic issues most of the time, respectively)-equivalent to 35.46%, 14.49%, and 55.42% of the Prevented Fraction for Population. Reducing socioeconomic inequalities by 50% could raise these estimations to 148.1 million (134.0-162.8) through education, 43.5 million (37.5-50.3) through occupation, and 223.6 million (209.3-237.8) through less economic issues. Enhancing access to university education, high-ranked occupations, and income impacts physical activity population levels in the European Union.

Classification of e-learning styles in online learning environment

Institutions have tended to provide online training and in-service training by using today's technologies due to the increasing number of employees and the increase in the number of in-service trainings to be given. While the number of trainings held in online environments is increasing day by day, it has gained importance to help learners learn and understand their e-learning styles to organize online learning environments according to their learning styles. The purpose of this research is to investigate the e-learning styles of employees who receive in-service training in corporate companies in online learning environment. The e-learning styles of the employees in this research investigated by gender, generation, education level, occupational experience period, occupational class, occupational lane, e-learning experience duration, and education category they have experienced. The data for the research were collected by the survey method. To determine the e-learning styles of the employees, the e-Learning Styles Questionnaire was applied. Data were collected by e-mail, and 2.796 people participated in the survey. Differences in e-learning styles were found in a sample of 2.796 people according to the variables of gender, generation, education level, occupational experience period, occupational class, occupational lane, e-learning experience duration, and education category they have experienced. As a result of this research, in order to create more learner-centered education environment, it is important to consider learners' e-learning styles. Also, establishing online training and development activities that appeal to the target audience or various learning styles by evaluating the learner profile in educational environments will serve the purpose of improving the competencies of the employees.

JOB AVAILABILITY FOR OLDER WORKERS IN A COMMUNITY: ANALYSIS ON JOB POSTINGS

Abstract Objectives This study examined the current job availability in a local job market for older workers and investigated the required skills the older workers to be competitive. Background Most studies approached older workers’ employment transition from the supply side of the labor market, examining individual-level factors for a successful employment transition. However, there is a lack of knowledge on the demand side, such as job opportunities, regarding older workers’ employment transition. Methods The study uses combined data with job postings collected in the 4th quarter of 2021 from three engines and the O*NET database with occupational information to identify job opportunities and required skills. Additionally, the 2020 and 2021 American Community Survey were used to explore the characteristics of the older workforce in the community. Results A total of 5,160 job postings divided into 468 occupations were found in the community. The most frequently available jobs were healthcare (14%), transportation and material moving (13 %), and sales (13%) occupations, which required some work experience needed. The older labor force mostly had a college or associate degree (45.8%) and was in educational (16%), office (11%), and sales (11%) occupations. All occupations require technological skills. Conclusion The study found a mismatch between the available jobs and the actual older labor force, and those who are in employment transition, even downward movement, would be required some related experience. These suggest that a pre-employment transition program providing job training and age-friendly employment support services would be helpful for older workers in all occupational classes.

Early growth, stress, and socioeconomic factors as predictors of the rate of multimorbidity accumulation across the life course: a longitudinal birth cohort study

Early growth, stress, and socioeconomic factors are associated with future risk of individual chronic diseases. It is uncertain whether they also affect the rate of multimorbidity accumulation later in life. This study aimed to explore whether early life factors are associated with the rate at which chronic diseases are accumulated across older age. In this national birth cohort study, we studied people born at Helsinki University Central Hospital, Helsinki, Finland between Jan 1, 1934, and Dec 31, 1944, who attended child welfare clinics in the city, and were living in Finland in 1971. Individuals who had died or emigrated from Finland before 1987 were excluded, alongside participants without any registry data and who died before the end of the registry follow-up on Dec 31, 2017. Early anthropometry, growth, wartime parental separation, and socioeconomic factors were recorded from birth, child welfare clinic, or school health-care records, and Finnish National Archives. International Classification of Diseases codes of diagnoses for chronic diseases were obtained from the Care Register for Health Care starting from 1987 (when participants were aged 42-53 years) until 2017. Linear mixed models were used to study the association between early-life factors and the rate of change in the number of chronic diseases over 10-year periods. From Jan 1, 1934, to Dec 31, 2017, 11 689 people (6064 [51·9%] men and 5625 [48·1%] women) were included in the study. Individuals born to mothers younger than 25 years (β 0·09; 95% CI 0·06-0·12), mothers with a BMI of 25-30 kg/m2 (0·08; 0·05-0·10), and mothers with a BMI more than 30 kg/m2 (0·26; 0·21-0·31) in late pregnancy accumulated chronic diseases faster than those born to older mothers (25-30 years) and those with a BMI of less than 25 kg/m2. Individuals with a birthweight less than 2·5 kg (0·17; 0·10-0·25) and those with a rapid growth in height and weight from birth until age 11 years accumulated chronic diseases faster during their life course. Additionally, paternal occupational class (manual workers vs upper-middle class 0·27; 0·23-0·30) and wartime parental separation (0·24; 0·19-0·29 for boys; 0·31; 0·25-0·36 for girls) were associated with a faster rate of chronic disease accumulation. Our findings suggest that the foundation for accumulating chronic diseases is established early in life. Early interventions might be needed for vulnerable populations, including war evacuee children and children with lower socioeconomic status. Finska Läkaresällskapet, Liv och Hälsa rf, the Finnish Pediatric Research Foundation, and Folkhälsan Research Center. For the Finnish and Swedish translations of the abstract see Supplementary Materials section.

Hip & Pelvis

The December 2023 Hip & Pelvis Roundup360 looks at: Early hip fracture surgery is safe for patients on direct oral anticoagulants; Time to return to work by occupational class after total hip or knee arthroplasty; Is there a consensus on air travel following hip and knee arthroplasty?; Predicting whether patients will achieve minimal clinically important differences following hip or knee arthroplasty; High-dose dual-antibiotic-loaded cement for hip hemiarthroplasty in the UK (WHiTE 8): a randomized controlled trial; Vitamin E – a positive thing in your poly?; Hydroxapatite-coated femoral stems: is there a difference in fixation?

Zero-Inflated Poisson Regression Modeling of Plant Protein Consumption

Summary This research fitted a discrete distribution for modeling count data. Specifically, Zero-Inflated Poisson (ZIP) regression was used to model plant protein consumption by 400 randomly sampled individuals in Wukari. The data was collected by questionnaire. The ZIP regression model was used based on its ability to model data with excess zeros present in the collected data. Variables considered and used for the analysis are Age, Body Mass Index, Blood Pressure, Occupation, Gender, Weight, Height, Body Reaction, and Consumption Class. The parameters of the ZIP model were estimated using the maximum likelihood estimation technique. The model was tested for Goodness of Fit (GoF) using deviance, scaled deviance, Pearson–χ 2 and scaled Pearson–χ 2 statistics. The results obtained showed that Age, Gender, and Reaction were significant at 5%, and the GoF tests revealed that the Zero-Inflated Poisson regression produces a good fit and is a good model for overcoming the overdispersion effect.

Perceived health inequalities: are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced?

BackgroundOne underexamined factor in the study of lay views of socioeconomic health inequalities is occupation-related health. Examining health by occupational social class has a long history in the UK but has been comparatively overlooked in US public health literatures, where the relationship between health and work has attended more to hazard exposure.MethodsRepresentative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We examine perceptions of inequality and desires for equality across occupation groups as a function of country and key socio-demographic variables.Results67.8% of UK and 53.7% of US participants identified that professionals live longer than routine workers. Multivariate models indicated that US participants were markedly less likely to be aware of occupation-related inequalities after controlling for age, gender, and education. Awareness was negatively related to age (in the US) and recent voting behaviours (both samples). Desiring equal life expectancy was less likely in the US sample, and less likely across both samples among older participants and those with lower levels of education.ConclusionEmploying a novel approach to measuring perceived and ideal life expectancy inequality, this is the first study to examine perceptions of lifespan inequality by occupational groups. It reports widespread understanding of the occupation-related gradient in lifespan and a desire that these inequalities be eliminated in the UK, but considerably less awareness and desire for equality in the US. Greater tolerance for social status inequalities in the US than other similar countries appear to also extend to differences in life expectancy.

Blood concentrations of metals, essential trace elements, rare earth elements and other chemicals in the general adult population of Barcelona: Distribution and associated sociodemographic factors

BackgroundVery little information is available on the population distribution and on sociodemographic predictors of body concentrations of rare earth elements (REE) and other chemicals used in the manufacturing of high-tech devices. ObjectivesTo analyze the distribution and associated sociodemographic factors of blood concentrations of chemical elements (including some metals, essential trace elements, rare earth elements and other minority elements) in a representative sample of the general population of Barcelona (Spain). MethodsA sample of participants in the Barcelona Health Survey of 2016 (N = 240) were interviewed face-to-face, gave blood, and underwent a physical exam. Concentrations of 50 chemical elements were analyzed by ICP-MS in whole blood samples. ResultsAll 50 chemicals studied, including 26 REE and minority elements, were detected. Lead, silver, arsenic, cadmium, mercury, antimony, strontium, thallium and six essential trace elements were detected in more than 70% of the population. The most frequently detected REE and minority elements were europium (62%), thulium (56%), gold (41%), indium (31%), ruthenium (24%), and tantalum (20%). Less affluent occupational social classes had higher percentages of detection of some REE. Median concentrations of silver, arsenic, cadmium and mercury were: 0.091, 3.01, 0.309, and 3.33 ng/mL, respectively. Women had lower median concentrations than men of lead (1.47 vs. 2.04 μg/dL, respectively), iron and zinc, and higher concentrations of copper and manganese. The influence of sociodemographic characteristics on chemical concentrations differed by sex. ConclusionsWhile well-known contaminants as lead, mercury, cadmium, or arsenic were detected in the majority of the population, numerous individuals had also detectable concentrations of chemicals as europium, indium, thulium, or gold. Sociodemographic and physical characteristics (sex, age, social class, weight change) influenced concentrations of some chemicals.

Populist partner: the influence of partner characteristics on populist radical right voting

Abstract In this study, the role of the partner’s self-assessed socio-economic status and political attitudes on populist radical right voting is studied. We made use of a survey among the adult Dutch population (the LISS panel), with information on the self-assessed occupational class, education and political preferences of both partners in cohabiting heterosexual couples. Our results show that, next to the more often found effect of one’s own socio-economic status, the lower the self-assessed occupational class and educational level of the partner, the more likely one is to vote for the PVV, a Dutch populist radical right party. Whereas previous literature has shown that partner’s socio-economic status affects voting behaviour through economic policy preferences, we show the partner’s self-assessed position, for both men and women, is also relevant in explaining behaviour via other political attitudes, such as anti-immigration views. Regardless of one’s own political attitudes, the attitudes of the partner affect one’s likelihood to vote for the populist radical right. With this study, we thus show that including partner characteristics provides further insight into the role of occupation, education, gender, and political attitudes in populist radical right voting, providing evidence of the importance of people’s strong ties in voting behaviour outcomes.

Trends in the ability of socioeconomic position to predict individual body mass index: an analysis of repeated cross-sectional data, 1991-2019.

The widening of group-level socioeconomic differences in body mass index (BMI) has received considerable research attention. However, the predictive power of socioeconomic position (SEP) indicators at the individual level remains uncertain, as does the potential temporal variation in their predictive value. Examining this is important given the increasing incorporation of SEP indicators into predictive algorithms and calls to reduce social inequality to tackle the obesity epidemic. We thus investigated SEP differences in BMI over three decades of the obesity epidemic in England, comparing population-wide (SEP group differences in mean BMI) and individual-level (out-of-sample prediction of individuals' BMI) approaches to understanding social inequalities. We used repeated cross-sectional data from the Health Survey for England, 1991-2019. BMI (kg/m2) was measured objectively, and SEP was measured via educational attainment, occupational class, and neighbourhood index of deprivation. We ran random forest models for each survey year and measure of SEP adjusting for age and sex. The mean and variance of BMI increased within each SEP group over the study period. Mean differences in BMI by SEP group also increased: differences between lowest and highest education groups were 1.0kg/m2 (0.4, 1.6) in 1991 and 1.3kg/m2 (0.7, 1.8) in 2019. At the individual level, the predictive capacity of SEP was low, though increased in later years: including education in models improved predictive accuracy (mean absolute error) by 0.14% (- 0.9, 1.08) in 1991 and 1.05% (0.18, 1.82) in 2019. Similar patterns were obtained for occupational class and neighbourhood deprivation and when analysing obesity as an outcome. SEP has become increasingly important at the population (group difference) and individual (prediction) levels. However, predictive ability remains low, suggesting limited utility of including SEP in prediction algorithms. Assuming links are causal, abolishing SEP differences in BMI could have a large effect on population health but would neither reverse the obesity epidemic nor reduce much of the variation in BMI.

Assessment of Knowledge and Attitude towards Oral Cancer among Healthy Individuals of Anand district, Gujarat

India has the highest incidence rate of Oral Cancer (OC) in the world and estimated 35% of all cancers in the country. Oral cancer is associated with significant morbidity, and low survival. Tobacco widely used in India and it is a major cause of cancer of the upper digestive and respiratory tract. Charotar (Anand) region, a middle Gujarat zone is well known for production and farming of Tobacco. Good Knowledge and Positive attitude towards disease condition are important for any future disease development, early prevention and detection. This study was undertaken with the aim to assess knowledge and attitude of healthy individuals of Anand region towards OCand also to establish levels of awareness regarding oral cancer. Methodology: Community based survey study was conducted using questionnaire during February 2023 to March 2023. Sociodemographic characteristic, knowledge regarding oral cancer, its risk factors, symptoms and attitude towards oral cancer were evaluated using a pre-tested structured questionnaire. Additionally, after receiving response from participants, they all were educated about OC, its risk factors and symptoms, prevention tips and their role as a contributor to society. Results: Total 140 participants were evaluated for Knowledge and attitude for Oral cancer. Majority of them had Poor knowledge, and only participants from Upper class had Good knowledge. On other hand, majority of participants had positive attitude oral cancer. Conclusion: Education level, Occupation and socioeconomic class found as a dependent factors for Knowledge and attitude towards OC. In general the awareness about the oral cancer is poor in participants. Oral Cancer awareness and screening programmes should be actively done among population of Anand district.

Identifying user profiles of healthcare, social and employment services in a working-age population: A cluster analysis with linked individual-level register data from Finland.

A thorough understanding of the use of services in the population is important in order to comprehend the varying service needs of different groups. This explorative study aimed to find distinct user profiles in a working-age population based on individuals' annual use of healthcare, social and employment services and to explore socio-demographic and morbidity-related predictors of the user groups. Administrative register data on the use of various services and individual-level covariates from year 2018 were linked for all residents aged 18-64 of the municipality of Oulu, Finland (N = 119,740). K-means cluster analysis was used to group the study subjects into clusters, based on their frequency of using 22 distinct healthcare, social and employment services during 2018. Multinomial logistic regression models were utilized to assess the associations of cluster assignment with socio-demographic and health-related covariates (sex, age, marital status, education, occupational class, income, days in employment, chronic disease and receipt of different social benefits). Five distinct clusters were identified in terms of service use, labelled low to moderate users of healthcare (82.0%), regular employment services users with moderate use of healthcare (9.6%), supported employment services users with moderate use of healthcare with an emphasis on preventive care (2.9%), frequent users of healthcare, social and employment services (2.9%), and rehabilitation, disability services and specialized healthcare users (2.6%). Each cluster not only showed different patterns of service use but were also differently associated with demographic, socio-economic and morbidity-related covariates, creating distinct service user types. Knowledge on the different user profiles and their determinants may help predict future need and use of services in a population, plan timely, coordinated and integrated services, and design early interventions and prevention measures. This is important in order to save costs and improve the effectiveness of services for groups with different care needs.

ОЦЕНКА ТОЛЕРАНТНОСТИ К ФИЗИЧЕСКОЙ НАГРУЗКЕ НА СТАЦИОНАРНОМ ЭТАПЕ РЕАБИЛИТАЦИИ У ЛИЦ, ПЕРЕНЕСШИХ ОСТРЫЙ КОРОНАРНЫЙ СИНДРОМ

Abstract. Introduction. It is proven that integrated cardiac rehabilitation helps reduce mortality and hospital readmission rates and improves the quality of life of patients with acute coronary syndrome experience. Key aspect of integrated cardiac rehabilitation is aerobic training contributing to higher exercise tolerance. Aim. This research aims at assessing the changes in exercise tolerance in acute coronary syndrome patients at the second stage of medical rehabilitation. Materials and Methods. The research involved 162 patients of the Department of Medical Rehabilitation of Adult Patients with Somatic Diseases, who have experienced acute coronary syndrome. To assess the patients’ exercise tolerance, we used the six-minute walk test under electrocardiography control with the Accordix system (Neurosoft, Russia) upon their admission and immediately before their discharge from the hospital. Along with drug therapy, the personalized medical rehabilitation plans included electrocardiography-controlled aerobic training, laser therapy, psychological intervention, and occupational therapy classes. Rehabilitation efficiency was assessed by six-minute walk test (m) and Functional Independence Measurement (FIM) scale (score). The findings were analyzed statistically using nonparametric criteria. Results and Discussion. There were reduced exercise tolerance and limited daily activities in a significant part of cardiological patients before admission to the hospital. Upon completion of the medical rehabilitation course, the patients’ exercise tolerance increased significantly, resulting in better individual exercise tolerances, longer distances covered within the six-minute walk test, and the larger total amount of daily activities the patients can perform. Conclusions. Electrocardiography-controlled physical training based on the patient’s initial stamina level promotes increasing their exercise tolerance, their tolerance to daily activities, their mobility, independence, and, accordingly, their life quality.

Classification of Potential Wetlands using the Random Forest in Google Earth Engine in Geomorphological Units - Rio Grande do Sul, Brazil

Wetlands are important and valuable ecosystems in the landscape of the extreme south of Brazil. However, they are among the ecosystems threatened by human pressures and climate change. Monitoring and managing these environments is a challenge due to their high spatial and temporal dynamics. The use of remote sensing techniques, supervised classification, and machine learning algorithms offers a promising opportunity to map and monitor wetlands. The objective of this work is to develop a method to map Potential Wetlands (PW) from the integration of images from different satellites, sensor systems, spectral, topographic, climatological and hydrological features, made available on the Google Earth Engine (GEE) cloud user platform. Supervised classification was performed on the geomorphological units Coastal Plain (CP) and Central Depression (CD) considering two classes: Potential Wetlands, which encompasses all types of wetlands, and No Wetlands, for the remaining land use and occupation classes. The supervised pixel-by-pixel classification, individual for each geomorphological unit, allowed more accurate results consistent with previous, consolidated mapping. The PW were mapped with a global accuracy higher than 88% and consumer and producer accuracy higher than 81% in the Coastal Plain and Central Depression. These results allow us to affirm that the proposed methodology enabled the identification of 22% to 24% increase in potential wetlands in geomorphological regions, from spectral signatures, and pixel-by-pixel supervised classification of PW using different image collections and sensor systems.