This document summarizes key findings from the Adult Changes in Thought (ACT) study on healthy aging. It discusses the concept of "enlightened aging" which involves taking proactive steps to build resilience against stressors like COVID-19. The ACT study has found that regular physical activity, education, and social connection can help compress morbidity in late life. It emphasizes developing "three reservoirs" of well-being - mental, physical, and social reserves - to promote successful aging. The COVID-19 pandemic highlighted the importance of these reservoirs, as isolation disrupted routines and increased depression. Overall, the document promotes a proactive approach to aging by managing health risks and adapting to changes with mindfulness.
Abstract On Peer Pressure
Abstract Paper On Stress
Abstract On Depression
Abstract On Water Pollution
Abstract Of Alcohol
Abstract Of Cloning
The Holocaust : An Abstract
Abortion Research Paper
Abstract On Peer Pressure
Abstract Paper On Stress
Abstract On Depression
Abstract On Water Pollution
Abstract Of Alcohol
Abstract Of Cloning
The Holocaust : An Abstract
Abortion Research Paper
Essay about Health and Wellbeing
Health Assessment Essay
Global Health Essay
Nutrition and Health Essay
A Career in Public Health Essay examples
Essay on Careers in Healthcare
Essay on Definitions of Health
Health Anxiety
Essay about Health and Wellbeing
Just Who Are The Baby Boomers
The baby boomers term is applied to individuals who are born after 2nd World War II and before the Vietnam War, thus possibly comprising more than one generation...
Chapter 3 Healthy Lifestyles and Successful AgingChapter 3 .docxwalterl4
Chapter 3 Healthy Lifestyles and Successful Aging
Chapter 3
Longer Lifespans
A. Longevity and Life Expectancy
1. Population trends indicate that, more than ever before in our history, adults are living longer and healthier lives.
2. Life expectancy, the prediction of how long an individual will live, has increased dramatically over the last several hundred years, particularly for women.
3. In all cultures and ethnicities, women live longer than men do.
4. Women generally take better care of their health and manage their stress better.
B. Centenarians
1. Healthy Life Studies of those who have the greatest longevity, the centenarians and supercentenarians, have found that rather than experiencing a typical aging process and simply living longer, these individuals age at a slower pace throughout adulthood.
2. Centenarians generally have controlled their weight, avoided smoking, and handled stress well.
3. There seems to be a genetic component to longevity, demonstrated by the findings that long life generally runs in families.
II. Healthy Lifestyles
A. Physical Fitness
1. The Centers for Disease Control and Prevention (CDC, 2009b) report that only 32.5% of American adults engage in regular leisure-time physical activity.
2. Adults who can complete a minimum of 20 minutes of vigorous and intense activity or a minimum of 30 minutes of moderately intense activity on at least 3 days of the week will find they have enhanced their physiological and psychological functioning as well as reduced the risk of many illnesses.
3. The benefits of maintaining a healthy lifestyle are both immediate and long lasting.
4. Among the many physiological benefits of exercise are:
a. Improved sleep
b. Flexibility
c. Muscle strength
d. Better balance and coordination
e. A stronger immune system (Aldwin et al., 2006; Chodzko- Zajko, 2000)
5. By maintaining a regular fitness program and a desirable weight, individuals may reduce their risk for
a. Coronary heart disease
b. Higher blood pressure
c. Osteoporosis
d. Diabetes
e. Arthritis
f. Some types of cancer (CDC, 2010c; PCPFS, 2010b)
B. Nutrition1. Most adults need to alter their diet to include more calcium, potassium, fiber, magnesium, and vitamins A, D, and E.
C. Sleep
1. Lack of quality sleep causes psychological and physiological problems that can dramatically affect daily functioning.
2. Poor sleep can result in sluggishness and lack of activity, which can reduce quality of life by causing further problems (Reynolds et al., 2001).
3. In the short term, poor sleep or lack of sleep can cause
a. Attention and memory problems
b. Depression
c. A greater risk of falling (AARP & [ILC-USA], 2003; [ILC-USA], 2003)
4. Poor sleep patterns over long periods.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Essay about Health and Wellbeing
Health Assessment Essay
Global Health Essay
Nutrition and Health Essay
A Career in Public Health Essay examples
Essay on Careers in Healthcare
Essay on Definitions of Health
Health Anxiety
Essay about Health and Wellbeing
Just Who Are The Baby Boomers
The baby boomers term is applied to individuals who are born after 2nd World War II and before the Vietnam War, thus possibly comprising more than one generation...
Chapter 3 Healthy Lifestyles and Successful AgingChapter 3 .docxwalterl4
Chapter 3 Healthy Lifestyles and Successful Aging
Chapter 3
Longer Lifespans
A. Longevity and Life Expectancy
1. Population trends indicate that, more than ever before in our history, adults are living longer and healthier lives.
2. Life expectancy, the prediction of how long an individual will live, has increased dramatically over the last several hundred years, particularly for women.
3. In all cultures and ethnicities, women live longer than men do.
4. Women generally take better care of their health and manage their stress better.
B. Centenarians
1. Healthy Life Studies of those who have the greatest longevity, the centenarians and supercentenarians, have found that rather than experiencing a typical aging process and simply living longer, these individuals age at a slower pace throughout adulthood.
2. Centenarians generally have controlled their weight, avoided smoking, and handled stress well.
3. There seems to be a genetic component to longevity, demonstrated by the findings that long life generally runs in families.
II. Healthy Lifestyles
A. Physical Fitness
1. The Centers for Disease Control and Prevention (CDC, 2009b) report that only 32.5% of American adults engage in regular leisure-time physical activity.
2. Adults who can complete a minimum of 20 minutes of vigorous and intense activity or a minimum of 30 minutes of moderately intense activity on at least 3 days of the week will find they have enhanced their physiological and psychological functioning as well as reduced the risk of many illnesses.
3. The benefits of maintaining a healthy lifestyle are both immediate and long lasting.
4. Among the many physiological benefits of exercise are:
a. Improved sleep
b. Flexibility
c. Muscle strength
d. Better balance and coordination
e. A stronger immune system (Aldwin et al., 2006; Chodzko- Zajko, 2000)
5. By maintaining a regular fitness program and a desirable weight, individuals may reduce their risk for
a. Coronary heart disease
b. Higher blood pressure
c. Osteoporosis
d. Diabetes
e. Arthritis
f. Some types of cancer (CDC, 2010c; PCPFS, 2010b)
B. Nutrition1. Most adults need to alter their diet to include more calcium, potassium, fiber, magnesium, and vitamins A, D, and E.
C. Sleep
1. Lack of quality sleep causes psychological and physiological problems that can dramatically affect daily functioning.
2. Poor sleep can result in sluggishness and lack of activity, which can reduce quality of life by causing further problems (Reynolds et al., 2001).
3. In the short term, poor sleep or lack of sleep can cause
a. Attention and memory problems
b. Depression
c. A greater risk of falling (AARP & [ILC-USA], 2003; [ILC-USA], 2003)
4. Poor sleep patterns over long periods.
Similar to Larson_Enlightened Aging_Skyline_Nov92023.pptx (14)
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Larson_Enlightened Aging_Skyline_Nov92023.pptx
1. October 2022
Enlightened Aging:
Building Resilience Lifelong Including
Amidst Stressors like COVID-19
Eric B. Larson, MD, MPH
Professor of Medicine and Health Services, University of Washington; Founding Principal
Investigator of the UW/Kaiser Permanente Adult Changes in Thought study
Skyline at First Hill
2. ACT study participant Evangeline Shuler, age 100
Community activist, mother,
social worker…and tango
dancer
A role model for “enlightened
aging”
Most of us have the potential
to live a shockingly good life
into our 90s and 100s.
2
4. What is “enlightened” aging?
4
Knowledge of healthy aging + foresight to use it.
• We take concrete steps to prepare well for late life.
• We adapt to changes that are natural part of aging.
• We expect stress: Bend not Break
5. The ACT Study: Adult Changes in Thought
A longitudinal study focused on promoting healthy aging.
A collaboration of Kaiser Permanente and the University of
Washington
Continuously funded for more than 30 years by the National
Institutes of Health
Maintains an enrollment of 2,000-3,000 persons aged 65 and older
Now includes one of the world’s largest research populations of
very old participants (over age 85).
Successful renewal: Expanded to $56M award
5
6. Why research on healthy aging matters
Fastest growing segment of our population is the oldest old:
1980: 720,000 Americans over age 90.
2010: 1.9 million Americans over age 90
And here comes the Baby Boom!
From 2010 to 2050, the total population aged 90 and over will
more than quadruple.
7. If current trends continue…
Half of all babies born in 2000 will live to see the year 2100!
7
8. Risk of dementia grows with age
Dementia currently affects:
3% of people age 65-75
19% of people age 75-85
35% of people age 85-90
50% of people age 90-95
75% of people age 95 and older
But what if we could change this? What if we don’t?
Much of our research focuses on ways to prevent or delay the
onset of dementia.
9. Lessons from “The Greatest Generation”
My parents' cohort lived
longer than they ever
imagined they would.
We witnessed their
victories and struggles.
What will we do
differently?
How will we benefit from
new discoveries in healthy
aging?
How can we experience
“enlightened aging”?
Palmer and Marion Larson, 2003
9
11. Good news: Compression of morbidity
Goal: To postpone disability and illnesses of old age until the very end.
Our studies show this compression is happening with Alzheimer’s
disease.
Rates of dementia are declining, showing that late-life dementia is
preventable or at least can be delayed.
• Number of people with Alzheimer’s and dementia is growing.
• But the percentage of very old with these conditions is actually dropping!
• Greater percent of very old people with Alzheimer’s disease and dementia are
staving off symptoms until just a year or two before they die.
12. What’s behind this compression of aging?
Advances in education
Better health care
Declines in cardiovascular risk (less smoking, better control of blood
pressure and cholesterol)
Healthier lifestyles
Better socioeconomic conditions
COVID-19: An opportunity to learn and adapt
Obesity epidemic and more diabetes could wipe out these gains.
But healthy lifestyles and better health care can turn the tide!
Cause for optimism: We can take steps to prevent or postpone
disability until well into late life.
14. Selected ACT findings: Falls & Footwear
1985-88: Early studies showed just how
devastating falls are—and how frequent.
Contributing factors: sleeping pills, other
common psychoactive drugs,
weakness, and impaired balance.
(Buchner, et al)
2004: To avoid falls, wear lace-up or
Velcro shoes with adequate heel
support and non-slip soles. Avoid high
heels. And don’t walk around barefoot
or in stocking feet—even
indoors.(Koepsell, et al)
15. Selected ACT findings: Drug effects
1987: Certain drugs, especially
sedatives, can cause confusion and
falling.(Larson et al)
2006: Statin drugs, used to treat
high cholesterol, may be linked to
fewer of the microscopic brain
changes that are typical of
Alzheimer’s disease. (Li, et al)
16. Selected ACT findings: Drug effects
2015: Long-term use of high doses
of anticholinergic drugs such as
Benadryl were linked to greater
risk of dementia. (Gray, et al)
2016: Benzodiazepines (Valium,
Zanax) and opioids do not seem to
increase risk of dementia, but have
other dangers in older people.
(Gray, et al)
17. Selected ACT findings: “Mixed dementia”
2011: Ecology of the aging brain: People without signs of dementia can live to old-old
age (older than 90)—even though their brains have advanced changes of
Alzheimer’s disease (plaques and tangles). (Sonnen, et al)
Brain tissue with neurofibrillary plaque
and neuritic tangle
Images: Neuropathology, Dimitri P.Agamanolis,MD. 2014
Large numbers of plaques and tangles
18. Selected ACT findings: Links between
dementia and other chronic conditions
2011: The most common kind of chronically irregular heartbeat
(atrial fibrillation) is associated with a greater risk of dementia,
including Alzheimer's disease. (Dublin, et al)
2011: Depression at age 50 or older is linked to an increase in
dementia and may be an early sign of the condition. (Li, et al)
2013: High blood sugar levels averaged over a five-year period
were associated with rising risks for dementia, even among people
who do not have diabetes. (Crane, et al)
19. Selected ACT findings: Physical activity
2006: Seniors who
exercise three or more
times a week have a 30-
40% lower risk for
dementia vs. those who
exercise less. Risk
reduction was greatest
for those with lower
performance levels.
Even small change
linked to big
improvement.
(Larson, et al)
20. Selected ACT findings: Physical activity
2006: First signs of dementia may
be changes in physical function,
often preceding mental decline.
Good physical function is linked to
delay in Alzheimer’s, so re-
engaging in physical activity may
help to stop or slow cognitive
decline. (Wang, et al)
2008: Seniors who participate in
fitness programs like Silver
Sneakers have lower health care
costs. (Nguyen, et al)
22. Summary: Impacts of COVID-19 on the ACT cohort
High response rate for surveys administered by phone / online
– Without efforts to recontact people who said they would fill out online
Non-respondents demographically similar but older / sicker / more
depressed compared to respondents
Most not impacted by the virus directly; very few of these individuals got
sick due to COVID
Impressive impact on daily life, physical activity, anxiety, and depression
Substantial increases in individual depression items
– Exception of restless sleep
Substantial shift upward of total depression scores
Almost everyone now vaccinated
24. Case in point: Ben Stevenson
Professor, writer, world
traveler, horseman
Built brain and body
reserves through exercise
and education
Stayed resilient through
physical, mental and social
activity
Lived to age 101
24
25. Resilience: The ability to adapt to adversity
Resilience allows
people to bounce
back from physical
set backs, illness,
and hardships.
Like a tree in a
windy climate, they
don’t break, they
bend.
26. Remember Evangeline Shuler
Widowed at 60, became a
world traveler
Adapted well to changes in
her living arrangements,
physical limitations, eventual
blindness.
Built resilience by staying
active physically, mentally.
Lived to age 107.
26
27. Enlightened aging follows a PATH
that leads to resilience
The steps on this PATH are:
Pro-activity: Take an active role in
managing your own health and well
being.
Acceptance: Know that changes will
come and accept them with
mindfulness and equanimity.
THree reservoirs: Build your reserves
of well being in three ways: Mentally,
physically, and socially—for the long,
fulfilling road ahead.
28. Pro-activity: Take an active role in health
Aging is NOT an inevitable downward spiral.
Older people now have a
greater chance of avoiding
disability than ever before!
Better control of
cardiovascular risk means
lower rates of dementia.
Up to half of all Alzheimer’s
cases may be attributable
to modifiable risk factors.
29. Pro-activity: Take an active role in your
own health and well being
Take charge of your health by preventing illness and managing
chronic conditions:
Don’t smoke or chew tobacco
Avoid excessive alcohol use
Maintain a healthy weight
Exercise regularly
Manage stress by learning to cope with problems
30. Pro-activity: Take an active role in your own
health and well being
Partner with your health
care providers to take
care of yourself :
“Shared decision-
making” about your
care
Avoiding
over-diagnosis,
over-treatment,
over-prescribing
31. Acceptance: Prepare for change with
equanimity and mindfulness
What do older people want? Survey of ACT and Kame
participants’ definition of “successful aging” showed:
Longevity? Not so much.
Meaning, fulfillment, purpose mattered most.
Strong relationships with friends and family
The ability to continue contributing through work,
volunteerism, hobbies.
Independence (“I don’t want to be a burden to others.”)
When you plan for the changes aging brings, keep these
values in mind.
32. Acceptance and the U-shaped happiness curve
Many studies have reached
the same conclusion about
happiness:
High at age 18-21
Low in middle age
Rises again in old old age.
32
33. THree reservoirs: Mental, physical,
and social
Mental reserves may be measured in brain
development and education.
Research shows people with higher levels of education
face a lower risk of Alzheimer’s disease later in life.
Keep replenishing mental reserve; Active not just
passive
34. THree reservoirs: Mental, physical,
and social
Build bone strength, muscles, cardiovascular system, vision, and
hearing.
Because the mind and body are linked, your physical reserves
have a tremendous influence on your mental capacity.
Our findings on regular physical activity to lower risk of dementia
demonstrate this connection.
Any physical activity better than none; avoid couch potato and
prolonged sedentary time
35. THree reservoirs: Mental, physical,
and social
Social connection
gives life meaning
and purpose
A strong social
network helps
older people to
grow old in a
place that’s safe
comfortable,
stimulating, and
stable.
.
36. THree reserves: mental, physical, social
Staving off disability requires four inter-related functions:
1. Cognitive function (Remember: The brain relies on whole-body health,
especially avoiding heart disease and stroke.)
2. Mobility (Takes balance, bone strength, and muscle strength)
3. Hearing
4. Vision
Preserve, protect, and enhance these functions by staying active
mentally, physically, and socially.
We’re like athletes in a marathon. We need resources all the way to
the finish line!
37. Societal challenges ahead: healthy longevity
Baby Boom generation is predicted live longer than any previous
generation.
Social policies are needed to:
Extend productive years, including working later without the
drudgery that makes retirement more attractive than work.
Adopt effective programs to reduce vascular risk factors,
especially obesity and diabetes.
Focus on health promotion and maintenance while meeting
everyday health care needs of people as they grow old.
Promote better late-life planning and decision making.
38. To address societal challenges
For the health of tomorrow’s generations of elderly:
Assure high-quality
early-life education
Create strong
communities:
• Social and
economic well being
• Fewer disparities
• Reduced poverty
40. And remember…
“There is only one solution if old age is not to be an
absurd parody of our former life, and that is to go on
pursuing ends that give our existence a meaning—
devotion to individuals, to groups or to causes,
social, political, intellectual.”
--Simone de Beauvoir (1908-1986)