Suchergebnisse

Structural and intercultural competence approaches have been widely applied to fields such as medical training, healthcare practice, healthcare policies and health promotion. Nevertheless, their systematic implementation in epidemiological research is absent. Based on a scoping review and a qualitative analysis, in this article we propose a checklist to assess cultural and structural competence in epidemiological research: the Structural and Intercultural Competence for Epidemiological Studies guidelines. These guidelines are organised as a checklist of 22 items and consider four dimensions of competence (awareness and reflexivity, cultural and structural validation, cultural and structural sensitivity, and cultural and structural representativeness), which are applied to the different stages of epidemiological research: (1) research team building and research questions; (2) study design, participant recruitment, data collection and data analysis; and (3) dissemination. These are the first guidelines addressing structural and cultural competence in epidemiological inquiry ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no 825884 (SYNergies for Cohorts in Health: integrating the ROle of all Stakeholders, SYNCHROS). AM-H acknowledges the financial support from Institut Català de la Recerca i Estudis Avançats (ICREA) under the ICREA Academia Award

Purpose As life expectancy increases, a progressively higher number of older adults have to cope with multiple chronic diseases, which cause functional deterioration and impaired quality of life and may impede ageing at home with autonomy and independence. Therefore, it is im-portant to have a reliable, valid and easy-to-apply measure of disease burden morbidity, cen-tered in the person. This study describes the metric properties of the disease burden morbidity assessment (DBMA)1,2 using Rasch analysis3, which allows developing linear measures that may be applied using computerized test assessment. Method Participants were 1400 adults aged 50 years and over from the Longitudinal Study Aging in Spain Pilot Survey (ELES-PS)4. The DBMA asked about the impact of several chronic health problems on activities of daily liv-ing, with a 5-point response scale. Rasch analysis was applied. Results & Discussion The par-ticipants¿ mean age was 65.5±10.40 years, 55.4% were women, and reported a mean number of chronic conditions of 2.5±2.25. After adjusting the response scale, a good fit to the Rasch model was achieved, with items local independence and unidimensionality, no differential item functioning, though with low reliability. The linear measure showed moderate correlations with physical function and self-rated health. In conclusion, after adjustment the DBMA offers results in a linear measure, with an adequate internal and construct validity. This measure allows as-sessing the impact of illness according to the patient¿s perspective and supports its application through computerized test assessment.

Introduction. Frailty is a dynamic syndrome and may be reversible. Despite this, little is known about trajectories or transitions between different stages of frailty. Methods. A systematic review was conducted, selecting studies reporting frailty trajectories or transition states for adults in any settings in European ADVANTAGE Joint Action Member States. Results. Only three papers were included. Data were from longitudinal communitybased cohorts in the United Kingdom, Netherlands and Italy. The English study investigated the effect of physical activity on the progression of frailty over a 10-year period. Two presented data on the proportion of participants experiencing at least one frailty transition over time (32.6% in the Italian sample aged ≥ 65 years followed for 4.4 years; 34.3% in the Dutch sample aged 65-75 years, followed for 2 years). Conclusions. Data on frailty trajectories and transition states were limited and heterogeneous. Well-designed prospective studies and harmonized approaches to data collection are now needed.