Cal cuidar-se per cuidar? qualitat de vida i sobrecàrrega del cuidador informal familiar en cuidadors de persones grans dependents

En les darreres dècades, l’esperança de vida ha augmentat notablement. Aquesta realitat no tan sols implica que visquem més anys sinó que, també, tinguem més possibilitats de patir tota mena de malalties pròpies de l’edat (com les demències, les degeneratives, etc.) i de patir-les més anys. Per edat, els que cuidaven ahir, són els cuidador d’avui: més grans, més envellits i que, a més, cuiden durant més anys. Un cuidador són dues vides. Així que, com la que s’està cuidant, la vida del cuidador també necessita ser cuidada ja que, sinó, la cura pot esdevenir una càrrega i un factor negatiu en el desenvolupament del mateix cuidador amb conseqüències tant físiques, com psíquiques i psicològiques. Aquesta investigació es centra en la realitat d’aquests cuidadors, en la seva qualitat de vida i en la seva experiència; tenint en compte també, els diversos punts de vista dels professionals que, des de institucions distintes, treballen i actuen en aquests casos.In recent decades, life expectancy has increased dramatically. This does not mean that only live longer but also more likely to suffer from all kinds of diseases typical of the age (such as dementia, degenerative, etc.) and years of suffering the most. For age, who took care of yesterday are the caregiver today: bigger, aging and also care for more years. A caregiver are two lives. So, as being caring, life caregiver also need to be careful because, but care can become a burden and a negative factor in the development of the same caregiver consequences both physical and mental and psychological. This research focuses on the reality of these carers in their quality of life and their experience; taking into account the various views of professionals from different institutions, work and act in such cases

Folic Acid Supplementation in Pregnancy and the Risk of Pre-Eclampsia-A Cohort Study.

This prospective cohort study designed to assess the effect of folic acid supplementation in pregnancy on the risk of preeclampsia (PE) took place in Ottawa, ON and Kingston, ON, Canada, from September 1, 2002 to August 31, 2008. Pregnant women, less than 20 weeks gestational age were recruited and delivered in the Ottawa region and the Kingston General Hospital. Demographic characteristics of the study participants and the patterns of supplementation of folic acid were described and occurrence of PE between women with folic acid supplementation during pregnancy and women without were compared. Multiple logistic regression was used in the estimation of the independent effect of supplementation of folic acid. Additional analyses assessing the effect of low RBC and serum folate and dose-response relationship were performed. Analyses were performed in all study participants, and then in high risk and low risk sub-groups, respectively. A total of 7,669 participants were included in the final analysis. Ninety five percent of the study participants were taking folic acid supplementation in early second trimester. The rate of PE was lower in the supplementation group than in the no supplementation group, and the difference was statistically significant in high risk women. Similar patterns of associations were observed in analysis by RBC and serum folate levels and in dose-response analysis. Folic acid supplementation in pregnancy may reduce PE risk in pregnant women, especially in those women with increased risk of developing PE

Adverse maternal and neonatal outcomes among singleton pregnancies in women of very advanced maternal age: a retrospective cohort study

Abstract Background There is an increasing prevalence of women who tend to delay childbirth until a very advanced age. However, there is sparse data regarding very advanced maternal age (vAMA) and the interplay between vAMA and assisted reproductive technology (ART) on adverse perinatal outcomes. The study aimed to assess the risk of adverse maternal and neonatal outcomes of vAMA women (≥43 years), and to investigate the effect of maternal age on adverse maternal and neonatal outcomes in ART pregnancies. Methods Data was obtained from a population-based retrospective cohort of women who delivered in Ontario, Canada, between April 1st, 2012 and March 31st, 2015. The adjusted relative risks (ARR) and 95% confidence intervals (CI) for adverse maternal and neonatal outcomes were estimated by using multivariate log-binomial regression models among age groups. All models were stratified by the utilization of ART (ART and spontaneous conceptions). Results Women at vAMA had a higher risk of composite outcome comprised of preeclampsia, intrauterine growth retardation, stillbirth, and placental abruption than the younger counterparts (ARR = 1.38, 95% CI: 1.23–1.55 compared to mothers aged 20–34; ARR = 1.26, 95% CI: 1.12–1.42 compared to mothers aged 35–42). Increased risk of the primary outcome in ART compared to spontaneous conception was only observed in women aged 20–34 years (ARR = 1.24, 95% CI: 1.14–1.35). For women conceived with ART, the risk for the primary outcome significantly increased in women at vAMA (ARR = 1.29, 95% CI: 1.01–1.65 compared to mothers aged 20–34; ARR = 1.36, 95% CI: 1.06–1.74 compared to mothers aged 35–42). Conclusion Women at vAMA have higher risks of adverse maternal and neonatal outcomes. Although the utilization of ART may carry an independent role for adverse perinatal outcomes, it does not further enhance the adverse effect of vAMA

Immunization and technology among newcomers: A needs assessment survey for a vaccine-tracking app

Objectives: Newcomers experience unique challenges with respect to vaccination. These challenges are compounded by the need to navigate complex vaccination catch-up schedules upon arrival in their new home countries. Our group has pioneered the development of CANImmunize, a free, bilingual, pan-Canadian digital application designed to empower individuals to manage their vaccination records. To inform how a vaccine tracking app such as CANImmunize might be tailored to meet the unique needs of newcomers, this study sought to determine commonly spoken languages, technology use, and current methods of vaccine tracking among recent newcomers to Canada. Methods: Government-assisted refugees attending a health clinic in Ottawa, Canada were invited to complete a 17-question needs assessment survey. The survey captured data on household demographics, spoken languages, country of origin, technology use and methods used to track vaccination history. Results: 50 newcomers completed the needs assessment survey. Arabic was the predominant language spoken by surveyed individuals. Although 92% of participants owned a smartphone, the majority did not actively use digital health applications. 18 (36%) participants reported being vaccinated before arriving in Canada. 27 (54%) participants were parents, 23 of whom reported that their children were vaccinated prior to arrival in Canada. 38 (76%) participants indicated that they would use a vaccine tracking app such as CANImmunize if it were translated into their primary language of communication. Conclusions: The results of our study indicate that mobile technology may be a useful tool to help newcomer families stay on track with provincial and territorial immunization schedules

Survival curves for cumulative incidences of gestational hypertension and pre-eclampsia, stratified by common risk factors.

<p>Survival curves stratified by BMI (a, b), parity and pre-eclampsia history (c, d), diabetes (e, f) and number of babies (g, h), adjusted by age, race, education, household income, smoking, folic acid supplementation, BMI, parity, pre-eclampsia history, conception through assisted reproductive technologies, diabetes, infant sex, and number of babies. Risk factors modified the average GA in women with GH and PE in similar patterns. The survival curves were left-shifted in high-risk women (overweight or obese, nulliparous, or with PE history) compared with those in low-risk women (normal-weight, parous, or without PE history). The curves for PE were also left-shifted compared with the curves for GH.</p

Comparison of outcomes in women with gestational hypertension and pre-eclampsia using logistic regression model.

<p>Comparison of outcomes in women with gestational hypertension and pre-eclampsia using logistic regression model.</p

Comparison of risk factors for early- and late-onset pre-eclampsia.

<p>Comparison of risk factors for early- and late-onset pre-eclampsia.</p

Incidence of gestational hypertension and pre-eclampsia by characteristics of participants in the OaK birth cohort.

<p>Incidence of gestational hypertension and pre-eclampsia by characteristics of participants in the OaK birth cohort.</p

Comparison of risk factors for gestational hypertension and pre-eclampsia.

<p>Comparison of risk factors for gestational hypertension and pre-eclampsia.</p