• Title/Summary/Keyword: 50 years and older

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Screening for Breast Cancer in a Low Middle Income Country: Predictors in a Rural Area of Kerala, India

  • Sreedevi, Aswathy;Quereshi, Mariya Amin;Kurian, Beteena;Kamalamma, Leelamoni
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1919-1924
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    • 2014
  • Background: In India, breast cancer is the leading malignancy among women in a majority of the cancer registries. Therefore it is important to understand screening practices and its predictors, including in rural areas with high female literacy and good health indices. Materials and Methods: A cross-sectional study with multistage sampling was conducted in Vypin Block, Ernakulam district, Kerala, India. Four Panchayats (self administration units) were randomly chosen and a woman in every second household was invited to participate from the tenth ward of each. Thus a total of 809 women were interviewed. Results: The majority of the repondents (82.1%) were not aware of risk factors and about a third (37.9%) were not aware of symptoms of breast cancer. About half of the population studied (46.6%) had undergone screening. Age (35-50 years), being married, health professionals as source of information and working were significant predictors of screening. Logistic regression showed that older women (35-50 yrs) were more likely to practice screening. Out of the never screened, about a third (35%) were desirous of doing it, but had not for various reasons and 53.5% were not willing to screen. The reasons identified for not screening among those desirous of doing it were grouped into knowledge 66 (43.4%), resources 23 (15.1%) and psychosocial 32(21.1%) factors. Unmarried women were significantly more likely to express factors related to all the three domains. Conclusions: This study showed that in spite of the absence of a population-based screening program, about half of the study population had undergone some type of screening. The older women (35-50 years) in particular were significantly more likely to practice screening. At this critical juncture, a high quality breast cancer awareness and screening initiative can help to consolidate the gains and tackle knowledge, resource and psychosocial barriers.

Clinical Outcomes and Cost-Effectiveness of Osteoporosis Screening With Dual-Energy X-ray Absorptiometry

  • Chiao-Lin Hsu;Pin-Chieh Wu;Chun-Hao Yin;Chung-Hwan Chen;King-Teh Lee;Chih-Lung Lin;Hon-Yi Shi
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1249-1259
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    • 2023
  • Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

Influence Factors on Subjective Health Status of middle-aged and Elderly: Utilized of the 7th National Health and Nutrition Examination Survey(2018) (중·장년, 노년의 주관적 건강상태에 미치는 영향요인: 제7기 국민건강영양조사(2018) 활용)

  • Hae-Ryoung Park
    • Journal of Industrial Convergence
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    • v.20 no.12
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    • pp.213-217
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    • 2022
  • The purpose of this study was to investigate the relationship between age, physical activity (walking, strength exercise), subjective body shape recognition, and weight change with subjective health status in the population aged 30 years or older among the data of the National Health and Nutrition Examination Survey (2018) of Koreans. The subject and method of this study was a secondary analysis study using the 7th 3rd year National Health and Nutrition Examination Survey (2018). Age, walking days per week, strength training days per week, subjective health status, subjective body shape recognition, and weight change during the year were used the SPSS (p<.01). The response rate of walking for 7 days (every day) was 21.9% for those aged 30-45, 27.2% for those aged 50-64, and 26.6% for those aged 65 or older. aged 8.4% and over 65 years old 7.9% (p<.001). The subjective health status was positively correlated with age (.091), number of walking days per week (.739), number of days of strength exercise per week (.530), subjective perception of body shape (.256), and weight change over one year (.303). There was a relationship (p<.01). In this study, the age group that answered 'bad' in subjective health status was the highest at 21.4% of those aged 65 or older, followed by 15.7% of those aged 50-64 and 11.0% of those aged 30-45. This could be expected to improve subjective health status by walking and strength training. Based on these results, it was intended to provide basic data for preparing health-related programs to improve subjective health status of individuals according to age.

Trends in Epidemiology, Clinical and Histopathological Characteristics of Breast Cancer in Iran: Results of a 17 Year Study

  • Afsharfard, Aboulfazl;Mozaffar, Mohammad;Orang, Elahe;Tahmasbpour, Eisa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6905-6911
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    • 2013
  • Background: Breast cancer (BC) is the top cancer among women worldwide and the most frequent malignancy among Iranian women over the past few decades. The increasing trend and high mortality rate of BC in the developing world necessitates studies concentrating on its characteristics in countries in Asia. The current study focused on clinical and histopathological features of BC among Iranian females. Materials and Methods: This retrospective study involved 714 Iranian patients with histopathologically proven BC undergoing resection of primary tumours and axillary clearance. Demographic, clinical and histopathological data were obtained and studied between ten year age groups (${\leq}40$ years, 41-50 years, 51-60 years, 61-70 years, and ${\leq}71$ years) in four chronologic phases from 1994-2009. Results: Mean age of patients was $49.4{\pm}13.1$ years. Most of cases (33.2%) were in 41-50 group. Mean size of primary tumors was $3.94{\pm}2.47$ cm and 87.1% of cases had infiltrative ductal carcinoma. Modified radical mastectomy was the most common method of surgery carried out (48.8%). Some 57.1% of tumors were in pT2 and tumor size decreased significantly during the period (p<0.05). The most common BC stage was llla (27%). Lower BC stages (0 and 1) constituted 13.9% of the diagnosed tumors. Our series of patients aged ${\leq}40$ had larger tumors (mean $4.73{\pm}3.02$ cm) compared to older age groups (p=0.003). Lower stages (0 and I) were more frequent among the oldest patients while nearly 50% of patients aged ${\leq}40$ had tumor stage III. We also observed a significant decreasing trend in the mean LN count (p<0.05) and blood vessel invasion (p=0.023) from younger to older age groups. Conclusions: More aggressive disease for younger age groups, earlier peak incidence age and high rate of advanced BC at the time of diagnosis among Iranian women, were the main findings of this study.

Complex Sample Analysis of the Effect of Alcohol Drinking and Smoking Period on Bone Mineral Densities in Korean Men Aged 50 Years and Over (50세 이상 한국 남성의 알코올과 흡연력이 골밀도에 미치는 영향에 대한 복합표본 분석)

  • Kim, Moon Ja;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.157-166
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    • 2018
  • Purpose: This study aimed to identify the effect of the level of alcohol drinking and smoking period on the occurrence of lumbar and femoral neck osteoporosis in men aged 50 years and over. Methods: This study analyzed the data of 1,410 men based on results of a National Survey on Nutritional Health for the period 2010-2012. Complex sample multi-variate logistic regression analysis was conducted to determine whether alcohol drinking and smoking period were associated with osteoporosis in men aged 50 years older. Results: The risk of osteoporosis in the femoral neck was 3.43 times (95% confidence interval [CI]=1.15~10.29) higher in men who consumed less alcohol and smoked for a long time compared to men who smoked more than 40 years and consumed much alcohol at once. The risk of osteoporosis in the lumbar spine was 3.45 times (95% confidence interval [CI]=1.69~7.04) higher respectively. Men who consumed much alcohol at a time and smoked less than 40 years were 1.54 (1/0.65) times (95% confidence interval [CI]=0.45~0.93) more likely to be classified as normal than the men who consumed much alcohol and had a long smoking period. Conclusion: The interaction of excessive drinking and smoking has a more detrimental effect on bone mineral density.

Factors Associated with Physical Activity in Older Adults Living Alone: Using Data from the 2019 Community Health Survey (지역사회 거주 1인가구 노인의 신체활동 관련요인: 2019년 지역사회건강조사 자료 이용)

  • Lee, Eun Sook;Kim, Hye Young;Ko, Eun
    • Journal of muscle and joint health
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    • v.30 no.3
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    • pp.242-253
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    • 2023
  • Purpose: The purpose of this study was to identify factors associated with physical activity in older adults living alone. Methods: This is cross-sectional, correlational study used secondary data from the 2019 Community Health Survey. The participants were 19,134 older adults aged 65 years or older and living alone. Data were analyzed using descriptive statistics, the 𝜒2 test, and linear regression with the SPSS/WIN 27.0 program. Results: The participants' average amount of physical activity was 1,359.32 MET-min/week; 50.7% were inactive, 38.6% were minimally active, and 10.7% were health-promoting active. Demographic factors that predicted physical activity were gender, age, education level and monthly income, whereas health behavior factors included subjective health status and high risk drinking (R2=.055, p<.001). Psychological factors were sleeping time, stress, depression and fear of falling, and social factors included social contact with neighbors or friends, and participation in social or leisure activites(R2=.070, p<.001). Conclusion: It is important to determine the level of physical activity in older adults living alone. Demographic characteristics, health behaviors, psychological factors, and social factors should be considered in the development of specific and integrated nursing interventions to increase physical activity in older adults.

Impact of COVID-19 on Dental Trauma in Korea (국내에서 발생한 치과적 외상에 대한 코로나 바이러스 감염증-19의 영향)

  • Son, Donghyun;Lee, Yoon;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.1
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    • pp.76-84
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    • 2022
  • The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service's Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed. Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply. After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

Predictive Model for Quality of Life of the Older Men Living Alone (남성 독거노인의 삶의 질 예측모형)

  • Kim, Su Jin;Jeon, Gyeong-Suk
    • Journal of Korean Academy of Nursing
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    • v.50 no.6
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    • pp.799-812
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    • 2020
  • Purpose: This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone. Methods: A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. Results: The final model with 14 of the 8 analysed paths showed a good fit to the empirical data: χ2 = 173.26(p < .001, df = 53), normed χ2 = 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects. The variables included in the eight significant paths explained 83.7% of variance in the prediction model. Conclusion: Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.

Helplessness and Health Behavior of Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 무기력과 건강행위에 관한 연구)

  • Han, Jung-Won;Park, In-Hyae
    • Journal of muscle and joint health
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    • v.15 no.1
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    • pp.33-40
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    • 2008
  • Purpose: This study was to find out the relationships between helplessness and health behavior of patients with rheumatoid arthritis. Method: The subjects were 293 rheumatoid arthritis patients who visit 2 rheumatology outpatient clinics in G city. Data were collected by questionnaires including Arthritis helplessness index(Nicassio, Wallston, Callahan, Herbert, & Pincus, 1985)and health behavior assessment scale(Jo, Oh & Choe, 2000). The data were analyzed with Pearson correlation coefficient, t-test, ANOVA and Duncan's multiple range test. Results: The majority of the subjects were women and the mean age was 50.4years. The mean duration of illness was 8.9years. There were negative correlations between the degree of helplessness and the degree of health behavior. The degree of helplessness was significantly high in those who were older, female, less educated, out of workforce, and those who had no chances to attend any arthritis-related classes. The degree of health behavior was significantly low in those who were older, high school graduate, in higher economic status, married, and those who had chances to attend arthritis-related classes. Conclusion: To reduce the helplessness of rheumatoid arthritis patients, the nursing intervention which is to increase the health behavior should be developed and provided to the rheumatoid arthritis patients.

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Ebstein's Anomaly in Transthoracic Echocardiography: Two Case Reports (경흉부 심초음파에서 관찰된 엡스타인 기형: 증례보고 2례)

  • Kim, Sung-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.265-269
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    • 2019
  • Ebstein's anomaly is attached to the right ventricle with the tricuspid leaf attached to the lower right ventricle without any attachment to the tricuspid annulus. Most patients in their 20s are alive. Patients older than 25 years of age are similar in the incidence of heart failure and sudden death, and survive approximately 70% from 2 years, and 50% from 3 years, from 5% to over 50 years of age. Through this example, Ebstein's anomaly exists in various forms. A 22 year old case with WPW syndrome and those who survived to 77 years of age are reported. The normal heart structure in the apical four-chamber view should be observed on similar lines, even though the tricuspid annulus is slightly lower than the mitral annulus. If not, there will be some doubt regarding this anomaly. Furthermore, echocardiography plays an important role in the diagnosis and prognosis of congenital heart disease.