RESUMO
With particular focus on availability of family care, research on relationships in later life have often emphasized dynamics inside homes and connections with direct family members. However, a growing number of scholars recognize changes in family practices and the prominence of different types of non-kin ties that are as important as family to older people. Connidis has proposed a sociological approach to capture the realities of personal relationship in later life. Informed by Connidis' approach, we apply qualitative lenses to study social capital in analyzing 40 semi-structured interviews conducted with Chilean people aged 60-74 years. We used a thematic analysis to examine the circumstances under which older people mobilize help through different types of kin and non-kin ties as bonding or bridging social capital. Though literature on social capital describes friends and family members as bonding ties, our findings indicate that they play a double role as bonding and bridging social capital in their own unique way, depending on circumstances. Friends, in comparison to family ties, bridge the older person with a variety of worldviews and lifestyles, helping them to advance their wellbeing in the face of life transitions and challenges experienced with aging. Study participants associated seeking help from others with notions of material and physical dependency, laziness, and a commitment to return help. The preference to seek different types of support from a variety of relationships can be interpreted as a way to manage ambivalence within a larger socio-cultural context.
Assuntos
Capital Social , Idoso , Chile , Família , Amigos , Humanos , Apego ao Objeto , Apoio SocialRESUMO
This study uses an interpretive narrative approach to compare and contrast assumptions regarding social integration (participation in meaningful and multiple roles, and engagement in social networks) as promoted in the Chilean Comprehensive Policy for Positive Aging, with the expectations of interviewees aged 60 to 74 years. The Policy assumes specific forms of social integration by: offering different options of social integration to dependent vs. independent older people, encouraging autonomy and self-management, and assuming the primacy of family responsibility in older people's care. Both the Policy and the interviewees emphasize the value of autonomy and independence in old age; the latter, however, do not place family at the frontline when care is needed. Understanding the matches and gaps between policy assumptions and older people's expectations for social integration, including the role of family caregiving, can open new possibilities to prevent social isolation and promote different forms of social support that are valued by older adults for their emotional and practical benefit.
Assuntos
Envelhecimento , Política Pública , Idoso , Humanos , Relações Interpessoais , Integração Social , Apoio SocialRESUMO
UNLABELLED: Background. Nutritional deficiencies may aggravate the course of chronic hepatitis C (CHC). Our aim has been to perform a comprehensive analysis of body composition and nutritional deficiencies in CHC patients in non-cirrhotic and compensated cirrhotic stages to correlate the detected deficiencies with the fibrosis stage. MATERIAL AND METHODS: Body multifrequency bioimpedance analysis (BIA) and a wide and simultaneous analytical profile were prospectively performed in 74 CHC patients (36 male) with known METAVIR fibrosis stage established with liver biopsy or transient elastography. Results were analyzed to identify deviations from the normal range and variations according to the fibrosis stage. RESULTS: Body fat compartment was greater in women. Body composition did not change among the 4 stages of liver fibrosis. Low levels (< 30 µg/L) of vitamin D were detected in 74.3% of patients irrespective of the fibrosis stage. Most analytical results remained into the normal range with the exceptions of thrombocytopenia and vitamin A deficiency, that were limited to the stage 4 of fibrosis, and low Zn and LDL-cholesterol values, that were frequently found in patients with advanced (F3 and F4) fibrosis stage. CONCLUSION: Body composition and most biochemical parameters, including cyanocobalamin, folic acid and vitamin E, are well preserved in compensated patients with CHC, with the exception of generalized vitamin D insufficiency and of deficiencies of vitamin A and zinc that are restricted to the more advanced, although still compensated, stages of the disease.
Assuntos
Composição Corporal , Hepatite C Crônica/sangue , Hipobetalipoproteinemias/sangue , Cirrose Hepática/sangue , Deficiência de Vitamina A/sangue , Deficiência de Vitamina D/sangue , Zinco/sangue , Idoso , Biópsia , LDL-Colesterol/sangue , Técnicas de Imagem por Elasticidade , Impedância Elétrica , Feminino , Ácido Fólico/sangue , Hepatite C Crônica/epidemiologia , Humanos , Hipobetalipoproteinemias/epidemiologia , Fígado/diagnóstico por imagem , Fígado/patologia , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/epidemiologia , Masculino , Desnutrição/sangue , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Trombocitopenia/epidemiologia , Deficiência de Vitamina A/epidemiologia , Vitamina B 12/sangue , Deficiência de Vitamina D/epidemiologia , Vitamina E/sangue , Zinco/deficiênciaRESUMO
BACKGROUND: Vitamin D has immunomodulatory properties, exerts an anti-hepatitis C virus (HCV) effect in vitro and improves response to interferon-based therapy in patients with chronic hepatitis C (CHC). Low serum levels of 25(OH) vitamin D [25(OH)D] are frequently found in CHC patients and seem to be related to more advanced stages of liver fibrosis. The study aims to establish the incidence of vitamin D deficiency in Spanish patients with CHC, its possible relation with features of liver damage and with the IL28B gene polymorphism, and the immediate effect of vitamin D therapy on CHC-related analytical variables. MATERIALS AND METHODS: Baseline serum 25(OH)D levels were measured in 108 consecutive CHC patients (60 men, age 54.3 ± 10.5 yrs). Results of transient elastography and of IL28B rs12979860C/T genotype were available in 89 and 95 patients, respectively. Forty one patients with insufficient levels of 25(OH)D received vitamin D supplements and were re-evaluated thereafter. RESULTS: Deficiency of vitamin D (< 20 µg/dL) and suboptimal levels (20-30 µg/mL) were detected in 36.1% and 40.9% of patients, respectively. No relationships were found between 25(OH)D levels and biochemical liver tests, fibrosis stage and IL28B genotype. Vitamin D therapy normalized 25(OH)D levels in all treated patients, but did not modify significantly HCV-RNA serum levels or biochemical tests. CONCLUSIONS: Vitamin D deficiency is common in Spanish patients with CHC but it is related neither to biochemical and virological variables nor with the fibrosis stage and IL28B polymorphism. Vitamin D therapy has no immediate effect on HCV-RNA serum levels.
Assuntos
Suplementos Nutricionais , Hepatite C Crônica/epidemiologia , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/análogos & derivados , Vitaminas/uso terapêutico , Adulto , Idoso , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Estudos Transversais , Técnicas de Imagem por Elasticidade , Feminino , Hepacivirus/genética , Hepatite C Crônica/sangue , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/genética , Hepatite C Crônica/imunologia , Humanos , Incidência , Interferons , Interleucinas/genética , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polimorfismo Genético , Valor Preditivo dos Testes , RNA Viral/sangue , Espanha/epidemiologia , Resultado do Tratamento , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/genética , Deficiência de Vitamina D/imunologiaRESUMO
BACKGROUND: The WHOQOL-BREF is a generic questionnaire to measure quality of life created by the Study Group on Quality of Life of the World Health Organization. AIM: To adapt and evaluate the psychometric properties of the Spanish version of the WHOQOL-BREF instrument in a group of Chilean older subjects living in Metropolitan Santiago. MATERIAL AND METHODS: A linguistic-cultural adaptation of the Spanish version of the WHOQOL-BREF was performed and tested in a pilot study. Subsequently, the modified scale was applied to a group of 1186 older women aged 72 ± 8 years and 334 men aged 72 ± 7 years. The psychometric properties such as internal consistency, item-total correlation of responses, and construct validity were evaluated. A confirmatory factor analysis was done to check if the dimensions described in the original version, were evaluated. Analyses were performed with STA-TA statistical software 10.0 and LISREL 8.50. RESULTS: Confirmatory factor analysis confirmed that the dimensions physical health, psychological, social relationships and environment, described by the authors in their original description, were maintained. The instrument had a good internal consistency with a Cronbach alpha of 0.88 for the total scale and ranging from 0.70 to 0.79 in each of the dimensions. CONCLUSIONS: The evaluated version of the WHOQOL-BREF has an acceptable reliability and validity, and suggests that it is suitable for the assessment of Quality of Life in elderly people in Chile.
Assuntos
Qualidade de Vida/psicologia , Inquéritos e Questionários , Idoso , Chile , Características Culturais , Feminino , Humanos , Idioma , Masculino , Reprodutibilidade dos Testes , Fatores Socioeconômicos , TraduçõesRESUMO
Background: The WHOQOL-BREF is a generic questionnaire to measure quality of life created by the Study Group on Quality of Life of the World Health Organization. Aim: To adapt and evaluate the psychometric properties of the Spanish version of the WHOQOL-BREF instrument in a group of Chilean older subjects living in Metropolitan Santiago. Material and Methods: A linguistic-cultural adaptation of the Spanish version of the WHOQOL-BREF was performed and tested in a pilot study. Subsequently, the modified scale was applied to a group of 1186 older women aged 72 ± 8 years and 334 men aged 72 ± 7 years. The psychometric properties such as internal consistency, item-total correlation of responses, and construct validity were evaluated. A confirmatory factor analysis was done to check if the dimensions described in the original version, were evaluated. Analyses were performed with STA-TA statistical software 10.0 and LISREL 8.50. Results: Confirmatory factor analysis confirmed that the dimensionsphysical health, psychological, social relationships and environment, described by the authors in their original description, were maintained. The instrument had a good internal consistency with a Cronbach alpha of 0.88 for the total scale and rangingfrom 0.70 to 0.79 in each of the dimensions. Conclusions: The evaluated version of the WHOQOL-BREF has an acceptable reliability and validity, and suggests that it is suitable for the assessment of Quality of Life in elderly people in Chile.