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BACKGROUND: Foot problems are highly prevalent in the community; however no large population-based studies have examined the characteristics of those who do and do not access podiatry services in Australia. The aim of this study was to explore patterns of podiatry utilisation in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide,
Hylton B Menz; Tiffany K Gill; Anne W Taylor; Catherine L Hill
Objective The aim of this study is to describe the evolution of multimorbidity. Study Design and Setting Data from 1854 South Australians who participated in the North West Adelaide longitudinal HealthStudy(NWAHS) was collected between baseline (2000–2002) and follow-up (2008–2010). Status for eight chronic diseases (CDs) was determined by biomedical measurement or self-report. Chronic disease (CD) mean age of occurrence and order of appearance was investigated. Results The prevalence of multimorbidity increased from 32% to 64% during the 7.8±1.1 years of follow-up. The estimated mean age of onset of a new CD was significantly older for hypertension, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) and younger for hypercholesterolemia, asthma and other mental problem. Hypercholesterolemia was more likely to develop as a first than as a subsequent CD (39%vs.16%, p<0.0001) while CVD (1%vs.5%, p<0.0001), diabetes (5%vs.11%, p<0.001) and COPD (6%vs.16%, p<0.0001) were less likely. The presence of mood disorders at baseline was associated with an increased risk of developing other mental disorders (36%vs.12%, p<0.0001), diabetes (18%vs.9%, p<0.01) and asthma (30%vs.21%, p<0.05). Conclusion Longitudinal data could be used to study the evolution of multimorbidity and could provide information on CDs mean age of occurrence, order of appearance and impact on the development of future CDs.
Ruel, Guillaume; Levesque, Jean-Frederic; Stocks, Nigel; Sirois, Caroline; Kroger, Edeltraut; Adams, Robert J.; Doucet, Marieve; Taylor, Anne W.
The North West AdelaideHealthStudy is a population-based biomedical cohort study investigating the prevalence of a number of chronic conditions and health-related risk factors along a continuum. This methodology may assist with evidence-based decisions for health policy makers and planners, and inform health professionals who are involved in chronic disease prevention and management, by providing a better description of people at risk of developing or already diagnosed with selected chronic conditions for more accurate targeting groups for health gain and improved health outcomes. Longitudinal data will provide information on progression of chronic conditions and allow description of those who move forward and back along the continuum over time. Detailed methods are provided regarding the random recruitment and examination of a representative sample of participants (n = 4060), including the rationale for various processes and valuable lessons learnt. Self-reported and biomedical data were obtained on risk factors (smoking, alcohol consumption, physical activity, family history, body mass index, blood pressure, cholesterol) and chronic conditions (asthma, chronic obstructive pulmonary disease, diabetes) to classify participants according to their status along a continuum. Segmenting this population sample along a continuum showed that 71.5% had at least one risk factor for developing asthma, chronic obstructive pulmonary disease or diabetes. Almost one-fifth (18.8%) had been previously diagnosed with at least one of these chronic conditions, and an additional 3.9% had at least one of these conditions but had not been diagnosed. This paper provides a novel opportunity to examine how a cohort study was born. It presents detailed methodology behind the selection, recruitment and examination of a cohort and how participants with selected chronic conditions can be segmented along a continuum that may assist with health promotion and health services planning.
Grant, Janet F; Chittleborough, Catherine R; Taylor, Anne W; Dal Grande, Eleonora; Wilson, David H; Phillips, Patrick J; Adams, Robert J; Cheek, Julianne; Price, Kay; Gill, Tiffany; Ruffin, Richard E
The Bachelor of Oral Health (B.O.H.) commenced at the University of Adelaide in 2002. The degree was formed by combining the Diploma in Dental Therapy and the Diploma and Advanced Diploma in Dental Hygiene. This preliminary study measured the predictive value of the selection criteria against students' academic performance at the end of each enrollment year of the B.O.H. program. Predictive indicators were prior academic achievement (i.e., tertiary entrance ranking [TER], university grade point average, or Special Tertiary Admissions Test scores) and the admission cognitive test score (i.e., Undergraduate Medical Admissions Test [UMAT] and Oral Assessment [OA] ranking). Predictive indicators were compared with the students' level of academic achievement across the three-year program. The aim of this study was to determine if prior academic achievement, cognitive test scores, and oral assessment predicted high level of academic achievement for B.O.H. students. The TER was found to be a strong predictor for academic performance after controlling for age, gender, type of applicant, and student preference in the first year along with older students (>25 years) and a higher UMAT score. Raising the TER cut-off for entry to the program should be considered, along with less emphasis on the OA and UMAT, because such a change would have little impact on achievement and would increase the pool of applicants. PMID:23225684
The input of groundwater-borne nutrients to Adelaide's (South Australia) coastal zone is not well known but could contribute to the ongoing decline of seagrass in the area. As a component of the Adelaide Coastal Waters Study (ACWS), the potential for using the radium quartet (223Ra, 224Ra, 226Ra and 228Ra) and 222Rn to evaluate submarine groundwater discharge (SGD) was evaluated. Potential
Sébastien Lamontagne; Corinne Le Gal La Salle; Gary J. Hancock; Ian T. Webster; Craig T. Simmons; Andrew J. Love; Julianne James-Smith; Anthony J. Smith; Jochen Kämpf; Howard J. Fallowfield
Describes a cooperative international education project involving Adelaide College (South Australia), Rio Salado Community College (Arizona), and Austin Community College (Texas). Considers each institution's contributions, program goals (e.g., cross-cultural sharing of experiences by students studying a similar subject, bridging long distances…
In recent times there have been changes to guidelines regarding the management of gonorrhoea, from both the Centers for Disease Control and Prevention in 2010 and the British Association for Sexual Health and HIV (BASHH) in 2011. Coinciding with their release we conducted a clinical audit of our treatment protocol for gonorrhoea. In 2010, local data on the minimum inhibitory concentrations for Neisseria gonorrhoeae indicated an increase in local isolates that were less sensitive to ceftriaxone (11.6% c.f. 5.3% in 2009). We have a long history of using 250 mg of ceftriaxone to treat all standard sites of gonorrhoea infection followed with tests of cure in all cases. In a retrospective clinical audit of an 11-year period from 2000 up to and including 2010 we identified six test-of-cure failures over 11 years after treating a total of 215 patients with pharyngeal gonorrhoea. PMID:23970709
Heat waves are considered a health risk and they are likely to increase in frequency, intensity and duration as a consequence of climate change. The effects of heat waves on human health could be reduced if individuals recognise the risks and adopt healthy behaviours during a heat wave. The purpose of this study was to determine the predictors of risk perception using a heat wave scenario and identify the constructs of the health belief model that could predict adaptive behaviours during a heat wave. A cross-sectional study was conducted during the summer of 2012 among a sample of persons aged between 30 to 69 years in Adelaide. Participants' perceptions were assessed using the health belief model as a conceptual frame. Their knowledge about heat waves and adaptive behaviours during heat waves was also assessed. Logistic regression analyses were performed to determine the predictors of risk perception to a heat wave scenario and adaptive behaviours during a heat wave. Of the 267 participants, about half (50.9%) had a high risk perception to heat waves while 82.8% had good adaptive behaviours during a heat wave. Multivariate models found that age was a significant predictor of risk perception. In addition, participants who were married (OR = 0.21; 95% CI, 0.07-0.62), who earned a gross annual household income of ?$60,000 (OR = 0.41; 95% CI, 0.17-0.94) and without a fan (OR = 0.29; 95% CI, 0.11-0.79) were less likely to have a high risk perception to heat waves. Those who were living with others (OR = 2.87; 95% CI, 1.19-6.90) were more likely to have a high risk perception to heat waves. On the other hand, participants with a high perceived benefit (OR = 2.14; 95% CI, 1.00-4.58), a high "cues to action" (OR = 3.71; 95% CI, 1.63-8.43), who had additional training or education after high school (OR = 2.65; 95% CI, 1.25-5.58) and who earned a gross annual household income of ?$60,000 (OR = 2.66; 95% CI, 1.07-6.56) were more likely to have good adaptive behaviours during a heat wave. The health belief model could be useful to guide the design and implementation of interventions to promote adaptive behaviours during heat waves. PMID:23759952
The stability of children's disorders was studied, using Adelaide versions of the Conners teachers and parent rating scales, with 5- to 12-year-olds. Of the 20 scales, 14 had high or moderate test-retest stability over the 1-year interval. Most scales also showed discriminant validity over this time. All but 2 of the 14 stable scales gave moderate stability coefficients at each
R. A. Fisher spent much of his final 3 years of life in Adelaide. It was a congenial place to live and work, and he was much in demand as a speaker, in Australia and overseas. It was, however, a difficult time for him because of the sustained criticism of fiducial inference from the early 1950s onwards. The article discusses some of Fisher's work on inference from an Adelaide perspective. It also considers some of the successes arising from this time, in the statistics of field experimentation and in evolutionary genetics. A few personal recollections of Fisher as houseguest are provided. This article is the text of a article presented on August 31, 2012 at the 26th International Biometric Conference, Kobe, Japan. PMID:24502277
Heat waves are a public health concern in Australia and unprecedented heat waves have been recorded in Adelaide over recent years. The aim of this study was to examine the perception and attitudes towards heat waves in the context of climate change among a group of residents in Adelaide, an Australian city with a temperate climate. A cross-sectional study was conducted in the summer of 2012 among a sample of 267 residents. The results of the survey found that television (89.9%), radio (71.2%), newspapers (45.3%) were the main sources from which respondents received information about heat waves. The majority of the respondents (73.0%) followed news about heat waves very or somewhat closely. About 26.6% of the respondents were extremely or very concerned about the effects of heat waves on them personally. The main issues that were of personal concern for respondents during a heat wave were their personal comfort (60.7%), their garden (48.7%), and sleeping well (47.6%). Overall, respondents were more concerned about the impacts of heat waves to the society than on themselves. There was a significant association between gender (?² = 21.2, df = 3, p = 0.000), gross annual household income (p = 0.03) and concern for the societal effects of heat waves. Less than half (43.2%) of the respondents believed that heat waves will extremely or very likely increase in Adelaide according to climate projections. Nearly half (49.3%) believed that the effects of heat waves were already being felt in Adelaide. These findings may inform the reframing and communication strategies for heat waves in Adelaide in the context of climate change. PMID:23343978
Except for the effects of terrestrial weathering on melilite, inclusions in Adelaide appear to retain the primary isotopic signatures acquired when they formed. Adelaide is thus an ideal meteorite for investigating processes that produced chondrules and C...
The MF Adelaide partial-reflection radar has been operating continuously since November 1983. This has enabled a climatology of gravity-wave activity to be constructed for the mesosphere. The data have been analyzed for a medium-period range of 1 to 8 hr. and a longer period range between 8 and 24 hr. covering the inertio-period waves. The tidal motions have been filtered out prior to analysis. For the data analyses so far (Nov. 1983 to Dec. 1984), a number of interesting features emerged. Firstly, the wave activity at heights above 80 km shows a small seimannual variation with season with the activity being strongest in summer and winter. At heights below 80 km however, there is a similar but more marked variation with the weakest amplitudes occurring at the time of the changeovers in the prevailing circulation. If breaking gravity waves are responsible for much of the turbulence in the mesosphere, then the periods March to April and September to October might also be expected to be periods of weak turbulence. The wave field appears to be partially polarized. The meridional amplitudes are larger than the zonal amplitudes, especially in water. It is found that the degree of polarization is about 15% in summer and 30% in winter. The polarized component is found to propagate in the opposite direction to the background flow in the stratosphere, which suggests that the polarization arises through directional filtering of the waves as they propagate up from below.
Background: Middle-aged adults are an important focus of dental policy with increasing retention of teeth and use of dental services. The aims of the study were to describe the caries experience of 45-54 year olds by dental visit pattern, dental behaviour, socio-demographics and socio-economic status. Methods: A random sample of 45-54 year olds from Adelaide, South Australia was surveyed by
Objective: Deinstitutionalization and mainstreaming may have contributed to increased attendance in public emergency departments by people with mental health problems. This study describes changing patterns of attendances by patients with mental health problems to the emergency department (ED) of a public teaching hospital in Adelaide, South Australia.Method: Records from a 10-year period from the ED were examined to identify changes
The City of Adelaide suffers from rapid damage to historic building materials due to salts, rising damp, and damp-proof course\\u000a failures. Adelaide City Council has partially funded repairs to over 400 buildings in the past 15 years. To begin to examine\\u000a the scope of this problem and the effectiveness of various treatments, 24 historic buildings in Adelaide were examined, with\\u000a a
P. Lopez-Arce; E. Doehne; J. Greenshields; D. Benavente; D. Young
Four infants aged between 8 and 13 months presented between November 2002 and May 2006 with dermatitis of the lower abdomen, perineum or buttocks. All lived in semi-rural properties in the Adelaide Hills and had not travelled outside South Australia. Wandering thread-like serpiginous tracks were evident on examination, consistent with a diagnosis of cutaneous larva migrans. No abnormalities were detected on full blood examination, Strongyloides stercoralis serology or faecal analysis. Treatment with oral albendazole resulted in rapid resolution of symptoms. An epidemiological survey was undertaken which suggested possums or millipedes may have been the source of nematode larvae, the precise nature of which is unclear but could include Parastrongyloides trichosuri and Rhabditis necromena. PMID:21198527
Black, Michael D; Grove, David I; Butcher, Andrew R; Warren, Lachlan J
The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study was established in 2009 to investigate the associations of sex steroids, inflammation, environmental and psychosocial factors with cardio-metabolic disease risk in men. The study population consists of 2569 men from the harmonisation of two studies: all participants of the Florey Adelaide Male Ageing Study (FAMAS) and eligible male participants of the North West AdelaideHealthStudy (NWAHS). The cohort has so far participated in three stages of the MAILES Study: MAILES1 (FAMAS Wave 1, from 2002-2005, and NWAHS Wave 2, from 2004-2006); MAILES2 (FAMAS Wave 2, from 2007-2010, and NWAHS Wave 3, from 2008-2010); and MAILES3 (a computer-assisted telephone interview (CATI) survey of all participants in the study, conducted in 2010). Data have been collected on a comprehensive range of physical, psychosocial and demographic issues relating to a number of chronic conditions (including cardiovascular disease, diabetes, arthritis and mental health) and health-related risk factors (including obesity, blood pressure, smoking, diet, alcohol intake and inflammatory markers), as well as on current and past health status and medication. Initial approaches or enquiries regarding the study can be made to either the principal investigator (firstname.lastname@example.org) or the project coordinator (email@example.com). PMID:23785097
Grant, Janet F; Martin, Sean A; Taylor, Anne W; Wilson, David H; Araujo, Andre; Adams, Robert Jt; Jenkins, Alicia; Milne, Robert W; Hugo, Graeme J; Atlantis, Evan; Wittert, Gary A
A prospective cohort study of commercial pesticide applicators, farmers and farmers' spouses in Iowa and North Carolina conducted in collaboration among the National Cancer Institute, the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency and the National Institute for Occupational Safety and Health.
A fact sheet about the Agricultural Heath Study, begun In 1993 by scientists from the National Cancer Institute, the National Institute of Environmental Health Sciences, and the U.S. Environmental Protection Agency.
The present research has sought to describe and analyze the overlapping health and educational services utilization pattern of children with disabilities and their families in a defined geographic area: Berkshire County, Massachusetts. The study tried to ...
The Women's HealthStudy (WHS) is a randomized, double-blind, placebo-controlled trial using a 2x2 factorial design, and conducted among 39,876 female health professionals in the United States. The WHS is sponsored by both the National Cancer Institute (NCI) and the National Heart, Lung, and Blood Institute (NHLBI). Participants were randomly assigned to either Vitamin E (600 IU every other day) or placebo; and to aspirin (100 mg every other day) or placebo.
For more than 25 years, the NYU Women’s HealthStudy has been committed to studying the potential causes of serious diseases in women in the United States. When the study began in 1985, its goal was to identify the role of hormones and diet in the development of the most common cancers in women, especially breast cancer.
The Institute of Electrical and Electronic Engineers (IEEE) International Symposium on Information Theory (ISIT) was held at the Adelaide Convention Center in Adelaide, South Australia from the 4th to the 9th of September 2005. Since 1950 the Symposium ha...
Launched in September 2010, the Ontario HealthStudy (OHS) is a prospective longitudinal cohort study. The OHS is an integrated platform for investigating the complex interplay of environmental, lifestyle and genetic components that increase individual and community risk of common adult diseases.
The Agricultural HealthStudy is a large cohort of 90,000 licensed pesticide applicators, plus 30,000 spouses and 20,000 children who are exposed either directly or indirectly. Exposure to pesticides is widespread and is important beyond the agricultural community. Other exposure...
Andrew Fearne, Professor of Food Marketing and Supply Chain Management and a Director of the dunnhumby Academy of Consumer Research at Kent University, UK, is a current Thinker in the Adelaide Thinkers in Residence (ATIR) program. Professor Fearne is the 14th person to undertake a Thinkers appointment. The residency theme, Food and Wine Value Chains: Prosperity through Collaboration, has provided
The Proterozoic sediments of the Adelaide Geosyncline were deformed and metamorphosed during the Ordovician Delamerian Orogeny. In much of the Flinders Ranges, the relatively unmetamorphosed sediments, such as those of the Brachina and Bunyeroo formations in the Central Flinders Ranges, are only weakly magnetic. In the Mount Lofty Ranges, where peak metamorphic grades were reached, the Brachina Formation and its
The Mayo Mammography HealthStudy (MMHS) is a prospective cohort comprised of 19,924 women ages 35 and over, living in the tri-state region surrounding the Mayo Clinic (Minnesota, Iowa, and Wisconsin), without a history of breast cancer, who were scheduled for a screening mammogram at the Mayo Clinic between October 2003 and September 2006. All women had a 4-view screening mammogram at the time of enrollment and completed a self-administered questionnaire.
The Health Planning Council, Inc. is concerned with Delaware's allied health manpower in the fields of administration, ambulatory services, audiology and speech, medical records, fiscal affairs, radiology, maintenance and housekeeping, nuclear medicine, i...
OBJECTIVESTo determine compliance with a voluntary code of practice (VCP) for restricting smoking in restaurants and to canvass the attitudes of restaurateurs towards tougher smoking restrictions.DESIGNCross-sectional survey conducted in 1996 using a telephone questionnaire.SETTINGMetropolitan restaurants and cafés in Adelaide, South Australia.PARTICIPANTS276 (86.8%) of a sample of randomly selected owners and managers.MAIN OUTCOME MEASURESRestaurant non-smoking policies, reported and anticipated change in
Kelly Jones; Melanie Wakefield; Deborah A Turnbull
Skip to Main Content at the National Institutes of Health | www.cancer.gov Epidemiology and Genomics Research In NCI's Division of Cancer Control and Population Sciences Menu Search EGRP Site: EGRP Home About the Program Mission & Vision Organizational
Evaluation of Skylab crewmembers for mission related effects on oral health in relation to possible dental injuries provided the following distinctive changes: (1) increased counts of specific anaerobic and streptococcal components; (2) elevations in levels of secretory IgA concurrent with diminutions of salivary lysozyme; and (3) increases in dental calculus and gingival inflammations. The clinical changes are considered to be more influenced by the preexisting state of dental health than by any mission related effects.
Brown, L. R.; Frome, W. J.; Handler, S.; Wheatcroft, M. G.; Rider, L. J.
The El Paso Childrens HealthStudy consisted of two waves of exposure monitoring, respiratory health questionnaires, and lung function examinations. The exposure assessment began with a pilot study using passive samplers for nitrogen dioxide in February, 1999 and was followed b...
HRS is a national panel study based on biennial interviews. The study provides a portrait of an aging America's physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning....
Results of an optometry manpower study, which is part of a larger Health Manpower Study in Virginia, are presented in this report which also includes information on the education of optometrists and manpower requirements for optometrists through 1990. The...
Results of a dental manpower study, which is part of a larger Health Manpower Study commissioned by the State Council of Higher Education, is presented in this report, which also includes information on the education of dentists, dental hygienists, dental...
Caladenia behrii, a sexually deceptive orchid, is an endangered terrestrial orchid endemic to the Adelaide Hills, South Australia. We examined\\u000a pollination success among individuals of different colours and heights in three populations of C. behrii in the northern Adelaide region. The labellum of C. behrii varies from cream to deep maroon. Over five years, the pollination success (pollinia deposited on
Meteor radar observations of the Mesosphere Lower Thermosphere region are routinely made at Adelaide (35S), Darwin (12S) and Davis Station (68S). In addition, MF radar observations are made at Adelaide and Davis. Intercomparison of these observations yields insight into the underlying physical processes and into the limitations of the techniques themselves. In this paper, we present observations from these three sites, discuss the underlying dynamics, and consider the implications of differences between the meteor radar, MF radar and satellite observations of winds and temperatures in this region.
Understanding the factors influencing mosquito distribution is important for effective surveillance and control of nuisance and disease vector mosquitoes. The goal of this study was to determine how trap height and distance to the city center influenced the abundance and species of mosquitoes collected in Adelaide, South Australia. Mosquito communities were sampled at two heights (<2 m and ~10 m) along an urban-rural gradient. A total of 5,133 mosquitoes was identified over 176 trap nights. Aedes notoscriptus, Ae. vigilax, and Culex molestus were all more abundant in lower traps while Cx. quinquefasciatus (an ornithophilic species) was found to be more abundant in high traps. Distance to city center correlated strongly with the abundance of Ae. vigilax, Ae. camptorhynchus, Cx. globocoxitus, and Cx. molestus, all of which were most common at the sites farthest from the city and closest to the saltmarsh. Overall, the important disease vectors in South Australia (Ae. vigilax, Ae. camptorhynchus, Ae. notoscriptus, and Cx. annulirostris) were more abundant in low traps farthest from the city and closest to the saltmarsh. The current mosquito surveillance practice of setting traps within two meters of the ground is effective for sampling populations of the important disease vector species in South Australia. PMID:24820555
This paper examines responses to racism and the pathways through which racism can affect health and wellbeing for Aboriginal people living in an urban environment. Face-to-face interviews were conducted in 2006/07 with 153 Aboriginal people living in Adelaide, Australia. Participants were asked about their experience of, and responses to, racism, and the impact of these experiences on their health. Racism was regularly experienced by 93% of participants. Almost two thirds of people felt that racism affected their health. Using a thematic analysis with a particular focus on how agency and structure interacted, a number of key reactions and responses to racism were identified. These included: emotional and physiological reactions; and responses such as gaining support from social networks; confronting the person/situation; ignoring it; avoiding situations where they might experience racism; 'minimising' the significance or severity of racism or questioning whether incidents were racist; and consuming alcohol, tobacco and other drugs. A further theme was a conscious decision to not 'allow' racism to affect health. Our study found that most people used more than one of these coping strategies, and that strategies were selected with an awareness of positive and negative health impacts. While individuals demonstrated substantial agency in their responses, there were clear structural constraints on how they reacted and responded. We found that not only was racism potentially detrimental to health, but so too were some responses. However, while some strategies appeared 'healthier' than others, most strategies entailed costs and benefits, and these depended on the meanings of responses for individuals. This paper concludes that initiatives to promote health-protective responses to racism need to consider structural constraints and the overarching goal of reducing systemic racism. PMID:21835522
Ziersch, Anna M; Gallaher, Gilbert; Baum, Fran; Bentley, Michael
The papers published in this volume were delivered at the First Australian Reading Conference, which was held in Adelaide in August 1975. Topics of discussion included, among others, preservice and inservice teacher education, facilities in reading, the development and use of reading materials, student motivation, children's literature, reading…
The eastern part of the Adelaide Geosyncline contains well preserved glaciomarine sequences of the Sturtian glaciation (?750–700 Ma) including calcareous or dolomitic siltstone, manganiferous siltstone, dolostone and diamictite units and the associated Braemar ironstone facies. The ironstone facies occurs as matrix to diamictites and as massive to laminated ironstones and comprises abundant Fe oxides (hematite, magnetite) and quartz, minor silicates
This study explores potential causes of cancer and other diseases among farmers and their families and among commercial pesticide applicators. Current medical research suggests that while agricultural workers are generally healthier than the general U.S. population, they may have higher rates of some cancers, including leukemia, myeloma, non-Hodgkin's lymphoma, and cancers of the lip, stomach, skin, brain, and prostate. Other conditions, like asthma, neurologic disease, and adverse reproductive outcomes may also be related to agricultural exposures.
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...
The upper Proterozoic- to Cambrian-aged sedimentary and volcanic rocks comprising the Adelaide Foldbelt were deformed and, in places, metamorphosed during the Cambro-Ordovician Delamerian Orogeny. Tectonic fabrics developed in the central portion of the foldbelt (Mt. Lofty Ranges) demonstrate westward transport during the orogeny. The sigmoidal shape outlined by the Kangaroo Is., Mt. Lofty Ranges, Olary portion of the foldbelt is interpreted to have been the result of dextral wrench faulting in the lower- to mid-Proterozoic basement. Thus, cover rocks overlying such basement wrench fault zones would have suffered a transpressional stress regime, giving rise to the observed fold axis oriented at an oblique angle to the thrust boundary. In the northern portion of the foldbelt (Northern Flinders Ranges), wrench faulting is interpreted to have accommodated considerable basement shortening which initiated a basement-cover décollement and resulted in thrust-bound pop-up structures in the cover.
Quasi-monochromatic gravity waves are frequently observed by airglow imagers. Gravity wave sources include orographic forcing, tropospheric storms and unsteady flows. Direct propagation from the source region is limited to relatively short distances, so it is likely that a significant percentage of observed gravity waves may be ducted [Walterscheid et al., 1999]. Thermal and Doppler ducting in the MLT region can therefore allow propagation of gravity waves over long distances, transferring energy and momentum far from the source region. Here we consider ducting of gravity waves over the Australian continent. Airglow imagers deployed at Alice Springs (23°42'S, 133°53' E) and Adelaide (34°55'S, 138°36'E) have been operating nearly continuously since late 2001. An automated image analysis technique is used to determine the wavelength, phase speed, and propagation direction of waves observed at each site. Monthly averages of these derived quantities are used to characterize the wave propagation for each site. The resulting climatology is then compared to rainfall statistics over the Australian continent in order to identify potential source regions. Australian rainfall statistics are used as a proxy for tropospheric storms believed to be the dominant gravity wave source in the region. We then calculate mean monthly vertical wavenumbers for the observed waves using SABER temperature profiles and HWM07 or MF radar wind profiles. Altitude profiles of the vertical wavenumber as a function of wave propagation direction are then compared with potential gravity wave source regions to identify ducted waves. Walterscheid, R. L., et al. (1999), Analysis and interpretation of airglow and radar observations of quasi-monochromatic gravity waves in the upper mesosphere and lower thermosphere over Adelaide, Australia (35S, 138E), J. Atmos. Sol. Terr. Phys., 61, 461- 478.
Gelinas, L. J.; Hecht, J. H.; Walterscheid, R. L.; Reid, I. M.; Woithe, J.
A suite of soft-sediment deformation structures occurs in tidal rhythmites of fine sand to silt grade in the late Neoproterozoic (˜600 Ma) Elatina Formation, which is part of the Marinoan glaciogenic succession in the Adelaide foldbelt, South Australia. The structures include: (1) sets of asymmetrical cuspate ridges (? = 13-50 cm, h = 3-5 cm) formed on bed surfaces and underlain by folds affecting as much as 60 cm thickness of strata; (2) symmetrical and interference ripple forms (? = 3-15 cm, h = ?1.5 cm) mostly confined to the troughs between the cuspate ridges and which are underlain by folds, involving up to 20 cm thickness of strata, that commonly parallel the undulations of the bed surface but in places have steepened limbs; (3) rill marks on the flanks of cuspate ridges and some ripple forms. The crests of the cuspate ridges and ripple forms commonly were draped and locally eroded and truncated during overall vertical accretion. The cuspate structures are interpreted as gravity slide deposits that formed after transformation of surficial sediment to a hydroplastic state, possibly by the cyclic stresses generated by storm waves, and its sliding on tidal-delta slopes. The ripple forms resulted from continuing wave activity and were maintained by draping and vertical accretion from unidirectional currents and locally by deposition of supercritical cross-lamination. The further deformation of the cuspate folds, as revealed by palaeomagnetic analyses of the structures, implies additional sliding and/or the differential loading of hydroplastic sediment in the troughs between the cuspate ridges. This study confirms that positive palaeomagnetic fold-tests on several cuspate folds indicate a primary origin for the shallow palaeomagnetic inclination (-5.3°) of the Elatina Formation and hence the equatorial palaeolatitude of late Neoproterozoic glaciation in South Australia.
Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. ‘health promoting communication’.
Host plants of Erwinia amylovora in the Royal Botanic Gardens of Melbourne (RBGM) and the Adelaide Botanic Gardens (ABG) were inspected for symptoms of fire\\u000a blight including dieback, and shoot and stem cankers. Forty five symptomatic plants were sampled and concurrently tested for\\u000a the presence of E. amylovora at the Institute for Horticultural Development, Victoria; Macquarie University, New South Wales;
S. JockA; B. RodoniB; M. Gillingsc; W.-S. Kim; C. Copes; P. Merriman; K. Geider
This paper reviews the health dimension and sociocultural, economic, and ecological determinants of health in existing global scenario studies. Not even half of the 31 scenarios reviewed gave a good description of future health developments and the different scenario studies did not handle health in a consistent way. Most of the global driving forces of health are addressed adequately in the selected scenarios, however, and it therefore would have been possible to describe the future developments in health as an outcome of these multiple driving forces. To provide examples on how future health can be incorporated in existing scenarios, we linked the sociocultural, economic, and environmental developments described in three sets of scenarios (special report on emission scenarios (SRES), global environmental outlook-3 (GEO3), and world water scenarios (WWS)) to three potential, but imaginary, health futures ("age of emerging infectious diseases", "age of medical technology", and "age of sustained health"). This paper provides useful insights into how to deal with future health in scenarios and shows that a comprehensive picture of future health evolves when all important driving forces and pressures are taken into account.
A prospective study of health service utilization carried out in the Correctional Services of Canada (CSC), Pacific Region, is reported. Health service encounters occurring at the six Regional Institutions with on-site health care centers between May 29th and June 28th, 1984 were surveyed using a health clinic encounter form.
Samuel B. Sheps; Martin T. Schechter; Real G. Prefontaine
The mesosphere and lower thermosphere (MALT) is a region largely controlled by tides and gravity waves. In this paper, we explore the seasonal and interannual variability of the MALT and its relationship to gravity wave fluxes using long-term airglow measurements at two Australian sites. The data presented here are the result of more than seven years of airglow imager observations at Adelaide 34°55’S, 138°36’ E) and Alice Springs (23°42’ S, 133°53’ E). The imagers measure rotational temperature and intensity of two atmospheric emissions, OH Meinel (6, 2) and O2 atmospheric (0, 1). Here we present analysis of the seasonal and interannual variation of gravity waves at both Australian sites. Automated analysis is used to determine individual gravity wave wavelength and orientation in each airglow image. Gravity wave statistics are then compiled and correlated with tropospheric disturbances, as characterized by Australian rainfall statistics and low pressure systems. By these methods, both seasonal variations in gravity wave occurrence and directionality and storm-related wave events can be identified.
Gelinas, L. J.; Hecht, J. H.; Reid, I. M.; Vincent, R. A.; Walterscheid, R. L.; Woithe, J. M.
The phase locked two day wave (PL/TDW) during austral summer is the most dramatic large scale event of the upper mesosphere. The PL/TDW wave can achieve amplitudes exceeding 70 m/s and involve the entire southern hemisphere and much of the northern hemisphere. The winds accelerate over a period of about 1 week and are accompanied by a near disappearance of the diurnal tide and stabilization of the two-day wave period at close to 48 hours. We have examined meteor wind data from the Andes Lidar Observatory at Cerro Pachon, Chile (30S, 70.1W) and MF radar data from the University of Adelaide (34.7S, 138.6E) located at similar latitudes. We find a remarkable coincidence between the oscillations. When adjustments for the separation in longitude are made the oscillations are nearly in phase. The amplitude of the oscillation is significantly greater at Chili, where winds approach 100 m/s. The diurnal tide is greatly diminished at both locations. These observations support the explanation that the PL/TDW is a subharmonic parametric instability of the diurnal tide (Walterscheid and Vincent, JGR, 1996). We will also present analysis of airglow data for the two-day wave at both locations.
Walterscheid, R. L.; Hecht, J. H.; Vincent, R. A.; Franke, S. J.; Taylor, M. J.; Pautet, P.; Zhao, Y.
Breastfeeding policies and practices were analysed in childcare settings in the metropolitan area of Adelaide, South Australia. Childcare centres were purposively selected based on their geographical location, type and socioeconomic score of the area. Qualitative inquiry approach was employed by undertaking interviews with childcare centres' director or baby house coordinator to explore their perception towards breastfeeding practice and support within their centre. Breastfeeding related policy documents, where available, were also collected during the interviews to triangulate data. A total of 15 face-to-face interviews were conducted. Six childcare centres had a written policy specifically on breastfeeding support, although the technical issues of handling breastmilk were included in most centres' food and nutrition guidelines. Most participants believed that decision to breastfeed is the personal choice of parents, and hence saw the childcare centre's role as supporting parental choice whether it is breastfeeding or not. The provision of physical space to breastfeed and facilities to store the expressed breast milk were the most common practices in support of parents who had chosen to continue breastfeeding. Participants perceived mothers' work-related issues such as distance from the centre, time, and unsupportive workplace the most important barriers that led to early introduction of bottle feeding or breastfeeding cessation. Most childcare centres support breastfeeding in a more passive than active way. Breastfeeding promotion needs to be an integral part of childcare centres training, policy and practice if an increased rate of breastfeeding is to be achieved particularly amongst working mothers. PMID:21948219
Javanparast, Sara; Newman, Lareen; Sweet, Linda; McIntyre, Ellen
Outlines the development of men's healthstudies, situating its development in a general historical context; discussing the study of men's health within the context of critical feminist theories and theories of men and masculinities; outlining and illustrating a relational theory for understanding men's health in an effort to integrate this study…
This article provides a brief outline of the development of men's healthstudies in the United States. Research on men's health is discussed within critical feminist theories that highlight the reciprocality of gender relations as well as power differences between men and women and among male subgroups. A relational theory of gender and health is used to identify both positive-gendered and negative-gendered health synergies that influence the health processes and outcomes of men and women. Several examples of gendered health synergies are presented to illustrate key concepts. Finally, some directions for future research and advocacy with reference to men's health are outlined. PMID:11125641
The intent of the small conference was to organize and convene a meeting of corporate medical directors, human resource and finance executives along with governmental research executives to discuss the general topic of health and productivity. The confere...
The sources of uncertainty in projecting the impacts of climate change on runoff are increasingly well recognized; however, translating these uncertainties to urban water security has received less attention in the literature. Furthermore, runoff cannot be used as a surrogate for water supply security when studying the impacts of climate change due to the nonlinear transformations in modeling water supply and the effects of additional uncertainties, such as demand. Consequently, this study presents a scenario-based sensitivity analysis to qualitatively rank the relative contributions of major sources of uncertainty in projecting the impacts of climate change on water supply security through time. This can then be used by water authorities to guide water planning and management decisions. The southern system of Adelaide, South Australia, is used to illustrate the methodology for which water supply system reliability is examined across six greenhouse gas (GHG) emissions scenarios, seven general circulation models, six demand projections, and 1000 stochastic rainfall time series. Results indicate the order of the relative contributions of uncertainty changes through time; however, demand is always the greatest source of uncertainty and GHG emissions scenarios the least. In general, reliability decreases over the planning horizon, illustrating the need for additional water sources or demand mitigation, while increasing uncertainty with time suggests flexible management is required to ensure future supply security with minimum regret.
We addressed the need for a biomarker of ingestion exposure to drinking water disinfection by-products by performing a human exposure trial. We evaluated urinary excretion of trichloroacetic acid (TCAA) as an exposure biomarker using 10 volunteers who normally consume their domestic tap water. We recruited the volunteers at a water quality research laboratory in Adelaide, Australia. Participants maintained a detailed consumption and exposure diary over the 5-week study. We also analyzed tap water and first morning urine (FMU) samples for TCAA, and tap water for chloral hydrate (CH). We documented both interindividual and intraindividual variability in TCAA ingestion and urinary excretion, and both were substantial. With a TCAA-free bottled water intervention, we used creatinine-adjusted urinary TCAA levels to estimate urinary TCAA excretion half-lives for three of the participants. We observed correspondence over time between estimated TCAA excretion, calculated from TCAA + CH ingestion levels, and measured TCAA urinary excretion. This study demonstrates the merits and feasibility of using TCAA in FMU as an exposure biomarker, and reveals remaining concerns about possible alternate sources of TCAA exposure for individuals with low drinking water ingestion exposure.
Froese, Kenneth L; Sinclair, Martha I; Hrudey, Steve E
Question: What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? Data Sources: The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. Study Selection: All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. Data Extraction: A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. Main Results: The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. Conclusion: The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored.
The Agricultural HealthStudy (AHS) was undertaken to ascertain the etiology of cancers observed to be elevated in agricultural populations. Methods: The AHS is a large prospective, cohort study of private applicators and commercial applicators licensed to apply restricted use ...
How does one learn about primary health care? Some might attend public health schools while others will find different ways to explore this fascinating field on their own. One particularly nice resource on the subject is this course from the Johns Hopkins School of Public Health. Offered as part of the Open Course Ware initiative, the course was first developed in the fall of 2011 and was co-taught by Henry Taylor and Henry Perry. It was designed to introduce students to "the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." The materials here include the syllabus, lecture materials, readings, and assignments. Within the Lecture Materials section visitors can watch or listen to conversions on the roots of community-based primary health care and women's empowerment via public health. Additionally, visitors can look over the course assignments or check out some of the discussion questions.
...the results of a health assessment or health effects study...to conduct the health assessment, and parties potentially...part (other than health assessments) shall be reported or...only after appropriate peer...
...the results of a health assessment or health effects study...to conduct the health assessment, and parties potentially...part (other than health assessments) shall be reported or...only after appropriate peer...
This report focuses on in-depth case studies of six employers, two health maintenance organizations (HMOs), and one managed behavioral healthcare organization (MBHO) in an effort to provide clear and well documented examples for other companies and manage...
Background Individuals with posttraumatic stress disorder (PTSD) are more likely to undertake harmful health behaviors like substance use. Less is known about the association of PTSD with healthful behaviors such as healthy diet and exercise. The purpose of this study was to examine differences across physical health indicators and health behaviors in individuals with and without PTSD. Methods A cross-sectional, case–control study of health indicators and self-reported health behaviors in a community and military veteran sample was used. Results Based on a structured psychiatric interview, 25 participants had PTSD, and the remaining 55 without PTSD served as the comparison group. Participants were 40 years old on average and 45% were female. Multivariate analysis of variance analyses revealed that participants with PTSD had significantly higher body mass index (p = 0.004), had more alcohol use (p = 0.007), and reported fewer minutes of vigorous exercise (p = 0.020) than those without PTSD. Chi-square analysis of diet content and eating behavior constructs found that individuals with PTSD ate fewer fruits (p = 0.035) and had more guilt after overeating (p = 0.006). Conclusions These findings replicate prior research on the link between PTSD and negative health outcomes and engagement in harmful health behaviors and highlight the need for further examination of the association between PTSD and other health behaviors like diet content, eating behaviors, and exercise.
From new lightcurves obtained near their 2014 oppositions rotation periods and amplitudes are found for 18 Melpomene 11.571 ± 0.002 hours, 0.16 ± 0.02 magnitudes; 234 Barbara 26.473 ± 0.002 hours, amplitude 0.16 ± 0.02 magnitudes; 236 Honoria 12.336 ± 0.001 hours, 0.23 ± 0.02 magnitudes; 520 Franziska 16.507 ± 0.001 hours, 0.35 ± 0.02 magnitudes; and 525 Adelaide 19.967 ± 0.001 hours, amplitude 0.35 ± 0.03 magnitudes near celestial longitude 180 degrees and 0.02 ± 0.01 magnitudes at celestial longitude 57 degrees, latitude -4 degrees. The amplitude - aspect method strongly suggests the latter position lies within a few degrees of one of the two rotational poles.
Many studies, both national and international, have shown that tea has protective effects on many chronic diseases and their risk factors. In cancer prevention, our studies indicated that tea drinking could inhibit the carcinogenicity of various chemical carcinogens, including oral tumors induced by 7,12-dimethylbenz[a]anthracene (DMBA) in Golden hamsters, esophageal tumors in rats by blocking in vivo synthesis of N-Nitroso-methylbenzylamine (NMBzA), esophageal cancer induced by NMBzA in rats, precancerous liver lesions (r-GT and GST-P) induced by diethylnitrosamine (DENA) in rats, intestinal preneoplastic lesion (ACF) and intestinal tumors induced by 1,2-dimethyl-hydrazine (DMH) in rats, lung carcinoma induced by nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone(NNK) in A/J mice. Our studies have also shown that the protective effects of tea against cancer is a combined effects of various tea ingredients, among which the major ones are polyphenols and tea pigments. Based on animal studies, antioxidant properties, protection against DNA damage and modulation of immune functions were found to be the main mechanisms of anticancer effects of tea. In human trials, tea drinking showed protective effects against oxidative damage and DNA damage caused by cigarette smoking. Mixed tea drinking significantly blocked lesion progress in patients with oral mucosa leukoplakia, therefore, demonstrated its protective effects on oral cancer. Our studies have also shown effects of tea on prevention of cardiovascular diseases (CVD). For example, tea pigments was found to significantly inhibit LDL oxidation induced by Cu2+, Fe2+ in in vitro studies. In vivo studies showed that tea could prevent blood coagulation, facilitate fibrinogen dissolution, inhibit platelet aggregation, lower endothelin levels, enhance GSH-Px activities, protect against oxidated LDL-induced damage in endothelium cells, and prevent atherosclerosis of coronary arteries. The mechanisms of these protective effects of tea are possibly related to its antioxidant properties or its inhibition of lipid oxidation. Green tea and pigments was also found to inhibit cardiac hypertrophy induced by renal hypertension in rat models, whose mechanisms might, at least partly, involve its modulation on nitric oxide, angiotensin II and endothelin-1. Clinical intervention trials have indicated that tea and tea extracts decreased blood lipid, improved blood flow of coronary artery, and played an important role in atherosis inhibition and prevention. Our studies also showed that tea drinking has protective effects on diabetes. White tea drinking could significantly relieve symptoms including polyuria, polydipsia, polyphagia and weight loss in diabetic mice, decrease fasting plasma glucose level and improve glucose tolerance. In human trial, continuous white tea drinking could significantly improve symptoms of diabetic patients, such as relieve polydipsia, decrease plasma glucose levels, both fasting and 2 hours after meal, and increase insulin secretion. The effective rate for glucose lowering is 48% in clinical study. PMID:22279681
Background: The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community…
Kyle, Tonja M.; Brener, Nancy D.; Kann, Laura; Ross, James G.; Roberts, Alice M.; Iachan, Ronaldo; Robb, William H.; McManus, Tim
Tea, next to water is the cheapest beverage humans consume. Drinking the beverage tea has been considered a health-promoting habit since ancient times. The modern medicinal research is providing a scientific basis for this belief. The evidence supporting the health benefits of tea drinking grows stronger with each new study that is published in the scientific literature. Tea plant Camellia sinensis has been cultivated for thousands of years and its leaves have been used for medicinal purposes. Tea is used as a popular beverage worldwide and its ingredients are now finding medicinal benefits. Encouraging data showing cancer-preventive effects of green tea from cell-culture, animal and human studies have emerged. Evidence is accumulating that black tea may have similar beneficial effects. Tea consumption has also been shown to be useful for prevention of many debilitating human diseases that include maintenance of cardiovascular and metabolic health. Various studies suggest that polyphenolic compounds present in green and black tea are associated with beneficial effects in prevention of cardiovascular diseases, particularly of atherosclerosis and coronary heart disease. In addition, anti-aging, antidiabetic and many other health beneficial effects associated with tea consumption are described. Evidence is accumulating that catechins and theaflavins, which are the main polyphenolic compounds of green and black tea, respectively, are responsible for most of the physiological effects of tea. This article describes the evidences from clinical and epidemiological studies in the prevention of chronic diseases like cancer and cardiovascular diseases and general health promotion associated with tea consumption.
This report describes the design and conduct of two sequential historical prospective morbidity surveys of workers and residents from the Upper Ottawa Street Landfill Site in Hamilton, Ontario. The workers study was carried out first and was a hypothesis-generating study. Workers and controls were administered a health questionnaire, which was followed by an assessment of recall bias through medical chart
Focuses on the need for health and safety for participants of study-abroad programs. Lists five themes that guide the Interorganizational Task Force on Safety and Responsibility in Study Abroad's efforts to ensure student safety, including: (1) the definition of "sponsor"; and (2) the need for guidelines for advisers and partner institutions. (CJW)
Background The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. Objective To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Method Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. Results 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. Conclusion We did not find use of psychedelics to be an independent risk factor for mental health problems.
As a nationally representative cohort of middle-aged and elderly adults with longitudinal data spanning nearly two decades, the Health and Retirement Study (HRS) is an important resource for researchers studying the dynamics of health insurance coverage in the United States and the relation of insurance coverage to the use of health services and to health outcomes. We assessed the strengths
John Z. Ayanian; Ellen Meara; J. Michael McWilliams
The purpose of the Canadian Study of Diet, Lifestyle, and Health is to investigate the relationship between diet, lifestyle factors, molecular markers, and cancer incidence in Canada. The cohort was established predominantly by recruiting alumni from the Universities of Alberta, Toronto, and Western Ontario between 1995 and 1998, but also includes a small contingent recruited mostly in 1992 through the Canadian Cancer Society.
Whether menthol cigarettes confer a higher risk of death than plain cigarettes is not known. The Lung HealthStudy (LHS) enrolled 5,887 adult smokers in a clinical trial of smoking cessation and ipratropium in the prevention of chronic obstructive pulmonary disease. LHS participants have been subjected to surveillance for mortality from all causes for 14 years. We examined these data for differences between self-reported smokers of menthol cigarettes versus plain cigarettes. Using proportional hazards regression methods, we found no differences in hazard ratios for coronary heart disease, cardiovascular disease, lung cancer, or death from any cause. Contrary to expectations about nicotine dependence, we found that users of menthol cigarettes had smoked fewer pack-years at baseline. We found no difference in success at smoking cessation with or without menthol. We conclude that our data contain no evidence that mentholation of cigarettes increases the hazards of smoking. PMID:17365741
Murray, Robert P; Connett, John E; Skeans, Melissa A; Tashkin, Donald P
The NIH-AARP (formally known as the American Association of Retired Persons) Diet and HealthStudy was initiated to investigate relations among diet, lifestyle, and cancer. In 1995 and 1996, the study recruited more than 560,000 AARP members, aged 50 to 71 years, who resided in one of six states (California, Florida, Pennsylvania, New Jersey, North Carolina, and Louisiana) or in two metropolitan areas (Atlanta, Georgia, and Detroit, Michigan). The baseline questionnaire collected information on diet and some lifestyle factors.
The Medicare Study of the Cooperative Health Education Project (CHEP) was a randomized, controlled, prospective trial of self-care interventions within the Medicare population of a health maintenance organization, the Rhode Island Group Health Association...
This report describes the design and conduct of two sequential historical prospective morbidity surveys of workers and residents from the Upper Ottawa Street Landfill Site in Hamilton, Ontario. The workers study was carried out first and was a hypothesis-generating study. Workers and controls were administered a health questionnaire, which was followed by an assessment of recall bias through medical chart abstraction. Multiple criteria were used to identify health problems associated with landfill site exposure. Those problems with highest credibility included clusters of respiratory, skin, narcotic, and mood disorders. These formed the hypothesis base in the subsequent healthstudy of residents living adjacent to the landfill site. In that study, the association between mood, narcotic, skin, and respiratory conditions with landfill site exposure was confirmed using the following criteria: strength of association; consistency with the workers study; risk gradient by duration of residence and proximity to the landfill; absence of evidence that less healthy people moved to the area; specificity; and the absence of recall bias. The validity of these associations were reduced by three principal problems: the high refusal rate among the control population; socioeconomic status differences between the study groups; and the fact that the conditions found in excess were imprecisely defined and potentially interchangeable with other conditions. Offsetting these problems were the multiple criteria used to assess each hypothesis, which were applied according to present rules. Evidence is presented that supports the hypothesis that vapors, fumes, or particulate matter emanating from the landfill site, as well as direct skin exposure, may have lead to the health problems found in excess. Evidence is also presented supporting the hypothesis that perception of exposure and, therefore, of risk, may explain the results of the study. However, based on the analyses performed, it is the conclusion of the authors that the adverse effects seen were more likely the result of chemical exposure than of perception of risk.
Heat waves are not uncommon in Australia, but the event of 2009 was particularly severe and ranks third of the 21 recorded heat wave events in south-eastern Australia in terms of the resulting mortality and morbidity. This is a review of Coronial autopsy findings in South Australia (which has an area of nearly 1 million square kilometres with a population of 1.6 million that predominantly resides within the region of the capital: Adelaide) during the period of the 2009 heat wave. Fifty-four post-mortem examinations were performed on cases in which exposure to high ambient temperature was regarded as having caused or significantly contributed to the death. The findings (including results of toxicological and biochemical analyses, where available) are reviewed and compared with the post-mortem examination findings in 22 deaths over the same period not attributed to the effects of heat. There were no specific autopsy findings that distinguished heat-related from non heat-related deaths. The lack of specific post-mortem findings increases the reliance on scene investigation in order to be able to categorise a death as being heat-related. A checklist for scene investigators is proposed in order to assist with collection of relevant data to assist the Coronial investigation process. PMID:24485426
Herbst, Jonathon; Mason, Kerryn; Byard, Roger W; Gilbert, John D; Charlwood, Cheryl; Heath, Karen J; Winskog, Carl; Langlois, Neil E I
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...
Background The role of health services must be re-oriented towards health promotion to more effectively contribute to population health. One of the objectives of the Swedish public health policy is that health promotion and disease prevention should be an integral part of the health care system and an important component of all care and treatment. However, the uncertainty about what the concepts of health and health promotion mean poses a challenge for implementation. Depending on how these concepts are interpreted, the attitudes of health professionals toward health promoting practices will differ. Thus, a more in-depth understanding of health professionals' views can be a starting point for a discussion about the values and attitudes that influence the current health care system and about the barriers and possibilities for future development of a health promoting health service. Methods Seven focus group discussions (n = 34) were carried out with health professionals, from different health care settings, to understand how they communicate about health and health promotion. The data were analyzed using qualitative content analysis. Results The analysis of health professional's general understanding of the concept of health resulted in the category; a multi-facetted concept, whilst the category; a subjective assessment describes what health means to themselves. A third category; health is about life, the whole life. describes their understanding of health as an outcome of a multiplicity of contextually dependent determinants. The health professional's multiple ways of associating health promotion to disease prevention suggest a concept that is diffuse, elusive and difficult to apply in practice. Despite a shared view of health, the health professionals described their health promotion role very differently depending partly on how the concept of health promotion was interpreted. The analysis resulted in the development of three ideal types, labelled the demarcater, the integrater and the promoter describing different strategies for handling a health promotion role in practice Conclusion The study suggests that different interpretations of what constitutes health promotion can lead to unnecessary misunderstandings and pose barriers to further development of a health promoting practice.
Johansson, Helene; Weinehall, Lars; Emmelin, Maria
Clinical data collected from a 15-year study of the homogenous group of pre-Shuttle astronauts have revealed no significant long-term effects from spaceflight. The current hypothesis suggests that repeated exposures to the space environment in the Shuttle era will similarly have no long-term health effects. However, a much more heterogenous group of astronauts and non-astronaut scientists will fly in Shuttle, and data on this group's adaptation to the space environment and readaptation to earth are currently sparse. In addition, very little information is available concerning the short- and long-term medical consequences of long duration exposure to space and subsequent readaptation to the earth environment. In this paper, retrospective clinical information on astronauts is reviewed and concepts for conducting epidemiological studies examining long-term health effects of spaceflight on humans, including associated occupational risks factors, are presented.
Nicogossian, A. E.; Pool, S. L.; Leach, C. S.; Moseley, E.; Rambaut, P. C.
Background The aims of this study were to assess women's knowledge and experiences of dental health in pregnancy and to examine the self-care practices of pregnant women in relation to their oral health. Methods Women in the postnatal ward at the Women's and Children's Hospital, Adelaide, completed a questionnaire to assess their knowledge, attitudes and practices to periodontal health. Pregnancy outcomes were collected from their medical records. Results were analysed by chi-square tests, using SAS. Results Of the 445 women enrolled in the survey, 388 (87 per cent) completed the questionnaire. Most women demonstrated reasonable knowledge about dental health. There was a significant association between dental knowledge and practices with both education and socio-economic status. Women with less education and lower socio-economic status were more likely to be at higher risk of poor periodontal health compared with women with greater levels of education and higher socioeconomic status. Conclusion Most women were knowledgeable about oral and dental health. Lack of knowledge about oral and dental health was strongly linked to women with lower education achievements and lower socioeconomic backgrounds. Whether more intensive dental health education in pregnancy can lead to improved oral health and ultimately improved pregnancy outcomes requires further study.
Thomas, Natalie J; Middleton, Philippa F; Crowther, Caroline A
The Health, Eating, Activity, and Lifestyle Study began in 1996. It enrolled approximately 1,200 women with early stage breast cancer and has completed 2-year, 5-year, and 10-year follow-up. Follow-up has been both active (at 2 years, 5 years, and 10 years for recurrences and updates of exposure variables) and passive (yearly through the respective SEER registries for vital status and second primaries).
The present health care system has evolved during a period of strong economic growth, low unemployment, businesses providing comprehensive first dollar group hospitalization plans for their employees, governmental grant programs, Medicare/Medicaid and rea...
The National Forum on the Future of Defense Health Information Systems (National Forum) held in Washington, DC in March 2008 provided a unique opportunity to conduct a case study of developing a large complex health information system. The concept of the health information system has evolved from the days to electronic hospital information system (HIS) to longitudinal health record (LHR)
Objective: To analyse teachers' health views in order to obtain general trends in factors influencing health and health education and to fit them into the negative-positive model of health proposed by Downie and collaborators. Method: This large international study involved 15 countries from Western and Eastern Europe, North and Sub-Saharan…
Jourdan, D.; Pironom, J.; Berger, D.; Carvalho, G. S.
Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1) facilitators that help mental health service users engage in better health behaviors and (2) the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1) factors of empowerment, self-value, and personal growth; (2) the need for social support; (3) pragmatic aspects of motivation and planning; and (4) access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Graham, Candida; de Leeuw, Sarah; Griffiths, Brenda
The Persian Gulf Women's Health Linkage Study will provide baseline health and risk factor information to estimate the prevalence of selected health conditions, with an emphasis on reproductive health. The research will compare the incidence, prevalence, ...
One of the most controversial explanations of class inequalities in health is the health selection hypothesis or drift hypothesis which suggests there is a casual link between the health status of individuals and their chances of social mobility, both inter- and intra-generational. This study tests this hypothesis, and tries to answer three related questions: (a) to what extent does health
Background: Health education in primary and middle schools in China has been implemented for more than two decades since 1990s. This study aims to assess the students’ health literacy gained through school health education, and provide scientific base to the concerned government agencies for updating the relevant national policy for school-based health education.Methods: The study was conducted through cross-sectional multi-stage
... research, published May 6 in the Annals of Internal Medicine , shows the public has received a high return ... Institute, Bethesda, Md.; May 6, 2014, Annals of Internal Medicine HealthDay Copyright (c) 2014 HealthDay . All rights reserved. ...
Background. The World Health Organisation defines health as “a state of complete physical, mental and social well-being, not merely the absence of disease or infermity”. In May 1984 the spiritual dimension became part of WHO Member States’ strategies for health. The WHO defines quality of life as “individuals’ perceptions of their position in life in the context of the culture
M. E. Boero; M. L. Caviglia; R. Monteverdi; V. Braida; M. Fabello; L. M. Zorzella
Background Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system. Methods A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Results Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health. Conclusions The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.
Background: Health education in primary and middle schools in China has been implemented for more than two decades since 1990s. This study aims to assess the students' health literacy gained through school health education, and provide scientific base to the concerned government agencies for updating the relevant national policy for school-based…
The Agricultural HealthStudy (AHS) is a collaborative effort between the National Cancer Institute, the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency, and the National Institute for Occupational Safety and Health. The AHS is the...
The microwave frequency (MF) partial-reflection radar ran continuously since November 1983, with data being analyzed in real time. The spaced antenna technique was used routinely to produce a climatology of the mean circulation, atmospheric tides, and gravity waves. Since the beginning of 1985, the system was also used as a Doppler radar to measure the spectral widths of the mesospheric echoes. This has enabled the turbulence dissipation rates to be determined. The Stratosphere-Troposphere (ST) radar was operated in the spaced antenna mode to measure winds in November 1984, in conjunction with a cooperative campaign to study the propagation of cold fronts across SE Australia. Observations were also performed to study the structure of the more intense and deeper cold fronts, which occur in late winter.
Consideration of children's distinctive susceptibility in environmental healthstudies. Pauline Mendola (US EPA, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC 27711) Children are a particularly susceptible subpopulation with ...
42 Public Health 1 2013-10-01 2013-10-01 false Decision to conduct health effects study. 90.7 Section 90.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...
The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign. PMID:23348094
Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L
Health care professionals often lack adequate knowledge about health literacy and the skills needed to address low health literacy among patients and their caregivers. Many promising practices for mitigating the effects of low health literacy are not used consistently. Improving health literacy training for health care professionals has received increasing emphasis in recent years. The development and evaluation of curricula for health professionals has been limited by the lack of agreed-upon educational competencies in this area. This study aimed to identify a set of health literacy educational competencies and target behaviors, or practices, relevant to the training of all health care professionals. The authors conducted a thorough literature review to identify a comprehensive list of potential health literacy competencies and practices, which they categorized into 1 or more educational domains (i.e., knowledge, skills, attitudes) or a practice domain. The authors stated each item in operationalized language following Bloom's Taxonomy. The authors then used a modified Delphi method to identify consensus among a group of 23 health professions education experts representing 11 fields in the health professions. Participants rated their level of agreement as to whether a competency or practice was both appropriate and important for all health professions students. A predetermined threshold of 70% agreement was used to define consensus. After 4 rounds of ratings and modifications, consensus agreement was reached on 62 out of 64 potential educational competencies (24 knowledge items, 27 skill items, and 11 attitude items), and 32 out of 33 potential practices. This study is the first known attempt to develop consensus on a list of health literacy practices and to translate recommended health literacy practices into an agreed-upon set of measurable educational competencies for health professionals. Further work is needed to prioritize the competencies and practices in terms of relative importance.
Coleman, Clifford A.; Hudson, Stan; Maine, Lucinda L.
The mental health component of the countywide human services planning program of the Johnson County Regional Planning Commission in Iowa is described. The report on mental health is one in a series of eight reports outlining the program. The overall goal ...
The Agricultural HealthStudy (AHS) is a collaborative effort between the National Cancer Institute, the National Institute of Environmental Health Sciences, and the U.S. Environmental Protection Agency to quantify cancer and non-cancer health risks in the agricultural communit...
Because the demand for health services exceeds the supply, information concerning the aspirations, interests, and motivating factors which lead individuals to choose a health career and the obstacles in the path of health career development are of vital concern to counselors and guidance personnel. This paper reports the findings of three studies…
Patients' health literacy is increasingly recognized as a critical factor affecting health communication and outcomes. We performed this study to assess the levels of health literacy by using Rapid Estimate of Adult Literacy in Medicine (REALM) and Newest Vital Sign (NVS) instruments. Patients (n = 456) at a family medicine clinic completed…
Mobile phones have been shown effective in several public health domains. However, there are few evaluations of the effectiveness of mobile health in health promotion. Also, although many studies have referenced behavioral theory, none appears to have explicitly tested theoretical assumptions or demonstrated mechanisms of change. More robust evaluation models that incorporate theory and measurement of behavioral mediators are needed.
W. Douglas Evans; Lorien C. Abroms; Ronald Poropatich; Peter E. Nielsen; Jasmine L. Wallace
Student health advocates (SHAs) are high school students who, under the supervision of the school nurse, provide health education and health promotion activities to other students via a peer education model. This 3-year follow-up study explored how the SHA experience influences career choice and attitudes of the participants. It also examined what…
The Oral Health Impact Profile (OHIP) is a measure of oral-health-related quality of life developed in Australia but being used increasingly in other populations. In view of the culturally specific nature of peoples' perceptions of health, if we are to make between-population comparisons of oral-health-related quality of life, cross-cultural equivalency of the relevant instruments needs to be verified. A study
A large national survey has been conducted to investigate the nature and prevalence of fallacious or questionable health beliefs and practices, and the susceptibility to them. Area probability techniques are used to produce a representative sample of the ...
This bulletin states the educational objectives of the Montgomery County, Maryland, public schools and outlines specific goals in the health education program for students from kindergarten through the twelfth grade. (JD)
Montgomery County Public Schools, Rockville, MD. Dept. of Instructional Planning and Development.
Background To assess the association of income-related social mobility between the age of 13 and 30 years on health-related quality of life among young adults. Methods In 1988-89 n?=?7,673 South Australian school children aged 13 years were sampled with n?=?4,604 children (60.0%) and n?=?4,476 parents (58.3%) returning questionnaires. In 2005-06 n?=?632 baseline study participants responded (43.0% of those traced and living in Adelaide). Results Multivariate regressions adjusting for sex, tooth brushing and smoking status at age 30 showed that compared to upwardly mobile persons social disadvantage was associated (p?0.05) with more oral health impact (Coeff?=?5.5), lower EQ-VAS health state (Coeff?=?-5.8), and worse satisfaction with life scores (Coeff?=?-3.5) at age 30 years, while downward mobility was also associated with lower satisfaction with life scores (Coeff?=?-1.3). Conclusions Stable income-related socioeconomic disadvantage was associated with more oral health impact, and lower health state and life satisfaction, while being downwardly mobile was associated with lower life satisfaction at age 30 years. Persons who were upwardly mobile were similar in health outcomes to stable advantaged persons.
In the present study, 805 Greek students participated by filling in self-report questionnaires studying depression (Center for Epidemiological Studies Depression Scale), general health status (General Health Questionnaire), general psychopathology (Symptom Checklist-90-R), and personal demographic features. Some of the more prevalent findings…
Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully. Additional formative and operational research is essential to explore the true potential of the technology. Frameworks for regulation in regards to eHealth governance should be the aim of future research on the integration of eHealth and mHealth into the Bangladesh health system.
All Norwegian twin pairs born 1967–1974 and still living in Norway in 1992 were invited to a health questionnaire study (Q1). 2,570 pairs (65%) participated. These cohorts and the twin cohorts born 1967–1979 were invited to a new questionnaire study (Q2) in 1998. This time 3,334 pairs (53%) participated. Almost all pairs having participated in the 1998 study were invited to an interview study of mental health (MHS), taking place 1999–2004. 1,391 complete pairs (44%) participated. The questionnaire studies included extensive data on somatic health with fewer items on mental health and demography. Health-related and demographic information available from the Medical Birth Registry on all invited twins was applied to predict participation to the first study. A few registry variables indicating poor health predicted nonparticipation in Q1. Health information and demography from Q1 were tested as predictors of participation in the follow-up study (Q2). Monozygosity, female sex, being unmarried, having no children, and high education predicted participation, whereas few indicators of poor mental and somatic health and unhealthy lifestyle moderately predicted nonparticipation in Q2. No health indicators reported in Q2 predicted further participation. Standard genetic twin analyses of indicators of various mental disorders from Q2, validated by diagnostic data from the MHS, did not indicate differences in genetic/environmental covariance structures between participants and nonparticipants in MHS. In general the results show a moderate selection towards good mental and somatic health. Attrition from Q2 to the MHS does not appear to affect twin analyses of mental health related variables.
Tambs, Kristian; R?nning, Torbj?rn; Prescott, C. A.; Kendler, Kenneth S.; Reichborn-Kjennerud, Ted; Torgersen, Svenn; Harris, Jennifer R.
The relationship between religion and health has been the subject of growing interest in epidemiological research. The aim of this paper is to review the data on relationship between health-related behaviors associated with religiosity and reduced mortality and morbidity. In this review beneficial effects of religiosity on specific physical and mental health diseases, focusing on coronary heart disease, cancer, depression, suicide, psychosis, and substance abuse are described. Religious beliefs and practices can represent powerful sources of comfort, hope, and meaning and they are associated with protective dietary habits and reduced risk of substance abuse. Religiosity can be also harmful as it is often entangled with neurotic and psychotic disorders. The current published data suggests that religiosity has a favorable effect on survival, although the methodological controversies including presence of biases typical for observational research indicate that results should be interpreted with caution. PMID:22779346
We have investigated the usefulness of environmental health indicators for the evaluation of environmental health in Korea. We also assessed the association between environmental contamination and health outcomes by integrating indicators into a composite measure. We selected health-related environmental indicators and environment-related health status indicators. The data were obtained from published statistical data from the period 2008–2009. Both synthesized measures of environmental indicators and health status indicators were calculated using Strahll’s taxonometric methods. The range of values determined by this method is 0–1, with higher values representing a better situation in the given area. The study area consisted of 16 large administrative areas within Korea. The arithmetic mean of the synthesized measure of environmental indicators was 0.348 (SD = 0.151), and that of the synthesized measure of health status indicators was 0.708 (SD = 0.107). The correlation coefficient between the synthesized measures of environmental indicators and health status indicators was 0.69 (95% CI: 0.28–0.88). Comparisons between local communities based on integrated indicators may provide useful information for decision-makers, allowing them to identify priorities in pollutant mitigation policies or in improvement actions for public health. Integrated indicators are also useful to describe the relationships between environmental contamination and health effects.
This study provided a comprehensive assessment of the association between social support and health using longitudinal data from the Veterans HealthStudy. Unlike previous studies which examined the relationship between one single domain of social support with either mental or physical health, the present study assessed the effects of three different domains of social support on multiple measures of health.
Xinhua S. Ren; Katherine Skinner; Austin Lee; Lewis Kazis
InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. After experiencing high growth, the company confronts several operational challenges. As a responsive measure, management considers developing an IT system. The system must go through the formal capital investment evaluation process, which requires estimation of costs and benefits and uses the NPV method.
Recently, the Veterans Administration (VA) Under Secretary for Health has designated functional status as one of the domains of value for the system, given its increasing importance for clinical care. The Veterans HealthStudy (VHS) was designed to assist the VA in monitoring outcomes and measuring the case mix of patients who use the VA. The Veterans SF-36 (short form
Lewis E. Kazis; Xinhua S. Ren; Austin Lee; Katherine Skinner; William Rogers; Jack Clark; Donald R. Miller
RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTHSTUDY Allison L. Naleway*, Nancy L. Sprince?, Erik R. Svendsen?, Ann M. Stromquist?, James A. Merchant? *Marshfield Medical Research and Education Foundation, Marshfield, WI; ?University of Iowa Co...
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study examining cancer and non-cancer health outcomes for over 55,000 pesticide applicators and 34,000 spouses in Iowa and North Carolina. Questionnaires were used to collect information about the use of specific ...
The health care delivery system in the Soledad Hospital District of Monterey County, California, is described in a study by the Mid-Coast Comprehensive Health Planning Association, and recommendations for improving local health care services are presented...
Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N?=?330 for each form of diet - vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors. PMID:24516625
Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with governments, professionals and civil societies, health systems or facilities for promoting best practices, improving quality of care and achieving better health for mothers and children.
Objective: To describe methods and challenges of oral healthstudies nested in a prospective cohort study of adults. Methods: A sample of 2,016 adults was investigated in 2009. Household visits were performed in order to apply a questionnaire on socioeconomic, demographic, health related variables, medicine consumption, blood donation, domestic violence and a set of questions related to women's health. Oral health data included self-reported oral health, number of remaining teeth, dental services use, perception of dental treatment needs, occurrence, intensity and impact of dental pain on daily life, xerostomia and chewing impairment due to poor oral health. In addition, participants' blood pressure, weight, height and waist circumference were measured. The second wave of the study was carried out in 2012. A questionnaire on socioeconomic factors, quality of life, discriminatory experiences, 24-hour dietary recall and oral health aspects (the same used in 2009) was applied. In addition, blood pressure, weight, and waist circumference were measured and clinical oral health status was assessed (dental caries, tooth loss, and periodontal outcomes). Results: Participation rate was 85.3% (n = 1,720) in 2009 and, among those, 1,222 (71.1%) were followed up in 2012. Conclusions: The follow-up of this population will contribute in the elucidation of the potentially causal associations between oral outcomes and general chronic diseases. PMID:24918424
Peres, Marco Aurelio; Peres, Karen Glazer; Boing, Antonio Fernando; Bastos, João Luiz; Silva, Diego Augusto; González-Chica, David Alejandro
This paper uses newly collected household survey data from Accra, Ghana, to investigate whether incomes affect acute and chronic health outcomes in settings that can be considered representative for the large and rapidly growing urban centers of sub-Saharan Africa. The Time Use and HealthStudy in Accra collected information on incomes, current health status, and health care use from 5,484 persons in 1,250 households, each repeatedly sampled on a rolling basis for a period of 13 weeks. Data collection took place during September 2008–March 2010 to capture seasonal variations. The study found that incomes varied widely between households, and that a high fraction of persons lived below the poverty line. Despite this level of income poverty and an overall remarkably high burden of treatable disease, no systematic differences in self-reported and objectively measured health conditions were detected across socioeconomic groups.
Introduction: The National Epidemiological and Environmental Assessment of Recreational Water Study (NEEAR) offers a rare opportunity for researchers. The study's design involves the collection of health data before and after visiting the beach in conjunction with water quality...
Background: As a result of low numbers and diversity in study type, occupational health intervention studies are not easy to locate in electronic literature databases. Aim: To develop a search strategy that facilitates finding occupational health intervention studies in Medline, both for researchers and practitioners. Methods: A gold standard of articles was created by going through two whole volumes of 19 biomedical journals, both occupational health specialty and non-occupational health journals. Criteria for occupational health intervention studies were: evaluating an intervention with an occupational health outcome and a study design with a control group. Each journal was searched independently by two of the authors. Search terms were developed by asking specialists and counting word frequencies in gold standard articles. Results: Out of 11 022 articles published we found 149 occupational health intervention studies. The most sensitive single terms were work*[tw] (sensitivity 71%, specificity 88%) and effect*[tw] (sensitivity 75%, specificity 63%). The most sensitive string was (effect*[tw] OR control*[tw] OR evaluation*[tw] OR program*[tw]) AND (work*[tw] OR occupation*[tw] OR prevention*[tw] OR protect*[tw]) (sensitivity 89%, specificity 78%). The most specific single terms were "occupational health"[tw] (sensitivity 22%, specificity 98%) and effectiveness[tw] (sensitivity 22%, specificity 98%). The most specific string was (program[tw] OR "prevention and control"[sh]) AND (occupational[tw] OR worker*[tw]) (sensitivity 47%, specificity 98%). Conclusion: No single search terms are available that can locate occupational health intervention studies sufficiently. The authors' search strings have acceptable sensitivity and specificity to be used by researchers and practitioners respectively. Redefinition and elaboration of keywords in Medline could greatly facilitate the location of occupational health intervention studies.
Verbeek, J; Salmi, J; Pasternack, I; Jauhiainen, M; Laamanen, I; Schaafsma, F; Hulshof, C; van Dijk, F
Background The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. Methods We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. Results The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. Conclusions It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers have a vital role to play in providing the complex evidence required to compare different models of prevention and service delivery. Those working in public health must develop leadership to raise the profile of health inequalities as an issue that merits attention, resources and workforce capacity; and advocate for central government to play a key role in shifting social norms.
The impact of conflict on population health and health infrastructure has been well documented; however the efforts of the international community to rebuild health systems in post-conflict periods have not been systematically examined. Based on a review of relevant literature, this paper develops a framework for analyzing health reform in post-conflict settings, and applies this framework to the case study of health system reform in post-conflict Kosovo. The paper examines two questions: first, the selection of health reform measures; and second, the outcome of the reform process. It measures the success of reforms by the extent to which reform achieved its objectives. Through an examination of primary documents and interviews with key stakeholders, the paper demonstrates that the external nature of the reform process, the compressed time period for reform, and weak state capacity undermined the ability of the success of the reform program.
Family is important to both health and adolescence. Adolescence is a time of peak health, but there are some important family based risk factors. The aim of this study was to explore the perspective of adolescent Iranians on issues of family and their health. We used descriptive, qualitative methodology and purposeful sampling and interviews for collecting the data. Forty?one participants explained their perspectives on health and family. Data were analysed using qualitative content analysis. Analysis revealed three categories of risk factors: a widening generation gap, effective parenting and family financial situation. To have healthy adolescents, both children and parents need more knowledge and better skills about adolescent health and development and about social trends. To understand adolescents in a more realistic way, parents should develop healthy communication to avoid family health problems.
Background Due to the aeging of the population, there is a societal need for workers to prolong their working lives. In the Netherlands, many employees still leave the workforce before the official retirement age of 65. Previous quantitative research showed that poor self-perceived health is a risk factor of (non-disability) early retirement. However, little is known on how poor health may lead to early retirement, and why poor health leads to early retirement in some employees, but not in others. Therefore, the present qualitative study aims to identify in which ways health influences early retirement. Methods Face-to-face semi-structured interviews were conducted with 30 employees (60–64 years) who retired before the official retirement age of 65. Participants were selected from the Study on Transitions in Employment, Ability and Motivation. The interviews were transcribed verbatim, a summary was made including a timeline, and the interviews were open coded. Results In 15 of the 30 persons, health played a role in early retirement. Both poor and good health influenced early retirement. For poor health, four pathways were identified. First, employees felt unable to work at all due to health problems. Second, health problems resulted in a self-perceived (future) decline in the ability to work, and employees chose to retire early. Third, employees with health problems were afraid of a further decline in health, and chose to retire early. Fourth, employees with poor health retired early because they felt pushed out by their employer, although they themselves did not experience a reduced work ability. A good health influenced early retirement, since persons wanted to enjoy life while their health still allowed to do so. The financial opportunity to retire sometimes triggered the influence of poor health on early retirement, and often triggered the influence of good health. Employees and employers barely discussed opportunities to prolong working life. Conclusions Poor and good health influence early retirement via several different pathways. To prolong working life, a dialogue between employers and employees and tailored work-related interventions may be helpful.
BACKGROUND: Middle-aged women experience various health-related problems. The aim of this study was to evaluate the impacts of menopause status and hormone intervention on women's health. METHODS: In an ongoing, population-based study, 4943 women, born 1935 to 1945 and living in the Lund area of Southern Sweden, were included in this analysis. They completed a generic questionnaire pertaining to socio-demographic
Cairu Li; Kittisak Wilawan; Jonas Lidfeldt; Carl-David Agardh; Christina Nerbrand
This curriculum guide for instructors provides a course of study (Nursing III) requisite for the third and concluding portion of a 1-year practical nursing curriculum designed to continue opportunities for career mobility in the health occupations. Content is in three sections: (1) Medical Surgical Nursing II, (2) Mental Health Nursing, and (3)…
BACKGROUND: There has been a consistent rise in bottled water consumption over the last decade. Little is known about the health beliefs held by the general public about bottled water as this issue is not addressed by the existing quantitative literature. The purpose of this study was to improve understanding of the public's health beliefs concerning bottled mineral water, and
Lorna A Ward; Owen L Cain; Ryan A Mullally; Kathryn S Holliday; Aaron GH Wernham; Paul D Baillie; Sheila M Greenfield
This study was undertaken to identify, classify, and interpret extant written school health policies. Furthermore, it was planned to ascertain whether schools were using standardized forms or systematic procedures to formulate school health policies. Administrators in school districts representing every geographical area of the U.S. were asked to…
With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in community health; enhance employability skills, especially in community health; and apply and reinforce…
Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.
This article introduces and explores the concept of political economy. In particular it focuses upon the political economy of health while also considering the implications for international nursing studies in the context of health care more generally. Political economy is not only about budgets, resources and policy. It is also about particular…
This meta-evaluation provides a standardized look at the quality of the economic evaluation literature for multi-component worksite health promotion programs. Analysis of 42 studies suggests that the evidence is very strong for average reductions in sick leave, health plan costs, and workers' compensation and disability costs of slightly more than…
Comparing agricultural cohorts with the general population is challenging because the general healthiness of farmers may mask potential adverse health effects of farming. Using data from the Agricultural HealthStudy, a cohort of 89,656 pesticide applicators and their spouses (...
Background: The School Health Policies and Programs Study (SHPPS) 2006 is the largest, most comprehensive assessment of school health programs in the United States ever conducted. Methods: The Centers for Disease Control and Prevention conducts SHPPS every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail…
Background Most western countries have disability benefit schemes ostensibly based upon requiring (1) a work inhibiting functional limitation that (2) can be attributed to a diagnosable condition, injury or disease. The present paper examines to what extent current practice matches the core premises of this model by examining how much poorer the perceived health of disability benefit recipients is, compared to the employed and the unemployed, and further to examine to what extent any poorer perceived health among benefit recipients can be attributed to mental or somatic illness and symptoms. Methods Information on disability benefit recipiency was obtained from Norwegian registry data, and merged with health information from the Hordaland HealthStudy (HUSK) in Western Norway, 1997–99. Participants (N = 14 946) aged 40–47 were assessed for perceived physical and mental health (Short Form-12), somatic symptoms, mental health, and self reported somatic conditions and diseases treated with medication. Differences associated with employment status were tested in chi-square and t-tests, as well as multivariate and univariate regression models to adjust for potential confounders. Results Recipients of disability benefits (n = 1 351) had poorer perceived physical and mental health than employees (n = 13 156); group differences were 1.86 and 0.74 pooled standard deviations respectively. Self reported somatic diagnoses, mental health and symptoms accounted for very little of this difference in perceived health. The unemployed (n = 439) were comparable to the employed rather than the recipients of disability benefits. Conclusion Recipients of disability benefits have poor perceived health compared to both the employed and the unemployed. Surprisingly little of this difference can be ascribed to respondents' descriptions of their illnesses and symptoms. Even allowing for potential underascertainment of condition severity, this finding supports the increasing focus on non-disease oriented contributing factors. Rehabilitation efforts aiming at return to work should have a strong focus on the patients' perceptions of their health in addition to symptom relief and social factors.
This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…
Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang
Many studies focusing on beliefs about health and health promotion have paid little attention to the life experiences of Black and other visible minority ethnic families in western societies. This paper is a report of a study exploring Black families' beliefs about health and the implications of such beliefs for health promotion. Ten Black…
Mobile phones have been shown effective in several public health domains. However, there are few evaluations of the effectiveness of mobile health in health promotion. Also, although many studies have referenced behavioral theory, none appears to have explicitly tested theoretical assumptions or demonstrated mechanisms of change. More robust evaluation models that incorporate theory and measurement of behavioral mediators are needed. As in all public health programs, mobile health operates within a social ecological context. For example, organizational- and individual-level programs seek to influence health and health care practices and individual health behaviors. New programs such as Text4baby demonstrate how theory and explicit testing of mediators can be incorporated in evaluations. There are challenges and opportunities facing mHealth evaluations given the nature of the mobile channel. Mobile communication is ubiquitous, available at all times and places, and thus experimental control is often difficult. Natural experiments using variation in dosage of mHealth and place- or location-based designs may increase experimental control. Text4baby is a text messaging program that provides prenatal care messages to pregnant women and new mothers. It uses a partnership model with health care facilities often serving as local implementation partners. The authors review a case example of the evaluation of Text4baby at Madigan Army Medical Center. Participants were randomized to usual prenatal care plus text messaging or usual care alone. The evaluation has a theoretical model of behavior change and measures mediators as well as behavioral outcomes. Results will inform how behavioral theory works within mobile health programs. PMID:22548595
Evans, W Douglas; Abroms, Lorien C; Poropatich, Ronald; Nielsen, Peter E; Wallace, Jasmine L
Introduction Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. Methods This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. Results The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. Conclusions District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.
It has been argued that social class, if not dead, is at least a 'zombie category' in contemporary Western society. However, epidemiological evidence shows that class-based inequalities have either persisted or widened, despite overall improvements in the health of Western populations. This article presents an exploratory qualitative study of the individualization of class identity and health conducted in a southern English city. Findings are presented in consideration of two competing argumentative positions around which participants worked to negotiate class identity and health. The first of these positions denied the significance of class for identity and health and was associated with the individualised heroic and stoic narratives of working class identity. The second position acknowledged the reality of class relations and their implications for health and identity, being associated with structurally and politically orientated narratives of middle class identity. In sum, resistance to class was associated with talk about individual, private experience whereas the acceptance of class was linked to discussion of health as a wider social or political phenomenon. This evidence lends qualified support to the individualization thesis: inequalities in health existing on structural or material levels are not simply reproduced, and indeed in some contexts may even juxtapose, accounts of social identity in interview and focus group contexts. Class identity and health are negotiated in lay talk as participants shift argumentatively back and forth between competing positions, and public and private realms, in the attempt to make sense of health and illness. The promotion of greater awareness and interest in health inequalities within wider public discourse may well help support attempts to tackle these injustices. PMID:15246166
Background Governments have been implementing policies aimed at halting the trend towards early retirement for Baby Boomers. Public policies can have a strong effect on when a person retires and this analysis contributes to an improved understanding of retirement aspirations in regards to health, social, workplace and economic determinants. Methods In October 2011 a telephone survey was undertaken with participants aged 50 to 65 years who were in paid employment and who had been in the workforce for the previous three years. Participants were obtained from two identical South Australian cohort studies - the North West AdelaideHealthStudy and the Florey Adelaide Male Ageing Study. The results of the telephone survey were linked to the original cohort data. Data were weighted by sex, age, postcode and probability of selection in the household. Work related questions included how much they thought about their retirement, current occupation, employment status, type of workplace and hours worked per week. Health related questions included current smoking status, physical activity, body mass index, self-reported health status and overall life satisfaction. Uni-variable and multi-variable analyses were undertaken to compare the different associations between people who were and were not intending to retire. Results In total, 25.9% (n?=?210) of people who were currently in paid employment indicated that they intend to retire completely from the workforce. The remainder indicated that they will continue to work (41.8% retire from full-time work but work part-time, 25.7% continue working part-time but reduce their current hours, and 6.7% never retire). The multi-variable results indicate that those with lower education, having a savings habit, and sales workers more likely to anticipate complete retirement. The self-employed, and those thinking only moderately about retirement, were more likely to extend their working life beyond age 65. Conclusion An important finding of this study is the large number of Baby Boomers who indicated that they would be happy to work part-time or never retire. Policies and continued dialogue aimed at making the workplace a safe, flexible and welcoming environment to accommodate this wish, and to entice others to take up this option over complete withdrawal from the labour force, is required.
This study investigates the delivery of all aspects of Primary Health Care (PHC) in a case study of one urban health centre in Maputo, Mozambique. Within the context of overall social and economic change, Mozambique has given priority to primary health care as the driving force in its newly developed National Health Service. The urban and rural health centres are intended to be the principal vehicles for PHC delivery, and in this study one of Maputo's recently opened health centres was investigated by observing all clinic sessions, interviewing all health centre workers and collecting data from health centre records. It was found that a dichotomy exists between the tasks ascribed to the health centre in the PHC framework, and the feasibility of their execution given existing personnel and material resources. This derives in part from lack of involvement of PHC practitioners in the organisation and planning of PHC, plus resource allocation which remains in favour of secondary and tertiary rather than primary care. Prevention is accorded priority in PHC theory, yet investigation showed that the major demand on the health centre is for curative care. The quality of both curative and preventive care was evaluated and the need for training in specialist diagnostic skills, and a more socially-based understanding of the determinants of health status and risk emerged, respectively for the groups of workers in the two sectors. The level of contact between the curative and preventive sectors was investigated as was the integration of the health centre into the health service as a whole. The problems arising in these areas must be viewed in the context of the very recent development of a National Health Service in a country where, previously, curative care was available only in urban areas and virtually no preventive programmes existed. This study shows that significant steps are being taken to develop a comprehensive PHC programme in Maputo. More important still will be the extension of this level of care provision to the country as a whole. PMID:6505746
This self-study instrument is designed to review graduate programs in health education and health promotion. Information collected can be utilized to assist administrators and faculty to properly assess the status of their specific programs (school health, community health, public health, health promotion/worksite health promotion, other) and…
The primary purpose of this study was to explore resources and programs available in health education for children ages two through twelve. Resources included state curriculum guides, textbooks, films, filmstrips and games. On-site-visits were conducted w...
The study analyzes the occupational structure and personnel practices at five diverse hospitals in the New England area. The researchers specifically address the issue of overlapping medical functions by various categories of allied health personnel and i...
This study investigates the association of several inflammatory markers with subclinical and clinical cardiovascular disease in older men and women. Data are from the baseline assessment of 3,045 well-functioning persons aged 70 to 79 years, participating in the Health, Aging and Body Composition study. The study sample was divided into 3 groups: “cardiovascular disease” (diagnosis of congestive heart failure, coronary
Matteo Cesari; Brenda W. J. H Penninx; Anne B Newman; Stephen B Kritchevsky; Barbara J Nicklas; Kim Sutton-Tyrrell; Russell P Tracy; Susan M Rubin; Tamara B Harris; Marco Pahor
This is the summary volume of a three-volume report of the Kosova coal gasification plant health effects study. The plant is of the Lurgi type and began commercial operation in 1971. The study was conducted under the auspices of the U.S.-Yugoslav Joint Board for Scientific and Technological Cooperation. It had five overall purposes: (1) Identify potential health risks in the
Though rates of foreclosure are at a historic high, relatively little is known about the link between foreclosure and health. We performed a case-control study to examine health conditions and health care utilization in the time period prior to foreclosure. Homeowners who received a home foreclosure notice from 2005 to 2008 were matched (by name and address) to a university hospital system in Philadelphia and compared with controls who received care from the hospital system and who lived in the same zip code as cases. Outcome measures included prevalent health conditions and visit history in the 2 years prior to foreclosure. We found that people undergoing foreclosure were similar to controls with regard to age, gender, and insurance status but significantly more likely to be African American. Rates of hypertension and renal disease were significantly higher among cases after adjustment for sociodemographic characteristics. In the 2 years prior to foreclosure, cases were more likely to visit the emergency department, have an outpatient visit, and have a no-show appointment. Cases were less likely to have a primary care physicians (PCP) visit in the 6 months immediately prior to the receipt of a foreclosure notice. The results suggest changes in health care utilization in the time period prior to foreclosure. Policies designed to decrease the incidence of home foreclosure and support people during the process should consider its association with poor health and changes in health care utilization. PMID:21491152
The World Health Organization (WHO) conducted a study to collect data on mental health resources of pilot areas within several European countries. This report presents data from the study and provides a detailed and reliable description of the development of mental health services within the WHO European Region. Part I of the report describes the…
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…
Background: Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to…
Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie; O'Haver, Judith; Small, Leigh; Mays, Mary Z.
BACKGROUND: Health care for cancer patients is primarily shaped by health care professionals. This raises the question to what extent health care professionals are aware of patients' preferences, needs and values. The aim of this study was to explore to what extent there is concordance between patients' preferences in cancer care and patients' preferences as estimated by health care professionals.
Hester Wessels; Alexander de Graeff; Klaske Wynia; Miriam de Heus; Cas LJJ Kruitwagen; Saskia CCM Teunissen; Emile E Voest
Understanding the conditions under which families try to influence members' health-related practices can provide information to build concepts adding to models of health promotion. This paper reports on an exploratory qualitative study examining the influences of intergenerational relationships in shaping beliefs, knowledge and practices about health and illness in a regional Australian city. We conducted semi-structured interviews with 27 adults with family members of other generations living in the city, all of whom had experience of asthma. We found that overall people's experience of health and illness, particularly in childhood, was taken for granted and not reflected upon. It was in the face of serious illness or death of a family member that objective knowledge about health and illness was sought and integrated within the family leading, in most cases, to significant lifestyle changes or 'doing things differently'. We drew on Bourdieu's concept of the three forms of theoretical knowledge in analysing our findings. We found the concept of knowledge as 'primary taken-for-granted experience', and the concept of praxeological knowledge as the knowledge created by the dialectical relationships between an individual subject and objectives structures were helpful. To influence individual health practices, we need to acknowledge how the family context confirms the taken-for-granted health practices of an individual and the family circumstances that might lead families to seek objective knowledge and make lifestyle changes to promote health. PMID:23232088
Background Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. Methods The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Results Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Conclusions Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.
Results obtained from self-reported health data may be biased if those being surveyed respond differently based on health status. This study was conducted to investigate if health, as measured by health care use preceding invitation, influenced response t...
B. Smith C. N. Spooner I. G. Jacobson T. C. Smith T. S. Wells
The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. The indicators "disability-free life expectancy", "handicap-free life expectancy" and "healthy life expectancy" (based on self-perceived health) were calculated according to Sullivan's method. The results show, for example, that 8.0 of the 16.0 years that men aged 60 years may expect to live, on average, will be free of disability. For men aged 80 years the figures are 1.3 of 5.5 years. For women at 60 years and 80 years the results are 7.3 and 0.5 disability-free years of 19.2 and 7.3 expected life years, respectively. Similar results were found for handicap-free life expectancies and healthy life expectancies. At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies.
Mutafova, M.; van de Water, H. P.; Perenboom, R. J.; Boshuizen, H. C.; Maleshkov, C.
The abstract describes the collaborative effort between the NCI, the NIEHS, the U.S. EPA, and NIOSH to conduct the Agricultural HealthStudy (AHS). The AHS is a prospective epidemiological study to identify factors that may affect the rate of cancer and other diseases among farme...
One of the most controversial explanations of class inequalities in health is the health selection hypothesis or drift hypothesis which suggests there is a casual link between the health status of individuals and their chances of social mobility, both inter- and intra-generational. This study tests this hypothesis, and tries to answer three related questions: (a) to what extent does health status influence the chances of intra-generational mobility of individuals? (b) what is the impact on health inequalities of the various kinds of social mobility (both mobility in the labour market and exit from employment)-do they increase or reduce inequalities? (c) to what extent does health-related intra-generational social mobility contribute to the production of health inequalities? The data analysed in this paper were drawn from the records of the Turin Longitudinal Study, which was set up to monitor health inequality of the Turin population by combining census data, population registry records and medical records. Occupational mobility was observed during the decade 1981-1991. To evaluate the impact of the various processes of social mobility on health inequalities, mortality was observed over the period 1991-1999. The study population consists of men and women aged 25-49 at the beginning of mortality follow-up (1991), and registered as resident in Turin at both the 1981 and the 1991 censuses (N = 127,384). Health status was determined by observing hospital admission. For the purpose of the study healthy individuals were those with no hospital admissions during the period 1984-1986, while those admitted were classed as unhealthy. Social mobility in the labour market was measured via an interval data index of upward and downward movements on a scale of social desirability of occupations, designed for the Italian labour force via an empirical study carried out by de Lillo and Schizzerotto (La valutazione sociale delle occupazioni. Una scala di stratificazione occupazionale per l'Italia contemporanea, Il Mulino, Bologna, 1985). Movement out of the labour market was described by a discrete variable with four conditions: employed, unemployed, early retired and women returning from work to the housewife status. The relationship between health status and occupational mobility was analysed via analysis of variance and multinomial logistic regression. Health inequalities were measured by the ratio of standardised mortality rates in the unskilled working class and the upper middle class. The study found a weak relationship between health status and occupational mobility chances. Decidedly stronger was the impact on occupational mobility of gender, education and "ethnicity" (being born in the South of Italy). The relationship between occupational mobility and health takes two different forms. Occupational mobility in the labour market decreases health inequalities; occupational mobility out of the labour market (early retirement, unemployment, housewife return) widens them. The maximum contribution health-related intra-generational social mobility can make towards health inequalities was estimated at about 13% for men. PMID:14759699
This paper describes a research study designed to evaluate a community health service development in one health authority in rural England. The study compared two types of primary care teams working towards the same objectives. Surveys of patients and staff in the health authority were conducted about a range of issues, defined by the original aims of the scheme. Measures were made of care received by people over 75 years of age, consumer satisfaction, staff experiences of the multi-disciplinary team, job satisfaction and liaison with social services personnel. Few differences existed between the two forms of care on all of these measures. This paper contains a discussion of the findings alongside an examination of the implications for future health service developments, particularly flagship enterprises such as nursing development units. The importance of well established baseline measurements is emphasized by both the research findings and the discussion. PMID:8138630
Background There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario. The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Methods Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Results Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Conclusions Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This study also highlights the critical role of governance and partnerships in facilitating a holistic approach to health. Further research on governance and partnership models, as well as systems-based organizational working practices, is needed to close the gap between One Health and EcoHealth theory and public health practice.
Despite low mortality and cancer incidence rates overall, farmers may experience excess risk of several cancers. These excesses have been observed in some, but not all, retrospective epidemiological studies of agricultural workers in several countries. Excess risk has been ob...
As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration.
Existing data on health status and health care provision in agricultural labour communities in Zimbabwe indicate that both are poor. In addition, there is evidence that the concentration of capital through increased areas of landholdings, through mechanisation and use of agrochemicals produces a rise in under- and unemployment within the agricultural sector, which increases the risk of ill health. This paper addresses this question in Zimbabwe by examining the nature of developments within the large scale agricultural sector in the last decade, and the consequent effects on employment and income. Rising capital intensity in the private large scale sector is found to be associated with increases in unemployment and underemployment. The impact of this socioeconomic pattern on health is assessed in a longitudinal assessment of 78 permanent labour families and 76 non-permanent (underemployed) labour families in the large scale farming sector. The study shows that while poor social, economic and health conditions exist in all groups, non-permanent labour households suffer greater insecurity of employment and income, poorer health status and lesser participation in sociopolitical structures important for negotiating primary health care gains. PMID:3227374
The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program.
George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.
Background Understanding the health status of North Korean refugees (NKRs), and changes in health during the resettlement process, is important from both the humanitarian standpoint and the scientific perspective. The NOrth Korean Refugee health iN South Korea (NORNS) study aims to document the health status and health determinants of North Korean refugees, to observe various health outcomes as they occur while adapting to the westernized lifestyle of South Korea, and to explain the mechanisms of how health of migrants and refugees changes in the context of new environmental risks and opportunities. Methods The NORNS study was composed of an initial survey and a follow-up survey 3.5 years apart. Participants were recruited voluntarily among those aged 30 or more living in Seoul. The survey consists of a health questionnaire and medical examination. The health questionnaire comprises the following six domains: 1) demographic and migration information 2) disease history, 3) mental health, 4) health-related lifestyle, 5) female reproductive health, and 6) sociocultural adaptation. The medical examination comprises anthropometric measurements, blood pressure and atherosclerosis, and various biochemical measurements. Prevalence of several diseases able to be diagnosed from the medical examination, the changes between the two surveys, and the association between the outcome and other measurements, such as length of stay and extent of adaptation in South Korea will be investigated. Furthermore, the outcome will be compared to a South Korean counterpart cohort to evaluate the relative health status of NKRs. Discussion The NORNS study targeting adult NKRs in South Korea is a valuable study because various scales and medical measurements are employed for the first time. The results obtained from this study are expected to be utilized for developing a health policy for NKRs and North Korean people after unification. Additionally, since NKRs are an immigrant group who are the same race and have the same genetic characteristics as South Koreans, this study has the characteristics of a unique type of migrant healthstudy.
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Objective: To establish the mental health needs of homeless children and families before and after rehousing. Design: Cross sectional, longitudinal study. Setting: City of Birmingham. Subjects: 58 rehoused families with 103 children aged 2-16 years and 21 comparison families of low socioeconomic status in stable housing, with 54 children. Main outcome measures: Children’s mental health problems and level of communication; mothers’ mental health problems and social support one year after rehousing. Results: Mental health problems remained significantly higher in rehoused mothers and their children than in the comparison group (mothers 26% v 5%, P=0.04; children 39% v 11%, P=0.0003). Homeless mothers continued to have significantly less social support at follow up. Mothers with a history of abuse and poor social integration were more likely to have children with persistent mental health problems. Conclusions: Homeless families have a high level of complex needs that cannot be met by conventional health services and arrangements. Local strategies for rapid rehousing into permanent accommodation, effective social support and health care for parents and children, and protection from violence and intimidation should be developed and implemented. Key messages Homeless children and their mothers have a high level of mental health problems Homeless families experience many risk factors, such as domestic violence, abuse, and family and social disruption In two fifths of children and a quarter of mothers, mental health problems persisted after rehousing In contrast with a comparison group of families of low socioeconomic status, a substantial proportion of homeless families remained residentially and socially unstable
Vostanis, Panos; Grattan, Eleanor; Cumella, Stuart
The ADELAIDE voxel model of paediatric anatomy was used with the EGSnrc Monte Carlo code to compare effective dose from computed tomography (CT) calculated with both the ICRP103 and ICRP60 definitions which are different in their tissue weighting factors and in the included tissues. The new tissue weighting factors resulted in a lower effective dose for pelvis CT (than if calculated using ICRP60 tissue weighting factors), by 6.5% but higher effective doses for all other examinations. ICRP103 calculated effective dose for CT abdomen + pelvis was higher by 4.6%, for CT abdomen (by 9.5%), for CT chest + abdomen + pelvis (by 6%), for CT chest + abdomen (by 9.6%), for CT chest (by 10.1%) and for cardiac CT (by 11.5%). These values, along with published values of effective dose from CT that were calculated for both sets of tissue weighting factors were used to determine single values for the ratio ICRP103:ICRP60 calculated effective doses from CT, for seven CT examinations. The following values for ICRP103:ICRP60 are suggested for use to convert ICRP60 calculated effective dose to ICRP103 calculated effective dose for the following CT examinations: Pelvis CT, 0.75; for abdomen CT, abdomen + pelvis CT, chest + abdomen + pelvis CT, 1.00; for chest + abdomen CT, and for chest CT. 1.15; for cardiac CT 1.25. PMID:23860741
Background/Objectives Periodontal disease has been associated with poorer cross-sectional cognitive function and is correlated with adverse vascular outcomes, but has received little prospective investigation in relation to cognitive decline. Design Analysis of a prospective cohort study. Setting The Health, Aging and Body Composition (Health ABC) Study Participants and measurements We examined the prospective association between a range of oral health parameters and cognitive function using data on 1053 participants who were administered the Modified Mini-Mental State Examination (3MS) at year 1 (baseline) and year 3, and had participated in a comprehensive periodontal examination at year 2. We investigated 3MS decline from year 3 to 5 in 947 (89.9%) participants. Covariates included age, sex, education, race, cardiovascular disease/risk and depressive symptoms. Results Most indicators of adverse oral health at year 2 were associated with cognitive impairment based on averaged 3MS scores <80 for years 1 and 3, but these associations were substantially confounded by education and race. Higher gingival index, a measure of gingival inflammation, at year 2 remained independently associated with this definition of cognitive impairment and, in fully adjusted analyses, was also an independent predictor of a 5+ point cognitive decline from years 3 to 5. Conclusion Periodontitis may be a risk factor for cognitive decline. Gingivitis is reversible and periodontitis to some degree is preventable and controllable when manifest. Therefore, further research is needed to clarify potential underlying mechanisms and oral health interventions that potentially might ameliorate cognitive decline.
Stewart, Robert; Weyant, Robert J.; Garcia, Melissa E.; Harris, Tamara; Launer, Lenore J.; Satterfield, Suzanne; Simonsick, Eleanor M.; Yaffe, Kristine; Newman, Anne B.
Published by the Virtual Health Care Team at the University of Missouri Ã¢ÂÂ Columbia School of Health Professions and created by Lorilie A. Weber-Hardy, the purpose of this case is to "test the knowledge and to build confidence in the advanced respiratory care practitioner's ability to critically think and perform in the care of a pediatric near-drown patient." In this case, a six-year-old boy has fallen into a freshwater lake and users are guided through the case in order to identify what equipment and procedures are needed for intubation and to raise the child's body temperature. The "Bibliography" section leads users to further online resources for more information. This case study along with all the cases available from the Virtual Health Care Team, are excellent additions to a classroom activity or assessment in order to help students prepare for health care careers.
Scientific and policy interest in health disparities, defined as systematic, plausibly avoidable health differences adversely affecting socially disadvantaged groups, has increased markedly over the past few decades. Like other research, research in health disparities is strongly influenced by the underlying conceptual model of the hypothetical causes of disparities. Conceptual models are important and a major source of debate because multiple types of factors and processes may be involved in generating disparities, because different disciplines emphasize different types of factors, and because the conceptual model often drives what is studied, how results are interpreted, and which interventions are identified as most promising. This article reviews common conceptual approaches to health disparities including the genetic model, the fundamental cause model, the pathways model, and the interaction model. Strengths and limitations of the approaches are highlighted. The article concludes by outlining key elements and implications of an integrative systems-based conceptual model.
This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. PMID:22218227
A cohort comprising residents of a housing regeneration and health programme was created from routinely collected data using a system which allows us to anonymously link housing data to individuals and their health. The regeneration programme incorporating four rolling work packages runs from 2009 to 2014. The main intervention cohort we describe here contains the 18 312 residents of 9051 residences at baseline. The cohort will be followed continuously through routine health data (demographics, mortality, hospital admissions and general practitioner records including prescriptions) with periodic updates of housing regeneration intervention data. Here, we describe the baseline data for the primary health outcomes of emergency hospital admissions for cardiovascular and respiratory conditions and injuries for those aged ?60 years. We will compare the health of residents within the homes before and after the housing regeneration work has taken place, and we will calculate the change in health service costs with use of hospital and General Practitioners (GP) services. We will also use a difference in differences approach to assess changes in comparison with comparator cohorts. These data will be accessible at the end of the study period in 2016. Further information about this study can be obtained from Ronan Lyons; firstname.lastname@example.org. PMID:23179304
Rodgers, Sarah E; Heaven, Martin; Lacey, Arron; Poortinga, Wouter; Dunstan, Frank D; Jones, Kerina H; Palmer, Stephen R; Phillips, Ceri J; Smith, Robert; John, Ann; Davies, Gwyneth A; Lyons, Ronan A
Background Public health provision in England is undergoing dramatic changes. Currently established partnerships are thus likely to be significantly disrupted by the radical reforms outlined in the Public Health White Paper. We therefore explored the process of partnership working in public health, in order to better understand the potential opportunities and threats associated with the proposed changes. Methodology/Principal Findings 70 participants took part in an in-depth qualitative study involving 40 semi-structured interviews and three focus group discussions. Participants were senior and middle grade public health decision makers working in Primary Care Trusts, Local Authorities, Department of Health, academia, General Practice and Hospital Trusts and the third sector in England. Despite mature arrangements for partnership working in many areas, and much support for joint working in principle, many important barriers exist. These include cultural issues such as a lack of shared values and language, the inherent complexity of intersectoral collaboration for public health, and macro issues including political and resource constraints. There is particular uncertainty and anxiety about the future of joint working relating to the availability and distribution of scarce and diminishing financial resources. There is also the concern that existing effective collaborative networks may be completely disrupted as the proposed changes unfold. The extent to which the proposed reforms might mitigate or potentiate these issues remains unclear. However the threats currently remain more salient than opportunities. Conclusions The current re-organisation of public health offers real opportunity to address some of the barriers to partnership working identified in this study. However, significant threats exist. These include the breakup of established networks, and the risk of cost cutting on effective public health interventions.
Taylor-Robinson, David Carlton; Lloyd-Williams, Ffion; Orton, Lois; Moonan, May; O'Flaherty, Martin; Capewell, Simon
The purpose of this study was to examine the association of public and private domains of religiosity and adolescent health-related outcomes using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of American adolescents in grades 7–12. The public religiosity variable combines two items measuring frequency of attendance at religious services and frequency of
James M. Nonnemaker; Clea A. McNeely; Robert Wm. Blum
Objectives While it is generally accepted that high job strain is associated with adverse occupational outcomes, the nature of this relationship and the causal pathways involved are not well elucidated. We aimed to assess the association between job strain and long-term sickness absence (LTSA), and investigate whether any associations could be explained by validated health measures. Methods Data from participants (n?=?7346) of the Hordaland HealthStudy (HUSK), aged 40–47 at baseline, were analyzed using multivariate Cox regression to evaluate the association between job strain and LTSA over one year. Further analyses examined whether mental and physical health mediated any association between job strain and sickness absence. Results A positive association was found between job strain and risk of a LTSA episode, even controlling for confounding factors (HR?=?1.64 (1.36–1.98); high job strain exposure accounted for a small proportion of LTSA episodes (population attributable risk 0.068). Further adjustments for physical health and mental health individually attenuated, but could not fully explain the association. In the fully adjusted model, the association between high job strain and LTSA remained significant (HR?=?1.30 (1.07–1.59)). Conclusion High job strain increases the risk of LTSA. While our results suggest that one in 15 cases of LTSA could be avoided if high job strain were eliminated, we also provide evidence against simplistic causal models. The impact of job strain on future LTSA could not be fully explained by impaired health at baseline, which suggests that factors besides ill health are important in explaining the link between job strain and sickness absence.
Wang, Min-Jung; Mykletun, Arnstein; M?yner, Ellen Ihlen; ?verland, Simon; Henderson, Max; Stansfeld, Stephen; Hotopf, Matthew; Harvey, Samuel B.
Exposure assessment is an integral component of occupational and environmental epidemiology, risk assessment and management, as well as regulatory compliance. For the most part, air sampling and analysis tools used in occupational and environmental exposure assessments are based on technologies that have changed little since the 1970s. In many cases the lack of simple, inexpensive, exposure assessment technologies has limited epidemiologists' and risk assessors' ability to evaluate the environmental and occupational causes of disease. While there have been tremendous investments and advances in medical diagnostic and biomonitoring technologies (e.g., glucose testing, human genetics), there has been less effort invested in advancing the science of exposure assessment. Recent developments in sensor technology have focused on medical and homeland security applications. Developing and applying new sensors to health effects studies can revolutionize the way epidemiologic studies are conducted. Time-series studies that investigate short-term (hours to days) changes in exposure that are linked to changes in health care encounters, symptoms, and biological markers of preclinical disease and/or susceptibility are needed to more fully evaluate the impact of chemicals and other agents on health. Current sampling technology limits our ability to assess time-varying concentrations. The purpose of this paper is to discuss the current state of air sampling and health assessment and the potential application of novel sensor technology for use in health effects studies.
Analysis of the workers' health at the Hanford plant produced no startling changes. Multiple myeloma is the only cancer type that shows a statistically significant trend of mortality with increasing radiation exposure. The study populations will be augmented by the addition of a group of construction workers in the future. Methodologic studies based on this data set are continuing.
We examined the relationship between 50 widely used agricultural pesticides and lung cancer incidence in the Agricultural HealthStudy, a prospective cohort study of 57,284 pesticide applicators, and 32,333 spouses of farmer applicators with no prior history of lung cancer. Self...
Researchers often wonder whether and how their studies are translated into policy or practice. AcademyHealth convened a roundtable of experts at the organization's 2003 Annual Research Meeting in Nashville to discuss how research on health insurance enters the policy process. The participants drew on their experience at the state, federal, and local levels to suggest ways that policy researchers can maximize the likelihood that their work will be used by decision-makers. The following report is based on the transcript from this 90-minute discussion; it captures the panel's answers to a series of questions posed by session-chair, Sherry Glied.
Background Respiratory disease can impose a significant burden on the health of rural populations. The Saskatchewan Rural HealthStudy (SRHS) is a new large prospective cohort study of ages 6 and over currently being conducted in farming and non-farming communities to evaluate potential health determinants associated with respiratory outcomes in rural populations. In this article, we describe the rationale and methodology for the adult component. The study is being conducted over 5 years (2009–15) in two phases, baseline and longitudinal. The baseline survey consists of two components, adults and children. The adult component consists of a questionnaire-based evaluation of individual and contextual factors of importance to respiratory health in two sub populations (a Farm Cohort and a Small Town Cohort) of rural families in Saskatchewan Rural Municipalities (RMs). Clinical studies of lung function and allergy tests are being conducted on selected sub-samples of the two cohorts based on the positive response to the last question on the baseline questionnaire: “Would you be willing to be contacted about having breathing and/or allergy tests at a nearby location?”. We adopted existing population health theory to evaluate individual factors, contextual factors, and principal covariates on the outcomes of chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea. Findings Of the RMs selected to participate, 32 (89%) out of 36 RMs and 15 (94%) out of 16 small towns within the RMs agreed to participate. Using the mail out survey method developed by Dillman, we obtained completed questionnaires from 4264 households (8261 individuals). We obtained lung function measurements on 1609 adults, allergy skin test information on 1615 adults; both measurements were available on 1549 adults. We observed differences between farm and non-farm rural residents with respect to individual, contextual factors and covariates. Discussion There are differences between farm and non-farm rural residents with respect to individual and contextual factors and other variables of importance. The findings of the SRHS will improve knowledge of respiratory disease etiology, assist in the development and targeting of prevention programs, and in planning health services with farm and small town populations.
PURPOSE A key component of primary care improvement efforts is timely access to care; however, little is known regarding the effects of extended (evening and weekend) office hours on health care use and outcomes. We examined the association between reported access to extended office hours and both health care expenditures and mortality. METHODS We analyzed data from individuals aged 18 to 90 years responding to the 2000–2008 Medical Expenditure Panel Surveys reporting access or no access to extended hours via a usual source of care in 2 successive years (year 1 and year 2; N = 30,714). Dependent variables were year 2 total health care expenditures and, for those enrolled in 2000–2005, all-cause mortality through 2006. Covariates were year 1 sociodemographics and health care use, and year 2 health insurance, health status, and chronic conditions. We conducted further analyses, progressively adjusting for year 2 use, to explore mechanisms. RESULTS Total expenditures were 10.4% lower (95% confidence interval, 7.2%–13.4%) among patients reporting access to extended hours in both years vs neither year. Adjustment for year 2 prescription drug expenditures, and to a lesser extent, office visit–related expenditures (but not total prescriptions or office visits, or emergency and inpatient expenditures) attenuated this relationship. Extended-hours access was not statistically associated with mortality. CONCLUSIONS Respondents reporting a usual source of care offering evening and weekend office hours had lower total health care expenditures than those without extended-hours access, an association related to lower prescription drug and office visit–related (eg, testing) expenditures, without adverse effects on mortality. Although requiring further study, extended office hours may be associated with more judicious use of health care resources.
Jerant, Anthony; Bertakis, Klea D.; Fenton, Joshua J.; Franks, Peter
Although the number of insecure jobs has increased considerably over the recent decades, relatively little is known about the health consequences of job insecurity, their international pattern, and factors that may modify them. In this paper, we investigated the association between job insecurity and self-rated health, and whether the relationship differs by country or individual-level characteristics. Cross-sectional data from 3 population-based studies on job insecurity, self-rated health, demographic, socioeconomic, work-related and behavioural factors and lifetime chronic diseases in 23,245 working subjects aged 45–70 years from 16 European countries were analysed using logistic regression and meta-analysis. In fully adjusted models, job insecurity was significantly associated with an increased risk of poor health in the Czech Republic, Denmark, Germany, Greece, Hungary, Israel, the Netherlands, Poland and Russia, with odds ratios ranging between 1.3 and 2.0. Similar, but not significant, associations were observed in Austria, France, Italy, Spain and Switzerland. We found no effect of job insecurity in Belgium and Sweden. In the pooled data, the odds ratio of poor health by job insecurity was 1.39. The association between job insecurity and health did not differ significantly by age, sex, education, and marital status. Persons with insecure jobs were at an increased risk of poor health in most of the countries included in the analysis. Given these results and trends towards increasing frequency of insecure jobs, attention needs to be paid to the public health consequences of job insecurity.
Laszlo, Krisztina D.; Pikhart, Hynek; Kopp, Maria S.; Bobak, Martin; Pajak, Andrzej; Malyutina, Sofia; Salavecz, Gyongyver; Marmot, Michael
Background: Cohort Norway (CONOR) containing blood samples and standardised health and exposure variables of about 170,000 subjects, is based on data from health surveys in different parts of Norway. In all participants mental distress is measured by seven questions modified after various mental health measure- ment instruments. The purpose of the present study was to examine the agreement between these
Anne Johanne Søgaard; Ingvar Bjelland; Grethe S. Tell; Espen Røysamb
Traditional studies of short-term air pollution health effects use time series data, while cohort studies generally focus on long-term effects. There is increasing interest in exploiting individual level cohort data to assess short-term health effects in order to understand the mechanisms and time scales of action. We extend semiparametric regression methods used to adjust for unmeasured confounding in time series studies to the cohort setting. Time series methods are not directly applicable since cohort data are typically collected over a prespecified time period and include exposure measurements on days without health observations. Therefore, long-time asymptotics are not appropriate, and it is possible to improve efficiency by exploiting the additional exposure data. We show that flexibility of the semiparametric adjustment model should match the complexity of the trend in the health outcome, in contrast to the time series setting where it suffices to match temporal structure in the exposure. We also demonstrate that pre-adjusting exposures concurrent with the health endpoints using trends in the complete exposure time series results in unbiased health effect estimation and can improve efficiency without additional confounding adjustment. A recently published article found evidence of an association between short-term exposure to ambient fine particulate matter (PM2.5 ) and retinal arteriolar diameter as measured by retinal photography in the Multi-Ethnic Study of Atherosclerosis (MESA). We reanalyze the data from this article in order to compare the methods described here, and we evaluate our methods in a simulation study based on the MESA data. PMID:24571570
Szpiro, Adam A; Sheppard, Lianne; Adar, Sara D; Kaufman, Joel D
The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative longitudinal survey of persons in China 45 years of age or older and their spouses, including assessments of social, economic, and health circumstances of community-residents. CHARLS examines health and economic adjustments to rapid ageing of the population in China. The national baseline survey for the study was conducted between June 2011 and March 2012 and involved 17 708 respondents. CHARLS respondents are followed every 2 years, using a face-to-face computer-assisted personal interview (CAPI). Physical measurements are made at every 2-year follow-up, and blood sample collection is done once in every two follow-up periods. A pilot survey for CHARLS was conducted in two provinces of China in 2008, on 2685 individuals, who were resurveyed in 2012. To ensure the adoption of best practices and international comparability of results, CHARLS was harmonized with leading international research studies in the Health and Retirement Study (HRS) model. Requests for collaborations should be directed to Dr Yaohui Zhao (email@example.com). All data in CHARLS are maintained at the National School of Development of Peking University and will be accessible to researchers around the world at the study website. The 2008 pilot data for CHARLS are available at: http://charls.ccer.edu.cn/charls/. National baseline data for the study are expected to be released in January 2013. PMID:23243115
The continuing studies of the teeth and faces of Australian twins and their families in the Craniofacial Biology Research Group in the School of Dentistry at the University of Adelaide began 30 years ago. Three main cohorts of twins have been recruited, enabling various objectives and specific hypotheses to be addressed about the roles of genetic, epigenetic and environmental influences on human dentofacial growth and development, as well as oral health. This paper highlights some key findings arising from these studies, emphasizing those of direct relevance to practising oral health professionals. We also draw on published literature to review the significant developments in relation to the use of precision 2D and 3D imaging equipment, the application of modern molecular techniques, and the development of sophisticated computer software for analysing genetic relationships and comparing complex shapes. Such developments are valuable for current and future work. Apart from the classical or traditional twin model, there are several other twin models that can be used in research to clarify the relative contributions of genetic, epigenetic and environmental contributions to phenotypic variation. The monozygotic (MZ) co-twin model is one particularly valuable method, given that examination of only one pair of MZ twins can provide considerable insights into underlying causes of observed variation. This model can be used in a dental practice environment, with oral health professionals having the opportunity to explore differences in orofacial structures between MZ co-twins who are attending as patients. As researchers have become more aware of the complexities of the interactions between the genome, the epigenome and the environment during development, there is the need to collect more phenotypic data and define new phenotypes that will better characterize variations in growth processes and health status. When coupled with powerful new genetic approaches, including genome-wide association studies and linkage analyses, exciting opportunities are opening up to unravel the causes of problems in craniofacial growth and common oral diseases in human populations. PMID:24117977
The issue of how immigrant populations combine traditional and Western health beliefs and practices has not been given due attention. Hence, this qualitative research study of Yoruba immigrants, an ethnic group from south-western Nigeria, living in the mid-Atlantic region of the United States, sheds some light on the question of how best to provide culturally appropriate health care to Yoruba immigrant groups with differences in health beliefs and practices. The study found that there are three types of Yoruba immigrant groups: (1) those who use only Western medicine (though mostly for pragmatic reason); (2) those who combine traditional Yoruba and Western beliefs; and (3) those who combine Western medicine and Christian beliefs. PMID:22924201
Usability factors are a major obstacle to health information technology (IT) adoption. The purpose of this paper is to review and categorize health IT usability study methods and to provide practical guidance on health IT usability evaluation. 2025 references were initially retrieved from the Medline database from 2003 to 2009 that evaluated health IT used by clinicians. Titles and abstracts were first reviewed for inclusion. Full-text articles were then examined to identify final eligibility studies. 629 studies were categorized into the five stages of an integrated usability specification and evaluation framework that was based on a usability model and the system development life cycle (SDLC)-associated stages of evaluation. Theoretical and methodological aspects of 319 studies were extracted in greater detail and studies that focused on system validation (SDLC stage 2) were not assessed further. The number of studies by stage was: stage 1, task-based or user–task interaction, n=42; stage 2, system–task interaction, n=310; stage 3, user–task–system interaction, n=69; stage 4, user–task–system–environment interaction, n=54; and stage 5, user–task–system–environment interaction in routine use, n=199. The studies applied a variety of quantitative and qualitative approaches. Methodological issues included lack of theoretical framework/model, lack of details regarding qualitative study approaches, single evaluation focus, environmental factors not evaluated in the early stages, and guideline adherence as the primary outcome for decision support system evaluations. Based on the findings, a three-level stratified view of health IT usability evaluation is proposed and methodological guidance is offered based upon the type of interaction that is of primary interest in the evaluation.
Armed conflict causes suffering in many countries; it contributes to poor health and hinders health services development. The effects of conflict are evidenced by weakened community structures and can make reconstruction efforts challenging. East Timor has a history of prolonged conflict and saw a resurgence of internal violence in 2006. This participant observation study discusses considerations for implementing public health
The research, conducted for the Public Health Service was directed toward the development of a total Emergency Health Care System Model that can be used to study and evaluate the nuclear postattack health posture of a single locality. This total model con...
E. L. Hill A. W. Voors R. O. Lyday J. N. Pyecha J. B. Hallan
As one article in a series on Global Mental Health Practice, Simone Honikman and colleagues from South Africa provide a case study of the Perinatal Mental Health Project, which delivered mental health care to pregnant women in a collaborative, step-wise manner, making use of existing resources in primary care.
Simone Honikman; Thandi van Heyningen; Sally Field; Emily Baron; Mark Tomlinson
In many countries, educational and health policies currently highlight the need to develop schools towards health promotion settings for pupils and school staff. The aim of this three-year follow-up study was to investigate teachers' assessments of goal attainment and possible changes in health promotion practices in the Finnish schools that…
Turunen, Hannele; Tossavainen, Kerttu; Jakonen, Sirkka; Vertio, Harri
As one article in a series on Global Mental Health Practice, Simone Honikman and colleagues from South Africa provide a case study of the Perinatal Mental Health Project, which delivered mental health care to pregnant women in a collaborative, step-wise manner, making use of existing resources in primary care. PMID:22666181
Honikman, Simone; van Heyningen, Thandi; Field, Sally; Baron, Emily; Tomlinson, Mark
Background Crowdsourced health research studies are the nexus of three contemporary trends: 1) citizen science (non-professionally trained individuals conducting science-related activities); 2) crowdsourcing (use of web-based technologies to recruit project participants); and 3) medicine 2.0 / health 2.0 (active participation of individuals in their health care particularly using web 2.0 technologies). Crowdsourced health research studies have arisen as a natural extension of the activities of health social networks (online health interest communities), and can be researcher-organized or participant-organized. In the last few years, professional researchers have been crowdsourcing cohorts from health social networks for the conduct of traditional studies. Participants have also begun to organize their own research studies through health social networks and health collaboration communities created especially for the purpose of self-experimentation and the investigation of health-related concerns. Objective The objective of this analysis is to undertake a comprehensive narrative review of crowdsourced health research studies. This review will assess the status, impact, and prospects of crowdsourced health research studies. Methods Crowdsourced health research studies were identified through a search of literature published from 2000 to 2011 and informal interviews conducted 2008-2011. Keyword terms related to crowdsourcing were sought in Medline/PubMed. Papers that presented results from human healthstudies that included crowdsourced populations were selected for inclusion. Crowdsourced health research studies not published in the scientific literature were identified by attending industry conferences and events, interviewing attendees, and reviewing related websites. Results Participatory health is a growing area with individuals using health social networks, crowdsourced studies, smartphone health applications, and personal health records to achieve positive outcomes for a variety of health conditions. PatientsLikeMe and 23andMe are the leading operators of researcher-organized, crowdsourced health research studies. These operators have published findings in the areas of disease research, drug response, user experience in crowdsourced studies, and genetic association. Quantified Self, Genomera, and DIYgenomics are communities of participant-organized health research studies where individuals conduct self-experimentation and group studies. Crowdsourced health research studies have a diversity of intended outcomes and levels of scientific rigor. Conclusions Participatory health initiatives are becoming part of the public health ecosystem and their rapid growth is facilitated by Internet and social networking influences. Large-scale parameter-stratified cohorts have potential to facilitate a next-generation understanding of disease and drug response. Not only is the large size of crowdsourced cohorts an asset to medical discovery, too is the near-immediate speed at which medical findings might be tested and applied. Participatory health initiatives are expanding the scope of medicine from a traditional focus on disease cure to a personalized preventive approach. Crowdsourced health research studies are a promising complement and extension to traditional clinical trials as a model for the conduct of health research.
Prospective epidemiological studies on swimmers¿ health that were conducted by the U.S. Environmental Protection Agency (U.S. EPA) between 1973 and 1980 defined highly credible gastrointestinal illness (HCGI) as the occurrence of one or more of the following set of symptoms: (1) ...
Prospective epidemiological studies on swimmers¿ health that were conducted by the U.S. Environmental Protection Agency between 1973 and 1980 defined highly credible gastrointestinal illness (HCGI) as the occurrence of one or more of the following set of symptoms: (1) vomiting, (...
We investigate positive effects of volunteering on psychological well-being and self-reported health using all four waves of the Wisconsin Longitudinal Study. Confirming previous research, volunteering was positively related to both outcome variables. Both consistency of volunteering over time and diversity of participation are significantly…
This case study describes 1 international student's treatment experience with an integrated health program on a college campus. This program uses a multidisciplinary, mind-body approach, which incorporates individual counseling, primary care, psychiatric consultation, a mindfulness-based cognitive therapy class, and a meditation group.
Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris
A 3-year study compared 52 undergraduate nursing students with 93 education majors and with the general population. No significant differences among students on 9 health behaviors appeared. Compared with the general population, nursing students had inadequate time for sleep, exercise, and eating breakfast. (Contains 77 references.) (SK)
In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O3), particulate matter (PM), sulfur dioxide (S...
This guide was developed by the Montgomery County (Maryland) Public Schools to assist elementary school teachers in implementing the instructional program in health education for kindergarten through sixth grade. Instructional objectives for teaching Family Life and Human Development and Safety during social studies time are organized by grade…
We applied a public health approach to the study of mental retardation by providing a basic descriptive epidemiological analysis using a large statewide linked birth and public school record database (N = 327,831). Sociodemographic factors played a key role across all levels of mental retardation. Birthweight less than 1000 g was associated with…
Chapman, Derek A.; Scott, Keith G.; Stanton-Chapman, Tina L.
In the Agricultural HealthStudy we evaluated the mortality experience of 52,395 farmers and 32,347 of their spouses in Iowa and North Carolina obtain information on cancer and other chronic disease risks from agricultural exposures and other factors associated with rural lifes...
Purpose: This analysis of the Agricultural HealthStudy cohort assesses the mortality experience of licensed pesticide applicators and their spouses. Methods: This report is based on 52,393 private applicators (who are mostly farmers) and 32,345 spouses of farmers in Iowa...
This article describes the Betula Study with respect to objectives, design, participants, and assessment instruments for health and cognition. Three waves of data collection have been completed in 5-year intervals since 1988–1990. A fourth wave started in 2003 and will be completed in 2005. An overview of Betula research is presented under the headings of memory and cognition and cognitive
Lars-Göran Nilsson; Rolf Adolfsson; Lars Bäckman; Cindy M. de Frias; Bo Molander; Lars Nyberg
The long-term health consequences of exposure to phenoxyherbicides used in Vietnam has been a great concern to the veterans. In addition to the Air Force Ranch Hand personnel, Army Chemical Corps personnel who served in Vietnam are thought to have had some of the highest herbicide exposures. The Department of Veterans Affairs commenced a study of veterans who served in
Han K. Kang; Nancy A. Dalager; Larry L. Needham; Donald G. Patterson; Genevieve M. Matanoski; Sukon Kanchanaraksa; Peter S. J. Lees
Marital separation and divorce are associated with increased risk for early death, and the magnitude of this association rivals that of many well-established public health factors. In the case of divorce, however, the mechanisms explaining precisely why and how some people are at risk for early death remain unclear. This paper reviews what is known about the association between divorce and risk for all-cause mortality, then discusses four emerging themes in this area of research: the biological intermediaries linking divorce to pathophysiology and disease onset, moving beyond the statistical mean, focusing research on the diathesis-stress model, and studying how opportunity foreclosures may place people on a trajectory toward poor distal health outcomes. These ideas are grounded in a set of public lay commentaries about the association between divorce and death; in this way, the paper seeks to integrate current research ideas with how the general public thinks about divorce and its correlates. Although this paper focuses on divorce, many of the emerging themes are applicable to the study of psychosocial stress and health more generally. Therefore, the study of divorce and death provides a good case study for health psychology and considers new questions that can be pursued in a variety of research areas.
Sbarra, David A.; Hasselmo, Karen; Nojopranoto, Widyasita
In the US, Mexican immigrant women often have better health outcomes than non-Hispanic white women despite a greater health risk profile. This cross-sectional pilot study compared women living in Chavinda, Michoacán (n = 102) to women who had migrated from Mexico to Madera, California (n = 93). The interview gathered information on acculturation and risk behaviors including smoking, alcohol use and number of sexual partners. The results suggest that more acculturated women living in the US are more likely to consume alcohol. US residence and higher acculturation level was marginally associated with having more than one sexual partner. There were no differences between odds of smoking among Chavinda and Madera women. While results with acculturation are not consistently significant due to small sample sizes, the results are suggestive that acculturation among immigrant Hispanic women in the US may be associated with adverse health behaviors, and selective migration seems less likely to account for these differences. PMID:20811952
Hennessy-Burt, Tamara E; Stoecklin-Marois, Maria T; Meneses-González, Fernando; Schenker, Marc B
Labor migration is thought to have significant mental and physical health impacts, given the risks for exploitation and abuse of migrant workers, particularly among those in semiskilled and unskilled positions, although empirical data are limited. This qualitative study, conducted in July 2010 in Banteay Meanchey Province, Cambodia, focused on psychosocial and mental health signs and symptoms associated with labor migration among Cambodian migrant workers to Thailand. Two qualitative methods identified a number of mental health problems faced by Cambodian migrant workers in Thailand, including the presence of anxiety and depression-like problems among this population, described in local terminology as pibak chet (sadness), keut chreun (thinking too much), and khval khvay khnong chet (worry in heart). Key informants revealed the extent to which psychosocial well-being is associated with conditions of poverty, including debt and lack of access to basic services. PMID:24566505
Meyer, Sarah R; Robinson, W Courtland; Chhim, Sotheara; Bass, Judith K
OBJECTIVES: To discuss issues in studying the effectiveness of health services for children, suggest areas in which more research is needed, and recommend strategies for future research. PRINCIPAL FINDINGS: Issues that should be considered include the choice of perspective, which will help determine the interventions studied and the measures of effectiveness and cost-effectiveness chosen. Unique challenges in this area include the fact that serious measurable morbidity is relatively uncommon in children, that causal relationships between services and outcomes may be difficult to establish, and that standard measures of cost-effectiveness may fail to accurately measure important benefits, such as reduced parental anxiety. More research is needed on high-risk and health-promoting behaviors, on critical parent behaviors, on classifying children by vulnerability status, on modes of delivery of preventive care, and on violence prevention. RECOMMENDATIONS: Group-randomized designs and observational research designs that take advantage of natural variations in practice may be increasingly useful in effectiveness studies. Parent- and patient-reported measures of health status and quality of life should be made briefer and more practical for routine use, and better measures of cost-effectiveness are needed. Future research efforts can best be supported by the concerted efforts of various constituencies, including health plans, providers, patients, researchers, and the government.
A research partnership of representatives from labor, academia, and public health enabled unionized San Francisco hotel workers to achieve important policy changes in workplace health and safety. Known as the "Housekeeping Study," the project took sixteen months to complete. A unique aspect of the project was that it utilized participatory action research methods, involving workers themselves as full participants in the study. A core group of 25 hotel room cleaners was involved in each phase of the project. The study developed health data which enabled room cleaners and their union to formulate and justify a contract proposal calling for a significant reduction in housekeeping workloads. The employer association agreed to a contract which reduced the maximum required room assignment from 15 rooms to 14 rooms per day in 14 San Francisco hotels. By lowering the maximum work assignment, these workers set a new standard which can potentially protect the health of room cleaners across the country. The project can serve as a model for worker and union participation in academic research, as well as for the application of research to improving working conditions, particularly for low-wage immigrant workers. PMID:12325285
The Adelaide Rift Complex in South Australia contains the type sections for Sturtian and Marinoan glacial deposits. The litho- and chemostratigraphy of these deposits play a central role in evaluating global Neoproterozoic ice age hypotheses ("snowball Earth") and Rodinia supercontinent reconstructions, but precise ages on igneous units do not yet exist. We report preliminary results of in situ Th-U-total Pb electron microprobe dating of monazite in sandstones within the Holowilena Ironstone ("older" Sturtian glacial at Enorama Creek) and at the top of the Enorama Shale (youngest pre-Marinoan, interglacial clastics at Elatina Creek). Several distinct populations are recognized. First, rounded cores with high Th, U, and Y + HREE abundances are interpreted as igneous or metamorphic detrital grains and yield ca. 1590 Ma, ca. 1280-1300 Ma, and ca. 1040 Ma dates related to well-known orogenic events in surrounding cratonic regions. A second group also occurs as "cores" but contains significantly lower U and Y + HREE, characteristics that may be indicative of an authigenic origin. Some rounded domains may represent "recycled" authigenic grains and yield dates of ca. 880 Ma and ca. 760 Ma. However, a subset observed in the Enorama sample occurs as very small (~2 x 10 microns), euhedral lathes that are unlikely to have survived a detrital history and yield a date of 680 +/-23 Ma. The youngest population forms very low Th and U, inclusion-rich overgrowths with ca. 500 Ma dates (Delamerian Orogeny) that probably grew hydrothermally. The recognition of "recycled" authigenic monazite further emphasizes the detail in textural and petrological documentation that is required for accurate geochronological interpretations. The date of 680 +/-23 Ma (1) provides an estimate for the age of the base of the Trezona carbon isotopic anomaly just beneath the Marinoan glacial deposits, (2) provides an absolute minimum age constraint on the underlying Sturtian glacial deposits, and (3) is confirming of proposed correlations between type Marinoan deposits and precisely dated glacial deposits in Namibia and China.
Methods: Participants in the Veterans HealthStudy, a 2-year longitudinal study, were recruited from a repre- sentative sample of patients receiving ambulatory care at 4 VA facilities in the New England region. The Veter- ans HealthStudy patients received questionnaires of health status, including the Medical Outcomes Study Short Form 36-Item Health Survey; and a health examination, clini- cal assessments,
Lewis E. Kazis; Donald R. Miller; Jack Clark; Katherine Skinner; Austin Lee; William Rogers; Avron Spiro III; Susan Payne; Graeme Fincke; Alfredo Selim; Mark Linzer
Background The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Methods Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. Results While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services’ responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse “dilemmatic space” in their work. Conclusions The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health’s recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study’s findings.
Evidence from animal, human cross-sectional, case-control, and prospective studies indicate that hormone replacement therapy (HRT) is a promising treatment to delay the onset of symptoms of dementia. The Women’s Health Initiative Memory Study (WHIMS) is the first double-masked, randomized, placebo-controlled, long-term clinical trial designed to test the hypothesis that HRT reduces the incidence of all-cause dementia in women aged 65
Sally A. Shumaker; Beth A. Reboussin; Mark A. Espeland; Stephen R. Rapp; Wendy L. McBee; Maggie Dailey; Deborah Bowen; Tim Terrell; Beverly N. Jones
BACKGROUND: Disparities in health status among ethnic groups favor the Caucasian population in the United States on almost all major indicators. Disparities in exposure to health-related mass media messages may be among the environmental factors contributing to the racial and ethnic imbalance in health outcomes. This study evaluated whether variations exist in health-related advertisements and health promotion cues among lay
Susan C Duerksen; Amy Mikail; Laura Tom; Annie Patton; Janina Lopez; Xavier Amador; Reynaldo Vargas; Maria Victorio; Brenda Kustin; Georgia Robins Sadler
In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential…
A study assessed the readability of health education pamphlets and booklets distributed to local health department clients in North Carolina through their maternal health, child health, and family planning clinics. The materials analyzed came from various vendors, but excluded materials developed by local and state public health staff. The sample…
The discomfort and frustration often experienced by patients with gastrointestinal (GI) disorders may lead many to seek alternative health care (AHC). This study was conducted to describe AHC use by patients with GI disorders in a convenience sample (N = 73) from a tertiary hospital in Florida. AHC was explored within social exchange theory. Measurement instruments included the Alternative Health Care Gastrointestinal Sociodemographic Questionnaire, Alternative Health Care Use Questionnaire, and Alternative Health Care Advantages/Disadvantages Questionnaire. The study indicated that 32 subjects (43%) had used AHC for their GI disorders during the past 2 years. Most frequently used AHC included relaxation therapy, herbs, lifestyle diets, megavitamins, massage, and home remedies. There was a greater use of AHC by young persons (t = 2.39, p = .02) and by those not retired (chi 2 = 4.58, p = .03). AHC was associated with perceived rewards (r = .38, p = .03) and perceived profits (r = .38, p = .03). AHC was not associated with type or duration of GI disorder or other demographic variables. Subjects specifically cited benefits with relaxation therapy, vegetarian diets, spiritual healing, fish oil for inflammatory bowel disease, and use of milk thistle for hepatitis. PMID:11096804
The Health and Retirement Study (HRS) is a nationally representative longitudinal survey of more than 37 000 individuals over age 50 in 23 000 households in the USA. The survey, which has been fielded every 2 years since 1992, was established to provide a national resource for data on the changing health and economic circumstances associated with ageing at both individual and population levels. Its multidisciplinary approach is focused on four broad topics-income and wealth; health, cognition and use of healthcare services; work and retirement; and family connections. HRS data are also linked at the individual level to administrative records from Social Security and Medicare, Veteran's Administration, the National Death Index and employer-provided pension plan information. Since 2006, data collection has expanded to include biomarkers and genetics as well as much greater depth in psychology and social context. This blend of economic, health and psychosocial information provides unprecedented potential to study increasingly complex questions about ageing and retirement. The HRS has been a leading force for rapid release of data while simultaneously protecting the confidentiality of respondents. Three categories of data-public, sensitive and restricted-can be accessed through procedures described on the HRS website (hrsonline.isr.umich.edu). PMID:24671021
Sonnega, Amanda; Faul, Jessica D; Ofstedal, Mary Beth; Langa, Kenneth M; Phillips, John W R; Weir, David R
The family planning program of Thailand was organized, planned, and implemented by means of the rural health and hospital services of the Ministry of Public Health. Without this integration, the program would not have been allowed by the government. The Thai health system was reasonably well-established, the use of its personnel lessened cost and duplication of efforts, and the resulting integration was successful. The program operated very quietly between 1968 and 1970. No public information was allowed. There were no full-time family planning workers, and no goals and incentives were offered. Only in 1970 when the government announced a national population policy were the restrictions on public information removed. In the development of the program, more than 7600 employees of the Ministry of Public Health received the 1-week training program. After training, family planning clinics were opened in the provincial hospitals and in those rural health centers staffed with a physician. Initially, the auxiliary midwives were expected only to motivate and provide information to those in their areas, referring interested couples to the centers and hospitals for the IUDs, oral contraceptives, and sterilization programs that were available. However, after the successful completion of a pilot study in 1970, the midwives were permitted to prescribe the oral contraceptive. A postpartum program which attempted to motivate women in the use of family planning 2-4 days following delivery revealed that with proper motivation efforts a majority of women will accept family planning services postpartum. A special evaluation section was developed within the Ministry to assess the progress of the program. Many problems continue to require attention, such as the need for high level government support shown by a budget increase and the development of effective supervision for staff within the health system. PMID:1147129
Background: Public health challenges can be better addressed if credible information about health risks and effective public health practices is readily available. The need for improved access to evidence-based public health information has been recognized by public health practitioners, researchers, policy makers, and librarians.\\u000aObjective: To understand the information needs of the public health workforce and to improve access to
E. Hatheway Simpson; Nancy R. LaPelle; Elaine Russo Martin
The paper shows the importance of e-health applications for electronic healthcare development. It describes several e-health applications for health data collecting and sharing that are running in the Czech Republic. These are IZIP system, electronic health record MUDR and K4CARE project applications. The e3-health concept is considered as a tool for judging e-health applications in different healthcare settings. PMID:22874276
Zvárová, Jana; Lhotská, Lenka; Seidl, Libor; Zvára, Karel
The article presents a case study of an outpatient mental health clinic serving Latino older adults. The study explored staff perceptions on the clinic development and the context within an immigrant multicultural community. The study used in-depth, semistructured interviews with support staff, clinical social workers, and administrators. Interviews were analyzed using a thematic content analysis. The mental health clinic formation
This paper discusses an integrated approach to mental healthstudies on Financing of Illness (FoI) and health accounting, Cost of Illness (CoI) and Burden of Disease (BoD). In order to expand the mental health policies, the following are suggested: (a) an international consensus on the standard scope, methods to collect and to analyse mental health data, as well as to report comparative information; (b) mathematical models are also to be validated and tested in an integrated approach, (c) a better knowledge transfer between clinicians and knowledge engineers, and between researchers and policy makers to translate economic analysis into practice and health planning. PMID:21657111
The idea that there are links between soils and human health is an ancient one. The Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people in approximately 1400 B.C. as they entered Canaan, and in 400 B.C. Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the ground. Moving into the 18th and 19th Centuries, some North American farmers have been documented as recognizing a link between soils and human vitality. However, the recognition of links between soils and human health by these early people was based on casual observations leading to logical conclusions rather than scientific investigation. In the 1900s the idea that soils influence human health gained considerable traction. At least three chapters in the 1938 USDA Yearbook of Agriculture included recognition of the importance of soil as the origin of many of the mineral elements necessary for human health and in the 1957 USDA Yearbook of Agriculture scientists realized that soils were not only important in the supply of essential nutrients, but that they could also supply toxic levels of elements to the human diet. The U.S. Department of Agriculture established the Plant, Soil and Nutrition Research Unit (PSNRU) on the Cornell University campus in 1940 with a mission to conduct research at the interface of human nutrition and agriculture to improve the nutritional quality and health-promoting properties of food crops. A major human health breakthrough in 1940 was the isolation of antibiotic compounds from soil organisms by the research group at Rutgers University lead by Selman Waksman. Soil microorganisms create antibiotic compounds in an effort to gain a competitive advantage in the soil ecosystem. Humans have been able to isolate those compounds and use them advantageously in the fight against bacterial infections. Waksman was awarded the Nobel Prize in Physiology or Medicine in 1952, the only soil scientist to date to be awarded a Nobel Prize. In the 1940s and 50s William Albrecht of the University of Missouri became interested in links between soils and human health, an interest that lead to the publication of several papers. Albrecht's works focused on links between soil fertility and dental health, with a particular focus on the relationships between soil fertility and dental cavities. However, Albrecht did extend the relationships between soil fertility and human health out to broader, more general health issues in some of his writings as well. Well-known figures such as Sir Albert Howard and J.I. Rodale also published works in the 1940s that included soils and human health components. Then André Voisin published "Soil, Grass, and Cancer" in 1959. Much of Voisin's work focused on nutrient content in soils, including both nutrient deficiencies and imbalances, and how that influences nutrient status in plants and animals that are in turn consumed by humans. Several health problems are discussed, including but not limited to birth defects, goiter, mental illness, diabetes, and cancer. Voisin concluded that the medical profession had largely ignored soils in their efforts to improve human health, but that soil science should be the foundation of preventative medicine. Soils and human healthstudies continued in the later part of the 20th Century. The health effects of exposures to radioactive elements in soils received considerable attention after the 1986 Chernobyl incident, however, even prior to Chernobyl radionuclides in the soil and how they may affect human health were receiving attention. Investigations into the effects of heavy metals in soils became a common theme as did organic chemicals in soils and the effects of trace elements on human health. Following up on the discovery of antibiotics, soil organisms received increased attention as they related to human health. By the end of the 1900s, M.A. Oliver (1997) noted that "… there is a dearth of quantitative information on the relations between elements in the soil and human health;
The Shanghai Men’s HealthStudy (SMHS) is a population-based cohort study that is being conducted in parallel with the Shanghai Women’s HealthStudy (SWHS) at Vanderbilt University in collaboration with the Shanghai Cancer Institute. This research is to establish a cohort of adult men in Shanghai for a long-term epidemiological study of cancer and other chronic diseases, with a focus on identifying modifiable protective dietary factors for cancers.
Objective This qualitative interview study explored perceptions of the phrases ‘population health’, ‘public health’ and ‘community health’. Setting Accountable care organisations (ACOs), and public health or similar agencies in different parts of the USA. Participants Purposive sample of 29 interviewees at four ACOs, and 10 interviewees at six public health or similar agencies. Results Interviewees working for ACOs most often viewed ‘population health’ as referring to a defined group of their organisation's patients, though a few applied the phrase to people living in a geographical area. In contrast, interviewees working for public health agencies were more likely to consider ‘population health’ from a geographical perspective. Conclusions Conflating geographical population health with the health of ACOs’ patients may divert attention and resources away from organisations that use non-medical means to improve the health of geographical populations. As ACOs battle to control costs of their population of patients, it would be more accurate to consider using a more specific phrase, such as ‘population of attributed patients’, to refer to ACOs’ efforts to care for the health of their defined group of patients.
Noble, Douglas J; Greenhalgh, Trisha; Casalino, Lawrence P
Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have significant meaning for future public health programs, which should be more tailored with use of such knowledge on behavioral clustering via e.g. Transfer Learning.
This is the first large, population-based prospective study to investigate the short- and long-term health effects of military service. After the 1991 Gulf War, research on illnesses was hampered by unavailability of objective measurements on exposures at the individual level, a lack of baseline health data, and an inability to adequately control for potential confounding factors. Public health experts recommended that the Department of Defense (DoD) establish a cohort with the capability to prospectively examine health outcomes among U.S. military service members.
The concept of the 'mindful body', 'coronary candidacy' and "prevention paradox' are three of many interesting themes explored in this paper which examines how, and to what extent, health information is received and translated into the daily domestic setting by coronary family groups. Taking an ethnographic approach to collecting data highlights both the advantages and disadvantages of this methodology in practice. Certainly, the emergence of a health promotion orientation in health care is an area which is intimately connected to aspects of human culture and society that have long been a central concern of anthropologists. This mini-ethnography provides an anthropological understanding of the knowledge, beliefs and behaviours associated with heart disease and its prevention. The concept of the 'mindful body' is provided as a critical interpretive approach to analysing the potential outcome of prescribed lifestyle changes, as given to coronary sufferers and their families during the period following coronary artery bypass surgery. Data drawn from this study confirms the evidence of lay epidemiology which works within the cultural field of fate, luck and destiny, and which has interesting implications as to how nurses might plan for their health promotion strategies in the future. PMID:9080283
Since the beginning of the Safe Motherhood Initiative, India has accounted for at least a quarter of maternal deaths reported globally. India's goal is to lower maternal mortality to less than 100 per 100,000 livebirths but that is still far away despite its programmatic efforts and rapid economic progress over the past two decades. Geographical vastness and sociocultural diversity mean that maternal mortality varies across the states, and uniform implementation of health-sector reforms is not possible. The case study analyzes the trends in maternal mortality nationally, the maternal healthcare-delivery system at different levels, and the implementation of national maternal health programmes, including recent innovative strategies. It identifies the causes for limited success in improving maternal health and suggests measures to rectify them. It recommends better reporting of maternal deaths and implementation of evidence-based, focused strategies along with effective monitoring for rapid progress. It also stresses the need for regulation of the private sector and encourages further public-private partnerships and policies, along with a strong political will and improved management capacity for improving maternal health.
The health of migrants in the UK and their access to healthcare is of considerable policy interest. There is evidence of ethnic inequalities in health and access to and use of healthcare but insufficient consideration of the importance of birth abroad and length of residence in the UK. This study examines indicators of health status, behaviour and healthcare use among mothers of infants in the Millennium Cohort Study, according to whether born in the UK or abroad, individual ethnic grouping, and length of residence. Our findings show there are both positive and negative health indicators associated with ethnicity, birth abroad, and length of residence and presenting results on a single factor in isolation could lead to a misinterpretation of associations. For mothers ethnicity has an important relationship with most health indicators independent of country of birth, length of residence and socio-demographic circumstances. Once adjusted for ethnicity and socio-demographic variables, association with birth abroad disappears for most health outcomes suggesting that there may not be an independent migrant penalty in health. There is a linear trend in decreasing health status with increasing length of residence but no independent association between length of residence and healthcare use. This suggests that while there are continuing barriers to good health for migrants in the receiving society as shown in other studies, factors important for one health outcome may not apply to another. Our findings challenge linear acculturation models for migrants' health in showing that a linear trend in improving socio-economic circumstances for mothers in some ethnic groups is not always associated with better health outcomes or changes in health behaviour. Our results point to a need for a comprehensive collection of information and analysis for all categories of migrants for understanding patterns of and factors underlying health and use of healthcare. PMID:20624665
Innovations in the training of community health personnel that emphasize the importance of the development of health personnel able and willing to serve the community by providing health care, promoting health, preventing disease, and caring for those in need are examined. The need for effective and efficient training programs relevant to present…
Industry practices such as advertising, production of unsafe products, and efforts to defeat health legislation play a major role in current patterns of U.S. ill health. Changing these practices may be a promising strategy to promote health. The authors analyze 12 campaigns designed to modify the health-related practices of U.S. corporations in…
The health manpower planning experiences of four countries reported here were presented in a traveling seminar held for member countries of the Pan American Health Organization. Focus was on what should be carried out in any country to coordinate the training of health workers with the operation of health services. Following the introduction, the…
this articlehas been funded in part by the United States Environmental Protection Agency throughagreement CR825173-01-0 to the University of Washington, it has as not been subjected tothe Agency's required peer and policy review and therefore does not necessarily reflect theviews of the Agency and no official endorsement should be inferred.Model Uncertainty andHealth Effect Studies for Particulate MatterSummary
Background This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus individual agency and the relationship between being 'at risk' and acceptance of social/structural explanations. Methods This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them. Results Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of individual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise individualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities. Conclusions Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers.
Background: UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents’ health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. Aim: to describe in detail the health status and healthcare resource use of UK care home residents Design and setting: a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Method: Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. Results: out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5–15.5), MMSE 13 (4–22) and number of medications 8 (5.5–10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. Conclusion: residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.
Gordon, Adam Lee; Franklin, Matthew; Bradshaw, Lucy; Logan, Pip; Elliott, Rachel; Gladman, John R.F.
Background The aims of the study were to assess the impact of both positive (PA) and negative affect (NA) on self-reported oral health-related quality of life and to determine the effect of including affectivity on the relationship between oral health-related quality of life and a set of explanatory variables consisting of oral health status, socio-economic status and dental visiting pattern. Methods A random sample of 45–54 year-olds from metropolitan Adelaide, South Australia was surveyed by mailed self-complete questionnaire during 2004–05 with up to four follow-up mailings of the questionnaire to non-respondents (n = 986 responded, response rate = 44.4%). Oral health-related quality of life was measured using OHIP-14 and affectivity using the Bradburn scale. Using OHIP-14 and subscales as the dependent variables, regression models were constructed first using oral health status, socio-economic characteristics and dental visit pattern and then adding PA and NA as independent variables, with nested models tested for change in R-squared values. Results PA and NA exhibited a negative correlation of -0.49 (P < 0.01). NA accounted for a larger percentage of variance in OHIP-14 scores (3.0% to 7.3%) than PA (1.4% to 4.6%). In models that included both PA and NA, PA accounted for 0.2% to 1.1% of variance in OHIP-14 scores compared to 1.8% to 3.9% for NA. Conclusion PA and NA both accounted for additional variance in quality of life scores, but did not substantially diminish the effect of established explanatory variables such as oral health status, socio-economic status and dental visit patterns.
Brennan, David S; Singh, Kiran A; Spencer, A John; Roberts-Thomson, Kaye F
Results are reported of health services provided for contract and volunteer hospital workers, of participation by hospital employee unions in the development of health and safety programs and of the policies and practices with respect to the health and sa...
Background The electronic health record (EHR) is an important application of information and communication technologies to the healthcare sector. EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. These benefits cannot be achieved without the adoption of EHR by healthcare professionals. Nevertheless, the influence of individual and organisational factors in determining EHR adoption is still unclear. This study aims to assess the unique contribution of individual and organisational factors on EHR adoption in healthcare settings, as well as possible interrelations between these factors. Methods A prospective study will be conducted. A stratified random sampling method will be used to select 50 healthcare organisations in the Quebec City Health Region (Canada). At the individual level, a sample of 15 to 30 health professionals will be chosen within each organisation depending on its size. A semi-structured questionnaire will be administered to two key informants in each organisation to collect organisational data. A composite adoption score of EHR adoption will be developed based on a Delphi process and will be used as the outcome variable. Twelve to eighteen months after the first contact, depending on the pace of EHR implementation, key informants and clinicians will be contacted once again to monitor the evolution of EHR adoption. A multilevel regression model will be applied to identify the organisational and individual determinants of EHR adoption in clinical settings. Alternative analytical models would be applied if necessary. Results The study will assess the contribution of organisational and individual factors, as well as their interactions, to the implementation of EHR in clinical settings. Conclusions These results will be very relevant for decision makers and managers who are facing the challenge of implementing EHR in the healthcare system. In addition, this research constitutes a major contribution to the field of knowledge transfer and implementation science.
This report presents the results of the serum dioxin analysis of the Air Force HealthStudy 1987 examination cycle. Its purpose is to determine whether long-term health effects are associated with serum dioxin levels for the participants in the study. For...
A. S. Brockman M. B. Lustik R. H. Roegner S. C. Henderson W. D. Grubbs
This study investigated the hypothesis that socioeconomic differences in health status change can largely be explained by the higher prevalence of individual health-risk behaviors among those of lower socioeconomic position. Data were from the Americans’ Changing Lives study, a longitudinal survey of 3617 adults representative of the US non-institutionalized population in 1986. The authors examined associations between income and education
Paula M. Lantz; John W. Lynch; James S. House; James M. Lepkowski; Richard P. Mero; Marc A. Musick; David R. Williams
The Black Church is the only institution that has consistently served the interest of African Americans, and there is no other institution in the African American community that rivals its influence (Camara, 2004). The spiritual well-fare, social support, health, and well-being of its people have been one of its main goals. With health disparities of African Americans still at an alarming rate, the Black Church has used informal education as a means to impart knowledge on health, as well as other non-religious and religious topics. One of the avenues least researched within the Black Church is the pastor's perception of its educational role in health and wellness and its efforts to reduce health discrimination and health disparities between African American and European Americans in the U.S. Since social justice appears as a theme and concern in the traditions of many churches, it is only appropriate that, among other things, the Black Church should address the issue of health education and interventions. The purpose of this study was to explore African American pastors' perceptions of the role of the Black Church in providing health care, health education, and wellness opportunities to African Americans. Many pastors reported their church provided some form of health education and/or health screenings. Their perceptions about the important issues facing their congregants versus African Americans in general were quite similar. PMID:23563927
The School health policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of suicide prevention, covering the following topics: (1) Health Education; (2) Health Services and Mental…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of violence prevention, covering the following topics: (1) Health Education; (2) Health Services and…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of injury prevention and safety, covering the following topics: (1) Health Education; (2) Health Services…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports 2006 study results in the area of pregnancy prevention, covering the following topics: (1) Health Education; and (2) Health Services…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of tobacco-use prevention, covering the following areas: (1) Health Education; (2) Health Services and…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of HIV prevention, covering the following topics: (1) Health Education; and (2) Health Services and Mental…
AIM: To investigate the incidence of gastrointestinal symptoms and the nature of consequent utilization of health care services in a Japanese population. METHODS: Using self-report, we conducted a prospective cohort study of a nationally representative sample of the Japanese population over a one-month period to determine the incidence of gastrointestinal symptoms of all kinds and resultant health care utilization. Both information on visits to physicians and use of complementary and alternative medicine therapies were collected. RESULTS: From a total of 3568 in the recruitment sample, 3477 participants completed a health diary (response rate 97%). The data of 112 participants with baseline active gastrointestinal diseases were excluded from the analysis, leaving 3365 participants in the study. The incidence of gastrointestinal symptoms was 25% and the mean number of symptomatic episodes was 0.66 in a month. Abdominal pain, diarrhea, nausea, constipation and dyspepsia were the most frequent symptoms. Female gender, younger age, and low baseline quality of life were risk factors for developing these symptoms. The participants were more likely to treat themselves, using dietary, complementary or alternative medicines, than to visit physicians, except in the case of vomiting. CONCLUSION: Gastrointestinal symptoms are common in the Japanese population, with an incidence of 25%. Abdominal pain, diarrhea, nausea, constipation and dyspepsia are the most frequent symptoms. Risk factors for developing these symptoms include female gender, younger age, and low baseline quality of life.
Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. Results. The patients (n = 43) could be divided into four groups: asthma (28%), asthma-like disorder (44%), idiopathic cough (12%), and a nonreversible bronchial obstructive group (16%). The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction.
The EC Regulation No. 1924/2006 on Nutrition and Health claims made on foods has generated considerable debate and concern among scientists and industry. At the time of writing, the European Food Safety Authority (EFSA) has not approved any probiotic claims despite numerous human trials and meta-analyses showing evidence of beneficial effects. On 29th and 30th September 2010, ten independent, academic scientists with a documented record in probiotic research, met to discuss designs for future probiotic studies to demonstrate health benefits for gut and immune function. The expert panel recommended the following: (i) always formulate a precise and concrete hypothesis, and appropriate goals and parameters before starting a trial; (ii) ensure trials have sufficient sample size, such that they are adequately powered to reach statistically significant conclusions, either supporting or rejecting the a priori hypothesis, taking into account adjustment for multiple testing (this might necessitate more than one recruitment site); (iii) ensure trials are of appropriate duration; (iv) focus on a single, primary objective and only evaluate multiple parameters when they are hypothesis-driven. The panel agreed that there was an urgent need to better define which biomarkers are considered valuable for substantiation of a health claim. As a first step, the panel welcomed the publication on the day of the meeting of EFSA's draft guidance document on immune and gut health, although it came too late for study designs and dossiers to be adjusted accordingly. New validated biomarkers need to be identified in order to properly determine the range of physiological functions influenced by probiotics. In addition, validated biomarkers reflecting risk factors for disease, are required for article 14 claims (EC Regulation No. 1924/2006). Finally, the panel concluded that consensus among scientists is needed to decide appropriate clinical endpoints for trials. PMID:22067941
Background: There is an international emphasis on providing timely and high quality data to monitor progress of countries toward Millennium Development Goals. Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) aimed to provide valid information on population and health outcomes to monitor progress in achieving national priorities and health programs and to assist policy makers to design effective strategies for improving health outcomes and equity in access to care. Methods: A cross-sectional multi-stage stratified cluster-random survey is conducted through face-to-face household interviews. The sampling frame is developed using Iran's 2006 population and housing census. Provincial samples ranging are from a minimum of 400 households per province to 6400 households in Tehran province. Cluster size is 10 households. The target sample includes 3096 clusters: 2187 clusters in urban and 909 clusters in rural areas. IrMIDHS instruments include three questionnaires: Household questionnaire, women aged 15-54 questionnaire, children under five questionnaire, supervision and quality assessment checklists and data collection sheets and standard weight and height measurement tools for under-five children. A cascading decentralized training method is used for training data collection and supervision teams. Quality assurance procedures are defined for the five steps of conducting the survey including: Sampling, training data collection and training teams, survey implementation, data entry and analysis. A multi-layer supervision and monitoring procedure is established. All the questionnaires are double entered. Conclusions: IrMIDHS will provide valuable data for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policy makers. The collaborative nature of the study may facilitate better usage of its results.
The current economic crisis in Africa has posed a serious challenge to policies of comprehensive and equitable health care. This paper examines the extent to which the Zimbabwe government has achieved the policy of "Equity in Health" it adopted at independence in 1980, that is provision of health care according to need. The paper identifies groups with the highest level of health needs in terms of both health status and economic factors which increase the risk of ill health. It describes a series of changes within the health sector in support of resource redistribution towards health needs, including a shift in the budget allocation towards preventive care, expansion of rural infrastructures, increased coverage of primary health care, introduction of free health services for those earning below Z$150 a month in 1980, increased manpower deployment in the public sector and the reorientation of medical training towards the health needs of the majority. The implementation of equity policies in health have however been challenged by several trends and features of the health care system, these becoming more pronounced in the economic stagnation period after 1983. These include the reduction in allocations to local authorities, increasing the pressure for fees, the static nominal level of the free health care limit despite inflation, the continued concentration of financial, higher cost manpower and other resources within urban, central and private sector health care and the lack of effective functioning of the referral system, with high cost central quaternary facilities being used as primary or secondary level care by nearby urban residents. While primary health care expansion has clearly been one of the success stories of Zimbabwe's health care post 1980, the paper notes plateauing coverage, with evidence of lack of coverage in more high risk, socio-economically marginal communities. Measures to address these continuing inequalities are discussed. Their implementation is seen to be dependent on increasing the capacity and organisation of the poor to more strongly influence policy and resource distribution in the health sector. PMID:1906200
Background Interdisciplinary research has been promoted as an optimal research paradigm in the health sciences, yet little is known about how researchers experience interdisciplinarity in practice. This study sought to determine how interdisciplinary research was conceptualized and operationalized from the researcher's perspective and to better understand how best to facilitate interdisciplinary research success. Methods Key informant interviews were conducted with health researchers with expertise or experience in conducting interdisciplinary research. Interviews were completed either in person or over the telephone using a semi-structured interview guide. Data collection occurred simultaneously with data analysis so that emerging themes could be explored in subsequent interviews. A content analysis approach was used. Results Nineteen researchers took part in this study. Interdisciplinary research was conceptualized disparately between participants, and there was modest attention towards operationalization of interdisciplinary research. There was one overriding theme, "It's all about relationships", that emerged from the data. Within this theme, there were four related subthemes: 1) Involvement in interdisciplinary research; 2) Why do I do interdisciplinary research?; 3) Managing and fostering interdisciplinary relationships; and 4) The prickly side to interdisciplinary research. Together, these themes suggest that the choice to conduct interdisciplinary research, though often driven by the research question, is highly influenced by interpersonal and relationship-related factors. In addition, researchers preferred to engage in interdisciplinary research with those that they had already established relationships and where their role in the research process was clearly articulated. A focus on relationship building was seen as a strong facilitator of interdisciplinary success. Conclusion Many health researchers experienced mixed reactions towards their involvement in interdisciplinary research. A well thought-out rationale for interdisciplinary research, and strategies to utilize the contribution of each researcher involved were seen as facilitators towards maximizing the benefits that could be derived from interdisciplinary research.
Nair, Kalpana M; Dolovich, Lisa; Brazil, Kevin; Raina, Parminder
This paper reports on the findings of a small-scale study carried out in Adelaide. We asked secondary students who had decided to continue or discontinue their language study once it was no longer compulsory what had prompted their decision. We also asked them whether they considered knowing a second language to be important. While all the…
In a community-based health insurance (CBHI) introduced in 2004 in Nouna health district, Burkina Faso, poor perceived quality of care by CBHI enrollees has been a key factor in observed high drop-out rates. The poor quality perceptions have been previously attributed to health worker dissatisfaction with the provider payment method used by the scheme and the resulting financial risk of health centers. This study applied a mixed-methods approach to investigate how health workers working in facilities contracted by the CBHI view the methods of provider payment used by the CBHI. In order to analyze these relationships, we conducted 23 in-depth interviews and a quantitative survey with 98 health workers working in the CBHI intervention zone. The qualitative in-depth interviews identified that insufficient levels of capitation payments, the infrequent schedule of capitation payment, and lack of a payment mechanism for reimbursing service fees were perceived as significant sources of health worker dissatisfaction and loss of work-related motivation. Combining qualitative interview and quantitative survey data in a mixed-methods analysis, this study identified that the declining quality of care due to the CBHI provider payment method was a source of significant professional stress and role strain for health workers. Health workers felt that the following five changes due to the provider payment methods introduced by the CBHI impeded their ability to fulfill professional roles and responsibilities: (i) increased financial volatility of health facilities, (ii) dissatisfaction with eligible costs to be covered by capitation; (iii) increased pharmacy stock-outs; (iv) limited financial and material support from the CBHI; and (v) the lack of mechanisms to increase provider motivation to support the CBHI. To address these challenges and improve CBHI uptake and health outcomes in the targeted populations, the health care financing and delivery model in the study zone should be reformed. We discuss concrete options for reform based on the study findings. PMID:24681326
...Other Disease Among Men and Women in Agriculture (NCI) SUMMARY: In compliance with...Other Disease Among Men and Women in Agriculture (NCI) (OMB : 0925-0406...information for respondents enrolled in the Agriculture HealthStudy. This represents a...
Background There is an increasing push for ‘evidence-based’ decision making in global health policy circles. However, at present there are no agreed upon standards or guidelines for how to evaluate evidence in global health. Recent evaluations of existing evidence frameworks that could serve such a purpose have identified details of program context and project implementation as missing components needed to inform policy. We performed a pilot study to assess the current state of reporting of context and implementation in studies of global health interventions. Methods We identified three existing criteria sets for implementation reporting and selected from them 10 criteria potentially relevant to the needs of policy makers in global health contexts. We applied these 10 criteria to 15 articles included in the evidence base for three global health interventions chosen to represent a diverse set of advocated global health programs or interventions: household water chlorination, prevention of mother-to-child transmission of HIV, and lay community health workers to reduce child mortality. We used a good-fair-poor/none scale for the ratings. Results The proportion of criteria for which reporting was poor/none ranged from 11% to 54% with an average of 30%. Eight articles had ‘good’ or ‘fair’ documentation for greater than 75% of criteria, while five articles had ‘poor or none’ documentation for 50% of criteria or more. Examples of good reporting were identified. Conclusions Reporting of context and implementation information in studies of global health interventions is mostly fair or poor, and highly variable. The idiosyncratic variability in reporting indicates that global health investigators need more guidance about what aspects of context and implementation to measure and how to report them. This lack of context and implementation information is a major gap in the evidence needed by global health policy makers to reach decisions.
This paper focuses on the issue of how a research project can shift from a positivist to a nonpositivist framework. Specific attention is given to changes in research methods and philosophical paradigm that emerged while conducting a study on the replacement of immigrant physicians in rural America. In its original conceptualization, the study was expected to yield a simple, right answer. Specifically, one or more types of health professionals (e.g., nurse practitioners, National Health Service Corps physicians) would be identified as expected replacements in the event of a cutback on immigrant physicians. However, as the research progressed, the quest for a simple, right answer became less realistic. The theoretical framework, methods, and research question changed, thereby allowing for greater complexity and ambiguity than anticipated at the outset of the study. What had been a positivist, statistical study was now a nonpositivist, qualitative study, and the research question shifted to include individual perspectives. An overview of such transitions leads to a discussion of the importance of context and ambiguity in research. PMID:12383467
BACKGROUND: Although young people's transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper
Swaran P Singh; Moli Paul; Tamsin Ford; Tami Kramer; Tim Weaver
As we increasingly recognize the complexity of the pollutants in indoor and outdoor microenvironments, a broad array of inhaled mixtures has assumed scientific, public health, and regulatory importance. Few adverse effects of environmental pollutants are specific, that is, uniquely associated with a single agent; the adverse effects that might be considered in an investigation of the consequences of exposure to an inhaled complex mixture are generally nonspecific. In the context of this paper, we will refer to binary mixtures as complex, though we realize that a more precise definition of complexity would restrict the term to mixtures of three or more constituents. Their causes potentially include not only pollutant exposures through the medium of inhaled air but other environmental agents, such as infectious organisms and radiation, and inherent characteristics of the exposed persons, such as atopy. We review the outcome measures that have been used in epidemiologic studies of the health effects of single pollutants and complex mixtures. Some of these outcome measures have been carefully standardized, whereas others need similar standardization and modification to improve sensitivity and specificity for investigating the health effects of air pollution.
Objectives We evaluated the use of hearing health care services (hearing testing and hearing aids) by adults aged 21 to 84 years. Methods Hearing was tested and medical and hearing health histories were obtained as part of the Beaver Dam Offspring Study between 2005 and 2008 (n = 3285, mean age = 49 years). Results Of the cohort, 34% (55% of participants aged ? 70 years) had a hearing test in the past 5 years. In multivariate modeling, older age, male gender, occupation, occupational noise, and having talked with a doctor about a hearing problem were independently associated with having had a hearing test in the past 5 years. Hearing aid use was low among participants with a moderate to severe hearing impairment (22.5%) and among participants with a hearing handicap (8.6%), as determined by the Hearing Handicap Inventory. Conclusions Data support the need for improvement in hearing health care. Hearing aids’ effectiveness is limited if patients do not acquire them or do not use them once acquired. Future research should focus on developing effective strategies for moving patients from diagnosis to treatment.
Nash, Scott D.; Cruickshanks, Karen J.; Huang, Guan-Hua; Klein, Barbara E. K.; Klein, Ronald; Nieto, F. Javier; Tweed, Theodore S.
Background In order to perform at top levels, elite athletes have to both protect and risk their health at the same time. Adolescent elite athletes have the additional challenge of coping with substantial physical, psychological and social transformations. The contradictory phenomenon of protecting and risking the adolescent athletes' health in sports challenges the development of health promotion and protection strategies. The GOAL Study (German Young Olympic Athletes' Lifestyle and Health Management Study) analyzes the individual and organizational management of health in adolescent elite sports. Methods/design We combine quantitative and qualitative approaches in a mixed-method study. This allows us to gather a broad range of representative information on squad athletes from all Olympic disciplines as well as in-depth information on four selected Olympic disciplines (artistic gymnastics, biathlon, handball and wrestling). Within the quantitative section we attempt to identify the young athletes' health and nutrition behavior, their subjective health state and their lay health representations, health-related social networks, and structures of medical attendance. 1138 national team level athletes born between 1992 and 1995 from 51 Olympic disciplines responded to the questionnaire (response rate: 61,75%). The qualitative section investigates the meaning and relevance of health and nutrition within the athletes' sports specific surroundings, the impact of biographic backgrounds on individual health behavior, and sports specific cultures of health, nutrition and risk. We interviewed 24 athletes and 28 coaching and medical experts, and carried out 14 multi-day participant observations at training sessions and competitions. Conclusions The studies' results will serve as the basis for developing tailored health promotion strategies to be in cooperation with German elite sports associations.
Internet-based discussion forums provide access to health information and social support, and serve as a resource for others. This investigation analyzed health-oriented Aboriginal Internet discussion forum (Forum A; Forum B) conversations. The findings were framed with Nutbeam's model of health literacy. Discussions within Forum B were centralized around issues of political activism and advocacy regarding Aboriginal health care. Activity in
Health technology assessment (HTA) is one of the major research enterprises of late modernity, reaching into fields of previously autonomous professional practice, and critically interrogating the organisation and delivery of health care. The ‘evaluation’ of new health technologies within the field of HTA is increasingly a normative political expectation, as discourses of ‘evidence-based’ practice run through health policy in the
Carl May; Maggie Mort; Tracy Williams; Frances Mair; Linda Gask
The report represents a culmination of research activity performed by the State of Iowa's Committee on Health Manpower, which was created by The Comprehensive Health Planning Council, State of Iowa, in order to expedite the assignment of identifying, anal...
As the Veterans Health Administration (VHA) places high priority on becoming a performance-based organization, there is an increasing need to quantify and refine its outcome measurement system. Using panel data from VHA ambulatory care patients (1996-1998), we conducted cross-lagged correlations and ordinary least squares regression to examine the relationship between 2 VHA health care values: health status and satisfaction with
Xinhua S. Ren; Lewis Kazis; Austin Lee; William Rogers; Susan Pendergrass
Researchers, educators, and service providers recognize that health behaviors and conditions are interdependent, yet they are too often addressed compartmentally. This “silo” approach is unfortunate because it leads to inefficiencies and less effective approaches to prevention. This article describes a process designed to promote better understanding of the interrelatedness of health behaviors and outcomes through a multidimensional Internet-based health survey
Ruth A. Gassman; Jon Agley; Jeanne D. Johnston; Susan E. Middlestadt; Marieke van Puymbroeck; Ahmed H. YoussefAgha
Background: School health education can effectively help reduce the prevalence of health-risk behaviors among students and have a positive influence on students' academic performance. This article describes the characteristics of school health education policies and programs in the United States at the state, district, school, and classroom…
Kann, Laura; Telljohann, Susan K.; Wooley, Susan F.
The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying a multifunctional telephone set and an IC memory card, by which complaints, symptoms,
H. Inada; H. Horio; K. Nakazawa; Y. Sekita; T. Yamanaka; E. Harasawa; H. Hosaka; K. Ishikawa
European colonisation had a devastating effect on the health and well-being of indigenous people in Australia. The history of Aboriginal health research has reflected the history of colonisation; research has understandably been viewed with distrust. The need for accurate statistics and improved understanding of health problems is clear, but obtaining them is not easy. In this paper we describe the
Wendy Holmes; Paul Stewart; Anne Garrow; Ian Anderson; Lisa Thorpe
A group (n = 170) of inner-city, predominantly African American, health clinic patients were asked to identify the characteristics they desired in a new clinic health educator. A plurality (44%) of the patients perceived a bachelor's degree would be a sufficient level of education. The vast majority of patients claimed the sex of the health…
Objective To examine adoption of telehealth in a rural public health district and to explain how the innovation became sustainable. Study Setting Longitudinal, qualitative study (1988–2008) of the largest public health district in Georgia. Study Design Case study design provided deep insights into the innovation's social dynamics. Punctuated equilibrium theory helped present and make sense of the process. We identified antecedent conditions and outcomes, and we distinguished between episodes and encounters based on the disruptive effects of events. Data Collection Twenty-five semistructured interviews with 19 decision makers and professionals, direct observations, published papers, grant proposals, technical specifications, and other written materials. Principal Findings Strong collaboration within the district, with local community, and with external partners energized the process. Well-functioning outreach clinics made telehealth desirable. Local champions cultivated participation and generative capability, and overcame barriers through opportunistic exploitation of technological and financial options. Telehealth usage fluctuated between medical and administrative operations in response to internal needs and contextual dynamics. External agencies provided initial funding and supported later expansion. Conclusions Extensive internal and external collaboration, and a combination of technology push and opportunistic exploitation, can enable sustainable rural telehealth innovation.
Singh, Rajendra; Mathiassen, Lars; Stachura, Max E; Astapova, Elena V
Cross-national surveys have the potential to make a significant contribution to the study of adolescent health. The Health\\u000a Behaviour in School-aged Children (HBSC) study was among the first international studies established in three countries in\\u000a 1983 and growing to more than 40 countries for the seventh wave of fieldwork in 2005\\/06. The original aim of the study has\\u000a remained largely
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...
Background Evidence-informed health policymaking logically depends on timely access to research evidence. To our knowledge, despite the substantial political and societal pressure to enhance the use of the best available research evidence in public health policy and program decision making, there is no study addressing availability of peer-reviewed research in Canadian health ministries. Objectives To assess availability of (1) a purposive sample of high-ranking scientific journals, (2) bibliographic databases, and (3) health library services in the fourteen Canadian health ministries. Methods From May to October 2011, we conducted a cross-sectional survey among librarians employed by Canadian health ministries to collect information relative to availability of scientific journals, bibliographic databases, and health library services. Availability of scientific journals in each ministry was determined using a sample of 48 journals selected from the 2009 Journal Citation Reports (Sciences and Social Sciences Editions). Selection criteria were: relevance for health policy based on scope note information about subject categories and journal popularity based on impact factors. Results We found that the majority of Canadian health ministries did not have subscription access to key journals and relied heavily on interlibrary loans. Overall, based on a sample of high-ranking scientific journals, availability of journals through interlibrary loans, online and print-only subscriptions was estimated at 63%, 28% and 3%, respectively. Health Canada had a 2.3-fold higher number of journal subscriptions than that of the provincial ministries’ average. Most of the organisations provided access to numerous discipline-specific and multidisciplinary databases. Many organisations provided access to the library resources described through library partnerships or consortia. No professionally led health library environment was found in four out of fourteen Canadian health ministries (i.e. Manitoba Health, Northwest Territories Department of Health and Social Services, Nunavut Department of Health and Social Services and Yukon Department of Health and Social Services). Conclusions There is inequity in availability of peer-reviewed research in the fourteen Canadian health ministries. This inequity could present a problem, as each province and territory is responsible for formulating and implementing evidence-informed health policies and services for the benefit of its population.
Migration is known to be associated with poor health outcomes for certain marginalised and socially disadvantaged populations. This paper reviews a number of reasons why residential mobility in the ‘host’ country may be associated with poor mental health for refugee populations and reports on a qualitative study of Somalis living in London, UK, and their beliefs about the relationship between
Nasir Warfa; Kamaldeep Bhui; Tom Craig; Sarah Curtis; Salaad Mohamud; Stephen Stansfeld; Paul McCrone; Graham Thornicroft
The study was conducted to determine whether there is a relationship between the Coordinated School Health Program (CSHP) and student academic performance. Data were collected from schools and the community for three reports for 50 states and the District of Columbia (DC). The School Health Policies and Programs Survey (SHPPS), the National…
A comprehensive health center integrates inpatient, outpatient, and public health services within the same medical and administrative structure. While health centers have been widely delveloped in other countries, only limited implementation has occured in the United States. This case study documents the successful implementation of the health center concept in a sparsely populated area of northwestern New Mexico. This remote
Richard A. Reid; Edward E. Bartlett; Richard Kozoll
A very brief synthesis is provided of the findings of the historical research the author first began more than forty years ago as to the initial beginnings of the studies on public health in Renaissance Spain. The role played by royal power from the standpoint of the beginnings of the modern State, the influence of Hippocratic environmentalism, keeping up cleanliness-related privileges at the personal level, the first beginnings of hygiene on a widespread basis in related to the plague epidemics and the contributions to medical care conditioned by the change in poverty-related values are discussed in turn. PMID:17193808
Environmental surfaces are likely to contribute to the transmission of health care-associated pathogens. The present study aimed to determine the most effective regimen or product for removing bioburden. An adenosine triphosphate assessment technique was used to compare cleaning methods and products for removing bioburden from soiled surfaces. Of the regimens or products tested, 2-step cleaning most thoroughly removed bioburden. The 2-in-1 products were no more effective in removing bioburden than a 1-step clean using a neutral detergent. PMID:21937146
Gillespie, Elizabeth E; Scott, Carmel; Wilson, Jill; Stuart, Rhonda
Introduction Recent UK health policies identified nurses as key contributors to the social justice agenda of reducing health inequalities, on the assumption that all nurses understand and wish to contribute to public health. Following this policy shift, public health content within pre-registration nursing curricula increased. However, public health nurse educators (PHNEs) had various backgrounds, and some had limited formal public health training, or involvement in or understanding of policy required to contribute effectively to it. Their knowledge of this subject, their understanding and interpretation of how it could be taught, was not fully understood. Methodology This research aimed to understand how public health nurse educators’ professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health, using a qualitative data analysis approach. Qualitative in-depth semi-structured interviews (n=26) were conducted with eleven university-based PHNEs. Results Integrating public health into all aspects of life was seen as central to the knowing and teaching of public health; this was conceptualised as ‘embodying knowledge’. Participants identified the meaning of embodying knowledge for teaching public health as: (a) possessing a wider vision of health; (b) reflecting and learning from experience; and (c) engaging in appropriate pedagogical practices. Conclusion The concept of public health can mean different things to different people. The variations of meaning ascribed to public health reflect the various backgrounds from which the public health workforce is drawn. The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. Their vision of public health is influenced by social justice principles in that health inequalities, socioeconomic determinants of health, epidemiology, and policy and politics are seen as essential areas of the public health curriculum. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change.
Describes adolescents' use of school-based health clinics (SBCs) for family planning and sexually transmitted disease (STD)-related services, using data from the National Longitudinal Study of Adolescent Health. Results indicated that 13 percent received family planning and 8.9 percent received STD-related services from SBCs. Factors affecting the…
Fundamental health care reforms in Estonia started in 1991 with the introduction of a social health insurance system. While increasing the efficiency of the health care system was one of the targets of the health care reforms, equity issues have received relatively less attention. The objective of this study is to provide an overview of social inequalities in health care
Background Studies relating adiposity to cognition in the elderly show conflicting results, which may be explained by the choice of adiposity measures. Thus, we studied the longitudinal associations of different adiposity measures, fat mass by bioelectrical impedance analysis (BIA), body mass index (BMI) and waist circumference (WC), with cognitive performance in the Cardiovascular HealthStudy. Methods Cognitive performance was assessed with the modified Mini Mental State Examination (3MS), the Digit Symbol Substitution Test (DSST), and a composite of both. We used linear mixed models to estimate rates of change in cognitive function scores associated with adiposity measured at baseline. Results The final sample was comprised of 2,681 women (57.9%) and 1,949 men (42.1%) aged 73 ± 5.2 and 73.9 ± 5.6 years. Adiposity was associated with slower cognitive decline in most analyses. Results were similar for fat mass, BMI and WC. Higher fat-free mass was also related to slower cognitive decline. Results were similar in analyses excluding persons with cancer, smokers, and persons with short follow-up, poor self-reported health, or persons with cardiovascular disease. Conclusions Higher adiposity and higher fat-free mass in the elderly was related to better cognitive performance. This finding was not explained by confounding by pre-existing conditions.
Luchsinger, Jose A.; Biggs, Mary L.; Kizer, Jorge; Barzilay, Joshua; Fitzpatrick, Annette; Newman, Anne; Longstreth, William T.; Lopez, Oscar; Siscovick, David; Kuller, Lewis
... With Us A long term healthstudy for oil spill clean-up workers and volunteers Follow-up underway! ... healthstudy for individuals who helped with the oil spill cleanup, took training, signed up to work, or ...
Case studies were presented to illustrate the effect of safety and health on the success of business management. The studies were intended to be used to help business administration students understand the importance of safety and health in business. The ...
The accuracy of the exposure assessment is a critical factor in epidemiological investigations of pesticide exposures and health in agricultural populations. However, few studies have been conducted to evaluate questionnaire-based exposure metrics. The Agricultural HealthStudy...
...Data from health and safety studies of microorganisms. 725.92 Section 725.92 ...REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Confidentiality and Public Access...Data from health and safety studies of microorganisms. (a) Information other than...
...Data from health and safety studies of microorganisms. 725.92 Section 725.92 ...REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Confidentiality and Public Access...Data from health and safety studies of microorganisms. (a) Information other than...
...Data from health and safety studies of microorganisms. 725.92 Section 725.92 ...REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Confidentiality and Public Access...Data from health and safety studies of microorganisms. (a) Information other than...
Background: With objective of health systems strengthening, as visualized under National Rural Health Mission (NRHM); one key strategic intervention is up-gradation of health service delivery facilities so as to provide sustainable quality care with accountability and people's participation, which required the development of a proper management structure called Rogi Kalyan Samitis (RKS). It is the State's attempt to make health everyone's business by de-mystifying health-care delivery at district and sub-district levels with reference to facility based health-care delivery by encouraging citizen's participation in management bodies. Objective: The study was an attempt to define ‘functional Health Systems’ with a focus on strategic issues concerning RKS operations. Materials and Methods: A mixed-method, multi-site, collective case study approach was adopted. In-depth interviews of key-stakeholders were conducted. Qualitative data were analyzed thematically and coded inductively. Results: RKS is yet to bring out quality component to the health services being provided through facilities. This can be attributed to structural and managerial weakness in the system; however, certainly NRHM has been consistent in creating a road-map for benefitting local community and their participation through RKS. Conclusion: The progress of the RKS can further be enhanced by giving due priority to critical areas. Furthermore, the results emphasize an urgent need for devising strategies and actions to overcome significant systemic constraints as highlighted in the present study.
Background Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas. Using a geo-epidemiological approach, the present study identified factors that contribute to the mental well-being in the slums of Dhaka, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. Methods The baseline data of a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (? 15 years). All respondents were geographically marked based on their households using global positioning systems (GPS). Very high-resolution land cover information was processed in a Geographic Information System (GIS) to obtain additional exposure information. We used a factor analysis to reduce the socio-physical explanatory variables to a fewer set of uncorrelated linear combinations of variables. We then regressed these factors on the WHO-5 Well-being Index that was used as a proxy for self-rated mental well-being. Results Mental well-being was significantly associated with various factors such as selected features of the natural environment, flood risk, sanitation, housing quality, sufficiency and durability. We further identified associations with population density, job satisfaction, and income generation while controlling for individual factors such as age, gender, and diseases. Conclusions Factors determining mental well-being were related to the socio-physical environment and individual level characteristics. Given that mental well-being is associated with physiological well-being, our study may provide crucial information for developing better health care and disease prevention programmes in slums of Dhaka and other comparable settings.
Background The negative effect of poverty on child health has been well established. However, rapid urbanization in developing countries prompts new research questions relating to socio-cultural practices and other related variables in these settings. Objective To examine the association between maternal cultural participation and child health status in impoverished neighbourhoods of Beirut, Lebanon. Methods A cross-sectional survey of 1,241 mothers with children under 5 years was conducted from randomly selected households in three impoverished neighbourhoods of diverse ethnic and religious make-up. The outcome variable was child health status (good/bad) as assessed by the mother. Maternal variables, including cultural participation, education, demographic, and environmental/structural factors were studied. Descriptive statistics and bivariate associations were provided using Pearson’s ?2 tests. Unadjusted and adjusted odds ratios were then obtained from binary logistic regression models. Results Two indicators of maternal cultural participation, namely watching entertaining television and attending movies/art exhibitions, were found to be significantly associated to child health status after controlling for other risk factors. The quality of water, the quality of local health services, and maternal education were also significantly associated with child health status. Household income, child gender, and household dampness had no significant association with child health status in this context. Conclusion Maternal cultural participation was a significant predictor of child health status in impoverished urban communities. Improving child health through culturally focused interventions for mothers, especially in deprived areas, may be great.
Environmental pollution, primarily from industrialization, has caused significant adverse effects to humans, animals, and the ecosystem. Attempts have been made to reduce and prevent these pollutants through better waste management practices. Incineration is one such practice, which seeks to prevent adverse health impacts to future generations by destroying waste today, without increasing risk to those living near incineration facilities in the process. As with any industrial process, however, proper design and operation are important requirements to ensure the facility can be operated safely. Any technology that cannot be managed safely should not be considered acceptable. This paper reviews the scientific basis of past allegations associated with the process of hazardous waste incineration. These five case studies, which have attracted considerable public attention, have not been shown to be scientifically accurate of factually based. This paper attempts to separate fact from fiction and to show some of the consistent inaccuracies that were repeated throughout all five studies. In reviewing the above cases and others in the literature, several common elements become apparent. 1. Most of the reports are based on single newspaper articles, activist newsletters, interviews with admittedly biased respondents, and other secondary or inappropriate sources of information that do not withstand scientific scrutiny. 2. Research studies are quoted incompletely or out of context. Often the original point made by the researcher is the exact opposite of the impression left by Costner and Thornton. 3. In four of five cases, no data were supplied to substantiate the claims. As an observation, where substantive research data do not exist to support allegations of adverse health effects, a tendency seems to be increasing over time to make allegations and then not provide supporting data. Because public damage is often done simply by making the allegation, this tactic appears to be effective. Thus, unsubstantiated allegations should not go unchallenged. 4. A relatively small group of people appears to be consistently generating most of the allegations. 5. The format of the allegations tends to be similar; often just the name of the facility changes. 6. Furthermore, these same few individuals tend to repeat the same allegations about the same facilities, even after the allegations have been long since proven incorrect. Despite the widespread prevalence of incineration facilities around the world and the millions of tons of waste destroyed in them each year, surprisingly few reports of adverse health effects exist in the scientific literature relative to other types of waste management practices. 7. The existing reports do not indicate that hazardous waste incineration has widespread potential for adverse health effects. However, as with all industrial processes, care must be taken to ensure that facilities are well designed and well operated to minimize or prevent adverse health effects. As with all environmental exposures, potential impacts on public health need to be addressed scientifically. Making a scientifically valid connection between operation of an incinerator and resulting disease within a population is a difficult undertaking, requiring the combined efforts of toxicologists, epidemiologists, chemists, physicians, and persons in other disciplines. Nevertheless, concerns regarding potential impacts of incineration must be addressed and communicated, both accurately and effectively, if the actual risks of incineration are to become widely understood. PMID:8794540
The Agricultural HealthStudy (AHS) is a prospective epidemiological study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to 2,4-D or chlorpyrifos is being measured for a subset of applicators in the AHS Pesticide Exposure Study to assess expos...
The Agricultural HealthStudy (AHS) is a prospective epidemiological study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to 2,4-D or chlorpyrifos is being measured for a subset of applicators in the AHS Pesticide Exposure Study to assess expos...
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study of pesticide applicators and spouses in Iowa and North Carolina. Exposure to 2,4-D or chlorpyrifos was measured for a subset of applicators and their families in the AHS Pesticide Exposure Study to assess...
An exploratory study was undertaken to determine the role and practice issues of radiology coding in health information management (HIM) practice. The study sought to identify the challenges of radiology coding and the solutions implemented to address these challenges. A self-report survey was sent to 828 American Health Information Management Association (AHIMA) members identified as directors, managers, or supervisors of HIM departments and/or coding. Two hundred seventy-eight surveys were used for data analysis purposes. Sites reported that on average they have 3.4 coders devoted to radiology coding who code an average of 4,245 reports per month. Productivity standards varied by exam type ranging from 7 (interventional radiology) to 31 (diagnostic) exams coded per hour. Diagnosis codes were assigned most frequently for diagnostic, ultrasound/nuclear, MRI/CT, and mammography exams, while diagnosis and procedural codes were assigned more frequently for interventional radiology exams. The need for education specifically focused on interventional radiology coding was identified along with other issues affecting the quality of radiology coding. Suggested solutions to challenges of radiology coding such as establishing a good working relationship with physicians, radiology, and charge description master (CDM) departments were suggested.
Background Post-conflict mental healthstudies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. Aims This prospective study compares mental health before and after exposure to direct political violence during the People’s War in Nepal. Method An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Results Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose–response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conclusions Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in post-conflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.
Kohrt, Brandon A.; Hruschka, Daniel J.; Worthman, Carol M.; Kunz, Richard D.; Baldwin, Jennifer L.; Upadhaya, Nawaraj; Acharya, Nanda Raj; Koirala, Suraj; Thapa, Suraj B.; Tol, Wietse A.; Jordans, Mark J. D.; Robkin, Navit; Sharma, Vidya Dev; Nepal, Mahendra K.
To meet the rapidly expanding need for musculoskeletal (MSK) specialists [physiotherapists (PTs), physiatrists] in haemophilia care in China, a 4-day Train the Trainer workshop was conducted in July/August 2009 in Beijing. A key focus was to train the participants to administer the Hemophilia Joint Health Score (HJHS) version 2.1 for effectively evaluating the MSK health of boys <18 years of age with haemophilia. The aim of this study was to test the HJHS version 2.1 inter- and intra-rater reliability in a group of Chinese PTs and physiatrists with limited experience in haemophilia care. Each of the trained Chinese physiatrists and PTs examined eight boys 4-17 years old with moderate and severe haemophilia on day 1 and repeated the examination on the same patients the next day using the HJHS version 2.1. The boys had a wide range of target joint involvement and arthropathy. The HJHS score sheet, work sheets and manual had been translated into simple Chinese prior to the study. The interrater (ICC 0.90) and intra-rater (ICC 0.91) reliability was excellent. The internal consistency of the HJHS items was also excellent with Cronbach's alpha of 0.86. With basic training in the administration of the HJHS version 2.1, the tool was reliably administered by Chinese PTs and physiatrists with limited haemophilic experience. PMID:24330460
Sun, J; Hilliard, P E; Feldman, B M; Zourikian, N; Chen, L; Blanchette, V S; Luke, K H; Poon, M-C
A study on the Huron service area health facility and service needs in Michigan is reported. The study was initiated by the East Central Michigan Comprehensive Health Planning Council in February 1974. The study defines health needs for the Huron service ...
... May 8 in the online British Journal of Sports Medicine , the researchers concluded that from age 30 until ... City; May 8, 2014, online British Journal of Sports Medicine HealthDay Copyright (c) 2014 HealthDay . All rights reserved. ...
The project aimed to assess stigmatized attitudes among health professionals directed towards patients with mental health problems. The Attitude to Mental Illness Questionnaire was used to assess participants' attitudes towards fictitious patients from a secure forensic hospital and patients with schizophrenia and substance use disorders. Participants were health professionals from acute and mental health settings. In total, 108 completed questionnaires were received. Participants had highly stigmatized attitudes towards patients from a forensic hospital and those with active substance use disorders. Attitudes were less stigmatized to people with substance use disorders who were recovering in remission. This suggested that health professionals have stigmatized attitudes towards an illness such as schizophrenia and this is worse towards patients from a secure hospital. The manner in which patients with substance use disorder are presented can have a significant effect on stigmatized attitudes by health professionals. PMID:19291157
Objective To analyze the relationship of ideal cardiovascular health to disease-specific death. Patients and Methods We used data from the Aerobics Center Longitudinal Study from October 9, 1987, to March 3, 1999, to estimate the prevalence of ideal cardiovascular health in 11,993 individuals (24.3% women) and to examine its relationship with deaths from all causes, cardiovascular disease (CVD), and cancer. Results During a mean follow-up of 11.6 years, 305 deaths occurred: 70 (23.0%) from CVD and 127 (41.6%) from cancer. In the entire cohort, only 29 individuals (0.2%) had 7 ideal metrics. After adjusting for age, sex, examination year, alcohol intake, and parental history of CVD, risk of death due to CVD was 55% lower in those participants who met 3 or 4 ideal metrics (hazard ratio, 0.45; 95% confidence interval, 0.27-0.77) and 63% lower in those with 5 to 7 ideal metrics (hazard ratio, 0.37; 95% confidence interval, 0.15-0.95), compared with those who met 0 to 2 ideal metrics. Although not significant, there was also a trend toward lower risk of death due to all causes across incremental numbers of ideal metrics. No association was observed for deaths due to cancer. Conclusion The prevalence of ideal cardiovascular health was extremely low in a middle-aged cohort of men and women recruited between 1987 and 1999. The American Heart Association construct reflects well the subsequent risk of CVD, as reflected by graded CVD mortality in relation to the number of ideal metrics.
Artero, Enrique G.; Espana-Romero, Vanesa; Lee, Duck-chul; Sui, Xuemei; Church, Timothy S.; Lavie, Carl J.; Blair, Steven N.
\\u000a According to World Health Organization (1948), health is defined as a state of complete physical, mental and social well-being\\u000a and not merely the absence of disease or infirmity. In terms of this definition, urban health is referred to as the health\\u000a of population living in the city or town (Galea and Vlahov 2005). More than half of the world population
The international study includes factors reflecting characteristics of health services systems in different social, economic, and political settings. Methods were developed for describing systems with data that were both available and comparable internati...
The purpose of this pilot study was to determine the willingness of the farm community to participate in a farm safety health initiative (expanding a community-based health program to include elements of the Certified Safe Farm program), as well as understand farmers' experiences with participation in the intervention. Focus groups and individual interviews were held to explore farmers' experience with the expanded health screening and on farm safety review. Results indicate that incorporation of the expanded intervention was well accepted amongst participants in this study. PMID:20407993
Schiller, Lisa F; Donham, Kelley; Anderson, Thomas; Dingledein, Dawn M; Strebel, Rhonda R
Objective: To identify key issues in the mental health policy development process in Cambodia that will contribute to an increased understanding of how mental health policy gets on the public policy agenda, how it stays there and why policy implementation fails or succeeds. The research was formative because mental health policy analysis is a young and newly emerging discipline.Method: A
Alexis Stockwell; Harvey Whiteford; Clare Townsend; Donald Stewart
The linkage between marital quality (marital adjustment and marital satisfaction) and mental health (midlife crisis symptoms and life satisfaction) as well as perceived health status in 378 Chinese married couples over 2 years was examined. Results showed that marital adjustment and marital satisfaction were concurrently related to midlife crisis symptoms, life satisfaction, and perceived health at Time 1 and Time
BACKGROUND: Collaborations are important to health promotion in addressing multi-party problems. Interest in collaborative processes in health promotion is rising, but still lacks monitoring instruments. The authors developed the DIagnosis of Sustainable Collaboration (DISC) model to enable comprehensive monitoring of public health collaboratives. The model focuses on opportunities and impediments for collaborative change, based on evidence from interorganizational collaboration, organizational
Mariken TW Leurs; Ingrid M Mur-Veeman; Rosalie van der Sar; Herman P Schaalma; Nanne K de Vries
A cross-sectional healthstudy of 101 cryolite workers was performed, using spirometry and a questionnaire. Multiple regression analysis revealed a significant correlation between the index of smoking and a decrease in FEV1 (per cent). There was no significant correlation between work-related exposure and lung function. Many cryolite workers described a group of symptoms appearing after 15 to 30 min of heavy dust exposure: nausea, followed by epigastric pain with relief after spontaneous or provoked vomiting. Thirty-four (33.6 per cent) workers complained of nausea, vomiting or diarrhoea in relation to work, compared to 3.8 per cent of 1752 men participating in the Copenhagen Male Study. PMID:2622142
Background Being female is a strong predictor of health promoting behaviours. Workplaces show great potential for lifestyle interventions, but such interventions do not necessarily take the gendered background of lifestyle behaviours into account. A perspective analyzing how masculine gender norms affect health promoting behaviours is important. This study aims to explore men's health beliefs and attitudes towards health promotion; in particular, it explores workplace physical activity in relation to masculine ideals among male employees. Methods In the Fall of 2008, we interviewed 13 white Dutch male employees aged 23-56 years. The men worked in a wide range of professions and occupational sectors and all interviewees had been offered a workplace physical activity program. Interviews lasted approximately one to one-and-a-half hour and addressed beliefs about health and lifestyle behaviours including workplace physical activity, as well as normative beliefs about masculinity. Thematic analysis was used to analyze the data. Results Two normative themes were found: first, the ideal man is equated with being a winner and real men are prepared to compete, and second, real men are not whiners and ideally, not vulnerable. Workplace physical activity is associated with a particular type of masculinity - young, occupied with looks, and interested in muscle building. Masculine norms are related to challenging health while taking care of health is feminine and, hence, something to avoid. Workplace physical activity is not framed as a health measure, and not mentioned as of importance to the work role. Conclusions Competitiveness and nonchalant attitudes towards health shape masculine ideals. In regards to workplace physical activity, some men resist what they perceive to be an emphasis on muscled looks, whereas for others it contributes to looking self-confident. In order to establish a greater reach among vulnerable employees such as ageing men, worksite health promotion programs including workplace physical activity may benefit from greater insight in the tensions between health behaviours and masculinity.
This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000-2001 and 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16-2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention. PMID:22806701
Background Only a few case reports and case series dealing with oral and dental health care are available in literature until now. The aim of the present pilot study was to determine the status of dental health in comparison to matched controls and to heighten the neurologists’ and dentists’ awareness of the oral aspects of the disease. Methods 42 Huntington’s disease (HD) participants were scored according to the Unified Huntington’s Disease Rating Scale. The dental status was assessed by using the well established score for decayed, missing, and filled teeth (DMFT) and the dental plaque score (Silness-Loe plaque index). Results Compared to controls HD participants showed significantly more decayed teeth and more plaques in both plaque indices. A higher motor impairment and a lower functional status of the patients lead to a worsening in dental status. Conclusion Possible reasons for our findings are discussed. Apart from local oral complications general complications may also occur. Thus, as a consequence, we would encourage patients, caregivers, neurologists, and the dentists to ensure regular preventive dental examinations and dental treatments of individuals with Huntington’s disease even in the premanifest stage of this disease.
Background: The Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) aims to clarify the complex associations between social factors and health from an interdisciplinary perspective and to provide a database for use in various health policy evaluations.Methods: J-SHINE is an ongoing longitudinal panel study of households of adults aged 25-50 years. The wave 1 survey was carried out in 2010 among adults randomly selected from the resident registry of four urban and suburban municipalities in the greater Tokyo metropolitan area, Japan. In 2011, surveys for the participants' spouse/partner and child were additionally conducted. The wave 2 survey was conducted in 2012 for the wave 1 participants and will be followed by the wave 2 survey for spouse/partner and child in 2013.Results: Wave 1 sample sizes were 4357 for wave 1 participants (valid response rate: 31.3%; cooperation rate: 51.8%), 1873 for spouse/partner (response rate: 61.9%), and 1520 for child (response rate: 67.7%). Wave 2 captured 69.0% of wave 1 participants. Information gathered covered socio-demographics, household economy, self-reported health conditions and healthcare utilization, stress and psychological values, and developmental history. A subpopulation underwent physiological (n = 2468) and biomarker (n = 1205) measurements.Conclusions: Longitudinal survey data, including repeated measures of social factors evaluated based on theories and techniques of various disciplines, like J-SHINE, should contribute toward opening a web of causality for society and health, which may have important policy implications for recent global health promotion strategies such as the World Health Organization's Social Determinants of Health approach and the second round of Japan's Healthy Japan 21. PMID:24814507
Background The Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) aims to clarify the complex associations between social factors and health from an interdisciplinary perspective and to provide a database for use in various health policy evaluations. Methods J-SHINE is an ongoing longitudinal panel study of households of adults aged 25–50 years. The wave 1 survey was carried out in 2010 among adults randomly selected from the resident registry of four urban and suburban municipalities in the greater Tokyo metropolitan area, Japan. In 2011, surveys for the participants’ spouse/partner and child were additionally conducted. The wave 2 survey was conducted in 2012 for the wave 1 participants and will be followed by the wave 2 survey for spouse/partner and child in 2013. Results Wave 1 sample sizes were 4357 for wave 1 participants (valid response rate: 31.3%; cooperation rate: 51.8%), 1873 for spouse/partner (response rate: 61.9%), and 1520 for child (response rate: 67.7%). Wave 2 captured 69.0% of wave 1 participants. Information gathered covered socio-demographics, household economy, self-reported health conditions and healthcare utilization, stress and psychological values, and developmental history. A subpopulation underwent physiological (n = 2468) and biomarker (n = 1205) measurements. Conclusions Longitudinal survey data, including repeated measures of social factors evaluated based on theories and techniques of various disciplines, like J-SHINE, should contribute toward opening a web of causality for society and health, which may have important policy implications for recent global health promotion strategies such as the World Health Organization’s Social Determinants of Health approach and the second round of Japan’s Healthy Japan 21.
Background Professional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills. Methods A cross-sectional study was conducted including all recent MEPH graduates and students from 2009–2012, out of 67 eligible candidates N?=?51 were contacted and N?=?33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale. Results Females scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P?=?0.022). Overall, the mean value of public health competencies was the lowest in students with “staff” preferences and the highest among students with mixed job preferences (P?0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r?=?0.61, P?0.001). Conclusions The study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership.
Many practical issues in medical ethics depend on an understanding of the concept of health. The main question is whether it is a purely descriptive or a partly evaluative or normative concept. After posing some puzzles about the concept, the views of C Boorse, who thinks it is descriptive, are discussed and difficulties are found for them. An evaluative treatment
Public welfare on a municipal level for groups with special health risks has been an important topic of public health service for more than a century. This notion has been taken up by the German "Protection against Infection Act" (IfSG) in § 19 IfSG. Local health service authorities may provide out-patient treatment in addition to counselling and diagnosis for patients with sexually transmitted infections and tuberculosis, which is covered by public resources in cases of apparent need. Due to altered legislation and increased global mobility, this may become important for migrants without access to regular health care.Aims of this study were recording, counselling, diagnosis and out-patient treatment of migrants without legal residence status under the German Protection against Infection Act in the public health care system.An electronic mail survey of all local health authorities (n=384) by means of a standardised questionnaire was undertaken. Data were analysed using descriptive statistics. In the annex of the questionnaire the participants were asked to describe a case study.139 of 384 local health authorities completed the questionnaire (36.2%) of whom approximately a quarter (24.6%) described contacts to "illegal" migrants. Contacts to migrants without legal residence status are more frequent in cities with more than 100?000 inhabitants than in ismaller cities (p<0.05). 22.6% of all local health authorities make an effort to reach undocumented migrants for counseling and diagnosis. 25 of the local health authorities (18.4%) indicated the capability to provide treatment in accordance with § 19 IfSG. A majority of these local health authorities also have contacts to undocumented migrants (75%). 16 local health authorities (13.3%) provide out-patient treatment for diseases not listed in Protection against Infection Act. 56 authorities (46.7%) refer patients to aid organisations or to resident doctors.Only a small number of local health authorities have contacts to migrants without health insurance. The option-al out-patient treatment is provided by few local health authorities especially in cases of sexual transmitted diseases except for HIV/AIDS. In most cases undocumented migrants are only one group among others. The large number of cases in cities with more than 500?000 inhabitants shows the massive requirements. PMID:24671893
Results are presented of a survey of occupational safety and health in U.S. hospitals. Illness is found to be the most frequent cause of absence in hospital employees, with respiratory problems the most frequent health problem. Strains and sprains and pun...
This volume includes (1) a review of the way smoking has been measured by other investigators, and how its effects on health status are assessed; (2) a review of the adverse effects of smoking on future health status, and the types of changes in smoking b...
Background Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. Objective A qualitative study with purposeful sampling sought to examine patients’ views and experiences with reading their health records, including their clinical notes, online. Methods Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Results Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Conclusions Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared records may or may not impact overall clinic workload, it is likely to change providers’ work, necessitating new types of skills to communicate and partner with patients.
Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W. Paul
Methods We examined the associations of constitutional risk factors and sun exposure with the risks of three types of skin cancer simultaneously and evaluated the interaction between constitutional susceptibility and sun exposure in a nested case-control study within the Nurses' HealthStudy (200 melanoma, 275 squamous cell carcinoma (SCC), and 283 basal cell carcinoma (BCC) cases, and 804 controls). Information
The Agricultural HealthStudy (AHS) is a prospective epidemiologic study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to targeted applied pesticides (2,4-D or chlorpyrifos) is being measured for a subset of applicators and their families in t...
In 1995, the Cambodian Urban Health Care Association (CUHCA) was set up as facilitator between private health care providers and patients, guaranteeing good quality health care and fair pricing to patients and providing training and logistic support to providers. Providers were engaged on a fee-for-service basis and competition encouraged. CUHCA's objectives followed the same line of thought as the 1993 World Development Report, aiming at influencing the unregulated private health care market through competition mechanisms. But soon after the start of the project the basic problem was recognized to be not the absence of effective government regulation but rather that consumers lack the requisite knowledge to make good choices in the market for health services. CUHCA had not adequately addressed the demand for health services. The original supply-side strategy of improving health services by increasing competition was a failure. In order to improve CUHCA's health programme efficiency the association's objectives were subsequently redefined and its functioning reorganized. CUHCA now tries to educate consumers and provides good quality services so that consumers will be able to act on the basis of their newly acquired knowledge. CUHCA's health centres serve as model clinics for first-line health care. Community educators organize information, education and communication (IEC) activities. Staff help school teachers to improve formal health education in schools and CUHCA assists local leaders in sanitation development. Only full-time personnel are employed, encouraging team spirit and communication with the target population. Salaries are based on team performance. The CUHCA programme demonstrates that, depending on the market situation, health programme models need to address both the supply and the demand for services in order to be efficient. Where consumers lack essential knowledge to make appropriate choices in the health service market, interventions should focus on health education and social marketing and provide models of quality care catering to informed consumer choice. PMID:10187596
The Health Workers Society (HWS), founded in 1980, was one of several progressive health organisations that fought for a democratic health system in South Africa. We document the sociopolitical context within which it operated and some of its achievements. HWS, many of whose members were staff and students of the University of Cape Town (UCT), provided a forum for debate on health-related issues, politics and society, and worked closely with other organisations to oppose the apartheid state's health policies and practices. They assisted with the formation of the first dedicated trade union for all healthcare workers and were one of the first to pioneer the primary healthcare approach in an informal settlement in Cape Town. PMID:22668919
Pick, W; Claassen, J W B; Le Grange, C A; Hussey, G D
The cultural aspects of health promotion are important in policy development as well as in assessing effectiveness of health promotion activities. The discourses on promoting health and well-being in journalism reflect the health promotion culture in society. This article illustrates how health promotion is portrayed by 147 newspaper items from the two Finnish quality dailies during the period 2002-2004 and introduces a semiotic Actantial Model of Health Promotion (AMHP) for studyinghealth promotion cultures. The most popular news themes on health promotion were physical and social environment, welfare services, nutrition and obesity, and mental well-being. The actants (actors, actions and abstract factor) of health promotion were identified and the AMHP with seven key actants (generator, health-object, public, tool, executor, threat and obstacle) was constructed. The model sheds light on two sides of health promotion discourses in journalism. The dominant culture of health promotion was represented by policy actions, information, education and scientific research, which were defined by health experts, decision-makers and researchers. Representations of the opposite culture--'the otherness' of health promotion included external harmful factors and unhealthy behaviours, mentalities opposed to being health-oriented, rationally uncontrolled living, disorder, disharmony and insecurity. The opposing factors were presented by people and institutions lacking the will, ability or motivation for a health-oriented life. To understand better the values of health promotion, it is necessary to assess the characteristics of the opposite side of health promotion culture, because the current dominant values can be described more clearly by the boundaries--by 'otherness'. The study argues that the AMHP can be used as a semiotic method to identify the value dimensions and the boundaries between the dominant and the opposite discourses of health promotion in various communications such as advertising and health education. Also, it provides a tool for the analysis of the media's role in 'victimization' or 'heroization' of various population groups. PMID:16567361
Background This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.
Gerritsen, Annette AM; Bramsen, Inge; Deville, Walter; van Willigen, Loes HM; Hovens, Johannes E; van der Ploeg, Henk M
Exposure assessment during and after acute chemical incidents and disasters is essential for healthstudies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure
Sim Bongers; Nicole A H Janssen; B Reiss; L Grievink; E Lebret; H Kromhout
Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…
Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana
Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…
Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief presents the results of the study in the area of physical activity, covering the following topics: (1) Health Education; (2) Physical…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports the results of the study in the area of alcohol- or other drug-use prevention, covering the following topics: (1) Health Education;…
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of sexually transmitted disease (STD) prevention, covering the following topics (1) Health Education; and…
The occupational healthstudy performed in Obilich, Kosova, Yugoslavia, evaluated the potential health impact of the operation of a commercial-scale coal gasification facility on the workers and on public health. The effect of exposures to various chemical agents in the working environment generated in the coal gasification process was studied in exposed and control worker populations. A detailed assessment of
M. T. Brandt; J. O. Jackson; C. R. Sutcliffe; O. Jr. White; E. T. Premuzic; S. C. Morris; M. A. Haxhiu; A. Abazi; M. Jockic; B. Jonuzi
BACKGROUND: Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. METHODS: The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional,
Kathleen M Griffiths; Helen Christensen; Anthony F Jorm
This qualitative study explored the motivations of vegetarians by means of online ethnographic research with participants in an international message board. The researcher participated in discussions on the board, gathered responses to questions from 33 participants, and conducted follow-up e-mail interviews with 18 of these participants. Respondents were predominantly from the US, Canada and the UK. Seventy per cent were females, and ages ranged from 14 to 53, with a median of 26 years. Data were analysed using a thematic approach. While this research found that health and the ethical treatment of animals were the main motivators for participants' vegetarianism, participants reported a range of commitments to environmental concerns, although in only one case was environmentalism a primary motivator for becoming a vegetarian. The data indicate that vegetarians may follow a trajectory, in which initial motivations are augmented over time by other reasons for sustaining or further restricting their diet. PMID:17980457
Objective Our objective is to re-evaluate cancer incidence among Agricultural HealthStudy participants. Methods Standardized incidence ratios (SIR) and Relative Standardized Ratios were calculated. Results A significant excess of prostate cancer was seen for private and commercial applicators, SIR = 1.19 (95% Confidence Interval (CI) 1.14, 1.25) and SIR = 1.28 (95% CI 1.00, 1.61), respectively. Excesses were observed for lip cancer, SIR = 1.97 (95% CI 1.02, 3.44), and multiple myeloma, SIR = 1.42 (95% CI 1.00, 1.95) among private applicators from North Carolina and for marginal zone lymphoma among Iowa spouses, SIR = 2.34 (95% CI 1.21, 4.09). Conclusions While lower rates of smoking and increased physical activity probably contribute to the lower overall cancer incidence, agricultural exposures including pesticides, viruses, bacteria, sunlight, and other chemicals may increase risks for specific cancer sites.
Koutros, Stella; Alavanja, Michael C.R.; Lubin, Jay H.; Sandler, Dale P.; Hoppin, Jane A.; Lynch, Charles F.; Knott, Charles; Blair, Aaron; Beane Freeman, Laura E.
The bibliography enumerates empirical studies of the interrelationships between health status and medical care utilization for the purpose of assisting health service researchers in identifying and reviewing pertinent literature. The entries are arranged ...
The participation of various individuals and institutions in the State financing, planning, and coordination of health manpower education is investigated. Health professions included in the study are medicine, osteopathy, podiatry, nursing, and allied hea...
Background Cancer survivors are at increased risk for second malignancies, cardiovascular disease, diabetes, and functional decline. Evidence suggests that a healthful diet and physical activity may reduce the risk of chronic disease and improve health in this population. Methods We conducted a feasibility study to evaluate a vegetable gardening intervention that paired 12 adult and child cancer survivors with Master Gardeners to explore effects on fruit and vegetable intake, physical activity, quality-of-life, and physical function. Throughout the year-long study period, the survivor-Master Gardener dyads worked together to plan/plant 3 gardens, harvest/rotate plantings, and troubleshoot/correct problems. Data on diet, physical activity, and quality-of-life were collected via surveys; anthropometrics and physical function were objectively measured. Acceptability of the intervention was assessed with a structured debriefing survey. Results The gardening intervention was feasible (robust enrollment; minimal attrition) and well-received by cancer survivors and Master Gardeners. Improvement in 3 of 4 objective measures of strength, agility, and endurance was observed in 90% of survivors, with the following change scores (median [interquartile range]) noted between baseline and 1-year follow-up: hand grip test (+4.8 [3.0, 6.7] kg), 8 foot Get-Up-and-Go (?1.0 [?1.8, ?0.2] seconds), 30-second chair stand (+3.0 [?1.0, 5.0] stands), and 6-minute walk (+38 [20, 160] feet). Increases of ?1 fruit and vegetable serving/ day and ?30 minutes/week of physical activity were observed in 40% and 60%, respectively. Conclusion These preliminary results support the feasibility and acceptability of a mentored gardening intervention and suggest that it may offer a novel and promising strategy to improve fruit and vegetable consumption, physical activity, and physical function in cancer survivors. A larger randomized controlled trial is needed to confirm our results.
Objective To evaluate the policy making process, implementation by NHS organisations, and patients’ and carers’ experiences of efforts to introduce an internet accessible personal electronic health record (HealthSpace) in a public sector healthcare system. Design Mixed method, multilevel case study. Setting English National Health Service; the basic HealthSpace technology (available throughout England) and the advanced version (available in a few localities where this option had been introduced) were considered. Main outcome measures National statistics on invitations sent, HealthSpace accounts created, and interviews and ethnographic observation of patients and carers. Data analysis was informed by a socio-technical approach which considered macro and micro influences on both adoption and non-adoption of innovations, and by the principles of critical discourse analysis. Participants 56 patients and carers (of whom 21 opened a basic HealthSpace account, 20 had diabetes but were not initially using HealthSpace, and 15 used advanced HealthSpace accounts to exchange messages with their general practitioner), 3000 pages of documents (policies, strategies, business plans, minutes of meetings, correspondence), observational field notes, and 160 interviews with policy makers, project managers, and clinical staff. Results Between 2007 and October 2010, 172?950 people opened a basic HealthSpace account. 2913 (0.13% of those invited) opened an advanced account, compared with 5-10% of the population anticipated in the original business case. Overall, patients perceived HealthSpace as neither useful nor easy to use and its functionality aligned poorly with their expectations and self management practices. Those who used email-style messaging were positive about its benefits, but enthusiasm beyond three early adopter clinicians was low, and fewer than 100 of 30?000 patients expressed interest. Policy makers’ hopes that “deploying” HealthSpace would lead to empowered patients, personalised care, lower NHS costs, better data quality, and improved health literacy were not realised over the three year evaluation period. Conclusion Unless personal electronic health records align closely with people’s attitudes, self management practices, identified information needs, and the wider care package (including organisational routines and incentive structures for clinicians), the risk that they will be abandoned or not adopted at all is substantial. Conceptualising such records dynamically (as components of a socio-technical network) rather than statically (as containers for data) and employing user centred design techniques might improve their chances of adoption and use. The findings raise questions about how eHealth programmes in England are developed and approved at policy level.
Community health information networks (CHINs) have emerged as a promising new technology to generate cost reductions and support change in the health care industry. The proliferation of CHINs has been thwarted, however, by a conspicuous lack of evidence to support the claims of enhanced efficiency and effectiveness from CHIN participation. A recent study of the Wisconsin Health Information Network, the nation's first fully functioning CHIN, documents the benefits of this emerging technology. The findings reveal the potential for significant cost savings via electronic transmission of patient clinical and administrative information as well as enhancement of the quality of patient care. PMID:10174731
Lassila, K S; Pemble, K R; DuPont, L A; Cheng, R H
Background: Inequality in households’ and individuals' consumption expenditures is one of the most important aspects of health status difference among households and individuals. Objectives: We investigated the impact of some macro-economic factors specially inequality factors on the Iranian rural health status since 1986 through 2012. Patients and Methods: We conducted a longitudinal ecological and analytical study. The average sample size was 14602 households whom Iranian Statistics Center selected by a multi-stages clustering sampling approach. All required data has been collected from Iranian Statistics Centre and Deputy for Curial Affaires of Iranian Ministry of Health. We calculated the Gini coefficients for the rural food and health expenditures, then conducted a transloge autoregressive order one (AR1) to investigate the association between the Iranian rural households' key mortality rates and the food and health expenditure Gini coefficients, time trend, GDP per capita (PPP), and GDP per capita Gini coefficients. Results: The mean of Gini coefficients were 0.137 and 0.21 for the rural food expenditures inequality based on current and constant price, respectively. In addition, the mean of Gini coefficients were 0.26 and 0.31 for the rural health expenditures inequality based on current and constant price, respectively. The time trend, transloged form of Gini coefficients for health expenditures and GDP per capita Gini coefficients presented a significant negative correlation with transloged form of neonatal mortality rate. With regard to the transloged form of under five mortality we observed a significant negative correlation with time trend and transloged form of Gini coefficients for health expenditure and GDP per capita. Finally, there was a significant negative correlation between transloged forms of maternal mortality rate. Conclusions: Iranian policy makers should consider the rural health and food expenditures inequality and try to adopt more effective policies and plans to decrease it. In addition, they should improve the macro-economic factors to improve the rural households' health status.
Background Health promotion is critical for community and family health. Health-promoting behaviours provide solutions for maintaining and promoting health. Although several studies have addressed the frequency and different types of health-promoting behaviours in women, little information is available about their experiences. This study aimed to explore the experiences of women of reproductive age regarding health-promoting behaviours. Methods In the present study, which was conducted in Tehran, Iran, 15 females, who were selected purposefully, participated in individual in-depth, semi-structured interviews. The interviews were recorded, transcribed verbatim, and analysed using conventional content analysis. Results Nine main categories were derived from the analysis, including establishing an appropriate eating pattern, establishing a balanced rest/activity pattern, spirituality, stress management, personal sensitivity and responsibility, establishing an appropriate pattern of social interactions, practicing safe and healthy recreations, feeling improvement in physical-functional health, and feeling improvement in emotional and psychological health. The first 7 categories represent the nature and types of real health-promoting behaviours in women of reproductive age, whereas the last 2 constitute feeling and understanding of the implementation of these behaviours. Conclusion The study findings show that the women experience improvement in physical-functional, emotional, and psychological health by implementing health-promoting behaviours. It is therefore necessary to introduce strategies in the context of the community culture for improving different aspects of health-promoting behaviours in women of reproductive age to maintain and improve their overall health.
Introduction Following twenty years of economic and social growth, Liberia's fourteen-year civil war destroyed its health system, with\\u000a most of the health workforce leaving the country. Following the inauguration of the Sirleaf administration in 2006, the Ministry\\u000a of Health & Social Welfare (MOHSW) has focused on rebuilding, with an emphasis on increasing the size and capacity of its\\u000a human resources for
This report examines the experiences of five provider organizations in developing, testing, and implementing quality-of-care indicators, based on data collected from their electronic health record (EHR) systems. HealthPartners used the EHR to compile blood pressure measurements, Park Nicollet Health Services developed a composite measure for care of people with diabetes, Billings Clinic tested an automatic alert on potential interactions between
Jinnet Briggs Fowles; Elizabeth A. Kind; Shadi Awwad; Jonathan P. Weiner; Kitty S. Chan
Objectives: To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren. Design: Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland. Subjects: A total of 8424 schoolchildren (aged 10-17 years)
Michal Molcho; Saoirse Nic Gabhainn; Colette Kelly; Sharon Friel; Cecily Kelleher
Background While decentralized and integrated primary mental healthcare forms the core of mental health policies in many low- and middle-income\\u000a countries (LMICs), implementation remains a challenge. The aim of this study was to understand how the use of a common implementation\\u000a framework could assist in the integration of mental health into primary healthcare in Ugandan and South African district demonstration\\u000a sites.
Inge Petersen; Joshua Ssebunnya; Arvin Bhana; Kim Baillie
The major hypothesis of this study was that graduate level course work about internationl health matters carried out in an international setting would reduce hostility and increase cooperativeness in attitudes toward international relations. An eight week program of this type was executed and a comparison of pre- and post-program measurements of these attitudes confirmed the hypotheses. However, it was noted even though statistically significant shifts occured, there were many students who reported negative changes or no change at all. It was also found there were moderately strong correlations between hostility and cooperation. The implications of these findings are that programs of this nature can have a positive impact on attitudes such as these, but that there may be mediating variables tied closely to participant receptiveness to the message of the program; variables which might be important to consider in selection and screening. However, if this were true, it might also be true that those individuals capable of greatest gains may be in least need of such a program and vice versa. PMID:1050531
This report, written for the general public, presents the results of a 15-month study of the health-related effects of marijuana. The introduction describes the goals and procedure for the study, including the composition of the 22-member steering committee and its functions, and the sources of information used for the study, i.e., published…
The research projects reported in this booklet were funded by DHEW to improve the operation, functioning, and effectiveness of health services for mothers and children and for crippled children. Ten projects are summarized. They address the ambulatory car...
Human beings are living between 70 and 90% inside of premises, where numerous air pollutants are existing: some of them have outdoor sources (industry, domestic burning, car traffic), some are produced indoors by human activities and equipment, by animals, or by various materials, products and furniture. According to their nature, they are listed as biological, physical or chemical pollutants. About health, serious poisonings and acute effects attributed to indoor air pollutants, and even short term effects (like sick building syndrome, infectious illness, pneumopathies,...), can be relatively easy to distinguish. Inversely the involvement of these pollutants in long term effects (like chronic bronchitis, asthma, cancers,...) is more difficult to establish. During the last 15 years we carried out several studies, which allowed us to separate the chemical air contaminants into two categories: those produced outdoors (sulphur dioxide, lead, chromium, nickel, nitrates), of whom we calculated the penetration coefficients, and those from both origin, outside and inside (nitrogen oxides, carbon monoxide, ammonia, aldehydes, particles, cadmium, vanadium, sulphates, ammonium salts). Aldehydes, which present important health risks, were especially investigated: in an office where several cigarettes were burning the measured concentrations were high in comparison with the threshold values existing in some foreign countries; in a cafeteria they were relatively low. To estimate the impregnation of non smokers by environmental tobacco smoke, we also determined, during same spaces of time, on the one hand nicotine in air, on the other hand nicotine and its metabolites excreted in the urine of exposed people. We thus observed that, in "real" situations, this impregnation is as a general rule extremely low. PMID:8038995
Background Although the social situation for gay, lesbian, and bisexual people has improved over the last decades, lesbian women still face unique challenges when seeking healthcare services. Objectives To explore lesbian women's healthcare experiences specifically related to sexual orientation to achieve knowledge which can contribute to increased quality of healthcare for lesbian women. Methods Qualitative study based on written stories, with recruitment, information, and data sampling over the internet. Data consisted of 128 anonymously written answers to a web-based, open-ended questionnaire from a convenience sample of self-identified lesbian women. Data were analysed with systematic text condensation. Interpretation of findings was supported by theories of heteronormativity. Main outcome measures Patients’ histories of experiences where a lesbian orientation was significant, when seeing a doctor or another healthcare professional. Results Analysis presented three different aspects of healthcare professionals’ abilities, regarded as essential by our lesbian participants. First, the perspective of awareness was addressed – is the healthcare professional able to think of and facilitate the disclosure of a lesbian orientation? Second, histories pointed to the attitudes towards homosexuality – does the healthcare professional acknowledge and respect the lesbian orientation? Third, the impact of specific and adequate medical knowledge was emphasized – does the healthcare professional know enough about the specific health concerns of lesbian women? Conclusion To obtain quality care for lesbian women, the healthcare professional needs a persistent awareness that not all patients are heterosexual, an open attitude towards a lesbian orientation, and specific knowledge of lesbian health issues. The dimensions of awareness, attitude, and knowledge are interconnected, and a positive direction on all three dimensions appears to be a necessary prerequisite.
The Adelaide rift complex in South Australia contains the type sections for Sturtian and Marinoan glacial deposits. The litho- and chemo-stratigraphy of these deposits play a central role in evaluating global Neoproterozoic ice age hypotheses and Rodinia supercontinent reconstructions, but reliable depositional age constraints have been extremely limited. We report results of in situ Th-U-total Pb (electron microprobe) dating of detrital and authigenic monazite in two samples from the Umberatana Group (Sturtian Holowilena Ironstone and pre-Marinoan Enorama Shale) in the Central Flinders Ranges. Several texturally and chemically distinct detrital and authigenic populations are recognized. Detrital dates range from 1600 Ma to 760 Ma and most relate to well-known orogenic or igneous events in surrounding cratonic regions. Authigenic monazite grew in three or more pulses ranging from 680 Ma to 500 Ma. The date of 680 ± 23 Ma (2 ?) for the earliest generation of authigenic monazite in sandstone from the Enorama Shale (1) provides an estimate for the age of the base of the Trezona carbon isotopic anomaly just beneath the Marinoan glacial deposits, (2) provides an absolute minimum age constraint on the underlying Sturtian glacial deposits, and (3) supports proposed correlations between type Marinoan deposits and precisely dated glacial deposits in Namibia and China, which bracket the presumed Marinoan equivalents between 655 and 635 Ma. This age is inconsistent with a Re-Os isochron age of 643 ± 2.4 Ma (2 ?) on shales near the bottom of the Sturtian-Marinoan interglacial succession, stratigraphically > 3000 m below the Enorama Shale sample, and militate against the hypothesis that the type Marinoan is correlative with the 580 Ma Gaskiers glaciation. Monazite growth near 600 Ma and again at about 500 Ma probably represent hydrothermal fluid-flow events, the latter of which also corresponds to the well-known Delamerian Orogeny during which the Adelaide sediments were folded into their present structural pattern.
Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular HealthStudy who were recruited from 4 US communities and studied from 1992 to 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFRcys). Cognitive function was assessed using the Modified Mini-Mental State Examination and the Digit Symbol Substitution Test, which were administered up to 7 times during annual visits. There was an association between eGFRcys and change in cognitive function after adjustment for confounders; persons with an eGFRcys of less than 60 mL/minute/1.73 m(2) had a 0.64 (95% confidence interval: 0.51, 0.77) points/year faster decline in Modified Mini-Mental State Examination score and a 0.42 (95% confidence interval: 0.28, 0.56) points/year faster decline in Digit Symbol Substitution Test score compared with persons with an eGFRcys of 90 or more mL/minute/1.73 m(2). Additional adjustment for intermediate cardiovascular events modestly affected these associations. Participants with an eGFRcys of less than 60 mL/minute/1.73 m(2) had fewer cognitive impairment-free life-years on average compared with those with eGFRcys of 90 or more mL/minute/1.73 m(2), independent of confounders and mediating cardiovascular events (mean difference = -0.44, 95% confidence interval: -0.62, -0.26). Older adults with lower kidney function are at higher risk of worsening cognitive function. PMID:24844846
Darsie, Brendan; Shlipak, Michael G; Sarnak, Mark J; Katz, Ronit; Fitzpatrick, Annette L; Odden, Michelle C
The National Center for Health Services Research and Health Care Technology Assessment conducted a study to examine how Americans use health care services and to determine national patterns of health expenditures and insurance coverage. Data were obtained from the National Medical Care Expenditure Survey interviews conducted with 14,000 randomly…
Background: The GLOBE study is a prospective cohort study specifically aimed at the explanation of socio-economic inequalities in health in the Netherlands. The returns of the study are reviewed after ten years of follow-up, and the studies' contribution to the development of policy measures to reduce inequalities in health in the Netherlands are described. Methods: The study started in 1991
FRANK J. VAN LENTHE; CAROLA T. M. SCHRIJVERS; MARIEL DROOMERS; INEZ M. A. JOUNG; MARIEKE J. LOUWMAN; JOHAN P. MACKENBACH
A survey of health facilities and services in LaPorte County, Indiana is presented by the Northwest Indiana Comprehensive Health Planning Council. LaPorte County contains a mixture of rural and urban populations, a large portion of which relies on industr...
Grassroots Educare Trust is a training and service organization for community-controlled educare centers. Sharon Hostetler, a volunteer community health worker/trainer, helped launch a 6-day health program for educare workers in South Africa. In post-aparthied South Africa, the preschool field has been identified as an important target group for…
Researchers at University of California, San Diego School of Medicine report that people living with depression, anxiety or other mental health conditions are twice as likely to have tried e-cigarettes and three times as likely to be current users of the controversial battery-powered nicotine-delivery devices, as people without mental health disorders.
The Health Assessment and Teaching Performance Examination (HATPE), a criterion-referenced examination, requires the application of theory and competence in the performance of health assessment and teaching. The HATPE incorporates the theory related to history taking, physical examination and organization of a summary of data as well as the…
New York State Education Dept., Albany. Cultural Education Center.
Background: People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both…
Background There is broad consensus on the value of integration of HIV services and reproductive health services in regions of the world with generalised HIV/AIDS epidemics and high reproductive morbidity. Integration is thought to increase access to and uptake of health services; and improves their efficiency and cost-effectiveness through better use of available resources. However, there is still very limited empirical literature on health service providers and how they experience and operationalize integration. This qualitative study was conducted among frontline health workers to explore provider experiences with integration in order to ascertain their significance to the performance of integrated health facilities. Methods Semi-structured in-depth interviews were conducted with 32 frontline clinical officers, registered nurses, and enrolled nurses in Kitui district (Eastern province) and Thika and Nyeri districts (Central province) in Kenya. The study was conducted in health facilities providing integrated HIV and reproductive health services (post-natal care and family planning). All interviews were conducted in English, transcribed and analysed using Nvivo 8 qualitative data analysis software. Results Providers reported delivering services in provider-level and unit-level integration, as well as a combination of both. Provider experiences of actual integration were mixed. At personal level, providers valued skills enhancement, more variety and challenge in their work, better job satisfaction through increased client-satisfaction. However, they also felt that their salaries were poor, they faced increased occupational stress from: increased workload, treating very sick/poor clients, and less quality time with clients. At operational level, providers reported increased service uptake, increased willingness among clients to take an HIV test, and reduced loss of clients. But the majority also reported infrastructural and logistic deficiencies (insufficient physical room space, equipment, drugs and other medical supplies), as well as increased workload, waiting times, contact session times and low staffing levels. Conclusions The success of integration primarily depends on the performance of service providers which, in turn, depends on a whole range of facilitative organisational factors. The central Ministry of Health should create a coherent policy environment, spearhead strategic planning and ensure availability of resources for implementation at lower levels of the health system. Health facility staffing norms, technical support, cost-sharing policies, clinical reporting procedures, salary and incentive schemes, clinical supply chains, and resourcing of health facility physical space upgrades, all need attention. Yet, despite these system challenges, this study has shown that integration can have a positive motivating effect on staff and can lead to better sharing of workload - these are important opportunities that deserve to be built on.
The Health and Ecological Effects Subcommittee (HEES) of the Advisory Council on Clean Air Compliance Analysis (Council), of the Science Advisory Board, has reviewed precursors to the first Prospective Study: Report to Congress. The HEES concludes that the approach to the health/ecological effects assessment lacks a framework for ecological evaluations. The Agency should develop a comprehensive methodology for valuing natural resources and ecological services, incorporating contemporary ecological thinking and findings. The HEES encourages the Agency to explore valuations at the watershed level or large (or other scales of concern) to avoid double-counting of pollutant effects and interactions among pollutants.
Objectives The objective of this study was to characterize patterns of formal health service utilization costs during older adults’ transition from community to institutional care. Methods Participants were 127 adults (age ? 65) from the British Columbia sample (N = 2,057) of the Canadian Study of Health and Aging who transitioned from community to institutional care between 1991 and 2001. Health service utilization costs were measured using Cost-Per-Day-At-Risk at five time points: > 12 months, 6–12 months, and ? 6 months preinstitutionalization, and ? 6 months and 6–12 months postinstitutionalization. Cost-Per-Day-At-Risk was measured for Continuing Care, Medical Services Plan, and PharmaCare costs by calculating total health service use over time, divided by the number of days the participant was alive. Results Significant differences in Cost-Per-Day-At-Risk were observed for Continuing Care, Medical Services Plan, and PharmaCare costs over time. All health service utilization costs increased significantly during the 6–12 months and ? 6 months prior to institutionalization. Postinstitutionalization Continuing Care costs continued to increase at ? 6 months before decreasing at 6–12 months, while decreases occurred for Medical Services Plan and PharmaCare costs relative to preinstitutionalization costs. Conclusions The increases in costs observed during the year prior to institutionalization, characterized by a flurry of health service utilization, provide evidence of distinct cost patterns over the transition period.
Naslund, John A.; Sauter, Agnes H.; Gutman, Gloria; Beattie, B. Lynn
The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps. Since 1991, a comprehensive primary health care programme in the remote Sayaboury Province of Lao PDR has focused on strengthening district health management, improving access to health facilities and responding to the most common causes of mortality and morbidity among women and children. Between 1996 and 2003, health-facility utilization tripled, and the proportion of households that have access to a facility increased to 92% compared with only 61% nationally. By 2003, infant and child mortality rates were less than one-third of the national rates. The maternal mortality ratio decreased by 50% despite comprehensive emergency obstetric care not being available in most district hospitals. These trends were achieved with an investment of approximately 4 million US dollars over 12 years (equivalent to US 1.00 US dollars per person per year). However, this project did not overcome weaknesses in some national disease-control programmes, especially the expanded programme on immunization, that require strong central management. In Lao PDR, which is not yet committed to using SWAps, tools developed in Sayaboury could help other district health offices assume greater planning responsibilities in the recently decentralized system. Development partners should balance their support for centrally managed disease-specific programmes with assistance to horizontally integrated primary health care at the district level.
Perks, Carol; Toole, Michael J.; Phouthonsy, Khamla
This paper discusses ongoing work to develop structural health monitoring techniques for composite aerospace structures such as aircraft control surfaces, fuselage sections or repairs, and reusable launch vehicle fuel tanks. The overall project is divided into four tasks: Operational evaluation, diagnostic measurements, information condensation, and damage detection. Five composite plates were constructed to study delaminations, disbonds, and fluid retention issues as the initial step in creating an operational system. These four square feet plates were graphite-epoxy with nomex honeycomb cores. The diagnostic measurements are composed of modal tests with a scanning laser vibrometer at over 500 scan points per plate covering the frequency range up to 2000 Hz. This data has been reduced into experimental dynamics matrices using a generic, software package developed at the University of Colorado at Boulder. The continuing effort will entail performing a series of damage identification studies to detect, localize, and determine the extent of the damage. This work is providing understanding and algorithm development for a global NDE technique for composite aerospace structures.
James, G.; Roach, D.; Hansche, B.; Meza, R.; Robinson, N.
This study assembles a geographic information system (GIS) to relate the 2000 census population (demand) with an inventory of health facilities (supply). It assesses the equity in access to health care by Costa Ricans and the impact on it by the ongoing reform of the health sector. It uses traditional measurements of access based on the distance to the closest
Hudson Valley Migrant Health (HVMH) (a Public Health Service program) collaborated with the Center for Disease Control (CDC) and the New York State Department of Health (NYSDOH) on a study of the incidence of sexually transmitted diseases and tuberculosis among migrant farmworkers in the mid-Hudson region of New York. CDC research personnel…
Objective: This study investigated how young urban students conceptualize health and fitness and tried to identify their sources of information about health-related issues. The findings are intended to help make suggestions for policy makers to design and develop effective health-education strategies. Methods: Focus group discussions (FGDs) of 20…
Wang, Shu Mei; Zou, Jin Liang; Gifford, Mervyn; Dalal, Koustuv
This study analyses health damages from particulate pollution and the corresponding social costs. The analyses, which are based on transferring dose–response functions to Norway, is made within an integrated approach, where the economic impacts of the health damages are handled separately from the non-economic welfare effects. We find that the social costs of health damages in Oslo are significant, and
This preliminary study investigates the current situation of school library support of K-12 health education in China. A survey of 42 school librarians and 115 K-12 teachers from selected schools was conducted to find out their views about school library's role in school health education and their current practice of library use in health…
BACKGROUND: It is important to obtain greater insight into health-related quality of life (HRQL) of injury patients in order to document people's pathways to recovery and to quantify the impact of injury on population health over time. We performed a systematic review of studies measuring HRQL in general injury populations with a generic health state measure to summarize existing knowledge.
Suzanne Polinder; Juanita A Haagsma; Eefje Belt; Ronan A Lyons; Vicki Erasmus; Johan Lund; Ed F van Beeck
Researchers conducted a two-wave panel study to test the hypothesis of the normal and reversed causal relationships of job characteristics, burnout, and psychological health. The hypotheses are as follows: job characteristics lead to burnout and psychological health over time; and vice versa, burnout and psychological health were expected to result in perceived job stress over time. Nearly 513 participants were
Yu-Hwa Huang; Chin-Hui Chen; Pey-Lan Du; Ing-Chung Huang
Researchers conducted a two-wave panel study to test the hypothesis of the normal and reversed causal relationships of job characteristics, burnout, and psychological health. The hypotheses are as follows: job characteristics lead to burnout and psychological health over time; and vice versa, burnout and psychological health were expected to result in perceived job stress over time. Nearly 513 participants were
Yu-Hwa Huang; Chin-Hui Chen; Pey-Lan Du; Ing-Chung Huang
To evaluate the idea of a multifunctional mobile pen computer to support information processing tasks of health care professionals we carried out a field study. On a tablet-sized mobile pen computer we set up a health professional workstation, MEDIAS\\/WIN, with most of the application systems that are presently used by health professionals at Heidelberg University Medical Center. Our experiences during
The Pennsylvania Department of Health conducted a health survey of a group of residents in the Lock Haven area who live in the immediate vicinity of the Drake Superfund site. A control group of residents were selected randomly from the remaining areas of Lock Haven. The study did not indicate the presence of any serious chronic health conditions in the
BACKGROUND: Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing
The bibliography is part of an extensive study of the barriers to women's success in the schools and practice of eight health professions. It divides resources into 14 segments: one covers the health professions in general; one treats women and careers in general; one is devoted to each of eight health professions (medicine, osteopathic medicine,…
Urban and Rural Systems Associates, San Francisco, CA.
As governments seek to expand access to quality health care services, policy makers in many countries are confronting the problem of informal payments to medical personnel. The aim of this study was to help health planners in Albania understand informal payments occurring in government health facilities. Researchers used in-depth interviews and focus groups with 131 general public and provider informants
Taryn Vian; Kristina Grybosk; Zamira Sinoimeri; Rachel Hall
Low health literacy is associated with poor health outcomes. Research is needed to understand the mechanisms and pathways of its effects. Computer-based assessment tools may improve efficiency and cost-effectiveness of health literacy research. The objective of this preliminary study was to assess if administration of the Short Test of Functional…
Summary The relationship between health complaints and flexible work schedules was studied in a patient population selected by general practitioners. Four hundred and eighty patients between 20 and 60 years, currently employed or on sick leave, completed questionnaires which compiled data on their work situation, subjective physical health, psychological well-being, and quality of sleep. Subjective health measurements were performed by
M. F. J. MARTENS; F. J. N. NIJHUIS; M. P. J. VAN BOXTEL
The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each
Javier Mignone; Judith Bartlett; John O'Neil; Treena Orchard
Background Population aging leads to increased burden of chronic diseases and demand in public health. This study aimed to assess whether the score of Primary Health Care (PHC) is associated with a) the model of care - Family Health Strategy (FHS) vs. traditional care model (the Basic Health Units; BHU); b) morbid conditions such as - hypertension, diabetes mellitus, mental disorders, chronic pain, obesity and central obesity; c) quality of life in elderly individuals who received care in those units. Methods A survey was conducted among the elderly between August 2010 and August 2011, in Ilheus, Bahia. We interviewed elderly patients - 60 years or older - who consulted at BHU or FHS units in that day or participated in a group activity, and those who were visited at home by the staff of PHC, selected through a random sample. Demographic and socioeconomic characteristics, services’ attainment of primary care attributes, health problems and quality of life were investigated. The Short Form Health Survey (SF-12) was used to assess quality of life and PCATool to generate PHC scores. In addition, weight, height and waist circumference were measured. Trained research assistants, under supervision performed the data collection. Results A total of 511 elderly individuals were identified, two declined to participate, resulting in 509 individuals interviewed. The health care provided by the FHS has higher attainment of PHC attributes, in comparison to the BHU, resulting in lower prevalence of score below six. Except for hypertension and cardiovascular disease, other chronic problems were not independently associated with low scores in PHC. It was observed an independent and positive association between PHC score and the mental component of quality of life and an inverse association with the physical component. Conclusions This study showed higher PHC attributes attainment in units with FHS, regardless of the health problem. The degree of orientation to PHC increased the mental component score of quality of life.
The grant provides for continued follow-up for and research on the Health Professionals Follow-up Study (HPFS) of 51,529 men who completed an extensive dietary questionnaire first in 1986 and again in 1990, 1994,1998, 2002, 2006, and 2010. The program project grant also supports the food composition database and nutrient analysis system used by the Nurses' HealthStudy, Nurses' HealthStudy II, and many other studies.
Advanced maternal age is associated with negative offspring health outcomes. This interpretation often relies on physiological processes related to aging, such as decreasing oocyte quality. We use a large, population-based sample of American adults to analyze how selection and lifespan overlap between generations influence the maternal age–offspring adult health association. We find that offspring born to mothers younger than age 25 or older than 35 have worse outcomes with respect to mortality, self-rated health, height, obesity, and the number of diagnosed conditions than those born to mothers aged 25–34. Controls for maternal education and age at which the child lost the mother eliminate the effect for advanced maternal age up to age 45. The association between young maternal age and negative offspring outcomes is robust to these controls. Our findings suggest that the advanced maternal age–offspring adult health association reflects selection and factors related to lifespan overlap. These may include shared frailty or parental investment but are not directly related to the physiological health of the mother during conception, fetal development, or birth. The results for young maternal age add to the evidence suggesting that children born to young mothers might be better off if the parents waited a few years.
Advanced maternal age is associated with negative offspring health outcomes. This interpretation often relies on physiological processes related to aging, such as decreasing oocyte quality. We use a large, population-based sample of American adults to analyze how selection and lifespan overlap between generations influence the maternal age-offspring adult health association. We find that offspring born to mothers younger than age 25 or older than 35 have worse outcomes with respect to mortality, self-rated health, height, obesity, and the number of diagnosed conditions than those born to mothers aged 25-34. Controls for maternal education and age at which the child lost the mother eliminate the effect for advanced maternal age up to age 45. The association between young maternal age and negative offspring outcomes is robust to these controls. Our findings suggest that the advanced maternal age-offspring adult health association reflects selection and factors related to lifespan overlap. These may include shared frailty or parental investment but are not directly related to the physiological health of the mother during conception, fetal development, or birth. The results for young maternal age add to the evidence suggesting that children born to young mothers might be better off if the parents waited a few years. PMID:22926440
St Claire L, Watkins CJ and Billinghurst B. Differences in meaning of health: an exploratory study of general practitioners and their patients. Family Practice 1996; 13: 511-516. Objectives. Many health-related behaviours, particularly non-compliance with medical ad- vice, seem irrational to professionals . 'Health' is a planned goal of health care but the ex- tent to which doctors and patients agree
Lindsay St Claire; Christopher J Watkins; Brenda Billinghurst
Purpose: This study seeks to measure the public knowledge, attitudes, and practices related to eye health and disease in New Zealand (NZ). Design/methodology/approach: A 22-item survey of 507 adults in NZ was conducted. The survey was developed using interviews and focus groups, as well as comparisons with other benchmark international studies.…
Ahn, Mark J.; Frederikson, Lesley; Borman, Barry; Bednarek, Rebecca
This paper was prepared for the Employment Conditions and Health Inequalities Knowledge Network (EMCONET), part of the WHO Commission on the Social Determinants of Health. We describe the Brazilian context of employment conditions, labor conditions and health, their characteristics and causal relationships. The social, political and economic factors that influence these relationships are also presented with an emphasis on social inequalities, and how they are reproduced within the labor market and thereby affect the health and wellbeing of workers. A literature review was conducted in SciELO, LILACS, Google and Google Scholar, MEDLINE and the CAPES Brazilian thesis database. We observed that there are more workers operating in the informal sector than in the formal sector and these former have no social insurance or any other social benefits. Work conditions and health are poor in both informal and formal enterprises since health and safety labor norms are not effective. The involvement of social movements and labor unions in the elaboration and management of workers' health polices and programs with universal coverage, is a promising initiative that is underway nationwide. PMID:22218587
Dias, Elizabeth Costa; Oliveira, Roberval Passos de; Machado, Jorge H; Minayo-Gomez, Carlos; Perez, Marco Antonio Gomes; Hoefel, Maria da Graça L; Santana, Vilma Sousa
Background In many countries, there has been substantial progress in establishing the electronic transmission of patients’ health information between health care providers, but little is known about how best to engage patients in the process. Objective We explored patients’ views about sharing of electronic health information and their preferences for learning about and participating in this process. Methods Patients in one Massachusetts community in the northeastern United States were recruited to participate in focus-group discussions. Prior to discussion, participants completed a written questionnaire that captured their reactions to draft educational materials and a consent form. The discussion moderator and two physicians analyzed the moderator’s detailed notes from each session and participants’ written comments, using an immersion-crystallization approach. Results Three dominant themes emerged: (1) concerns about privacy and security, (2) the potential benefit to a person’s health, and (3) the desire for more information about the consent process. On the pre-discussion questionnaire, 55 out of 62 participants (88%) indicated that they would provide consent for their information to be shared electronically among their health care providers, given the materials they had reviewed. Conclusions Patients are enthusiastic about electronic health information exchange, recognizing its capacity to improve the quality and safety of health care; however, they are also concerned about its potential to result in breached privacy and misuse of health data. As the exchange of electronic health information becomes more widespread, policy makers will need to ensure that patients have access to concise educational materials and opportunities to engage in conversations about the risks and benefits of participation.
Evans, J Stewart; Benjamin, Alison; Delano, David; Bates, David W
Health Effects of Arsenic Longitudinal Study (HEALS), a multidisciplinary and large prospective cohort study in Araihazar, Bangladesh, was established to evaluate the effects of full-dose range arsenic (As) exposure on various health outcomes, including premalignant and malignant skin tumors, total mortality, pregnancy outcomes, and children's cognitive development. In this paper, we provide descriptions of the study methods including study design,
Habibul Ahsan; Yu Chen; Faruque Parvez; Maria Argos; Azm Iftikhar Hussain; Hassina Momotaj; Diane Levy; Alexander van Geen; Geoffrey Howe; Joseph Graziano
This article examines retirement outcomes in the first four waves of the 1992-1998 Health and Retirement Study (HRS). Measured retirement is seen to differ, sometimes substantially, with the definition of retirement used and among various groups analyzed. Moreover, those differences vary with the wave of the survey as respondents age. Retirement comprises a complex set of flows among states representing nonretirement, partial retirement, and complete retirement. Using the self-reported definition of retirement, 77 percent of transitions continue in the same or equivalent states between adjoining waves of the HRS, 17 percent involve a move from greater to lesser labor force participation, and 6 percent involve a move from lesser to greater labor force participation. Twenty-two percent of the sample report they were partially retired at some time in the first four waves, and by age 65, over a fifth of the population is partially retired. Altogether, 17 percent of the sample experienced a reversal in the course of the survey, moving from a state of less work to a state of more work. A comparison of retirement flows for men between the HRS and the 1969-1979 Retirement History Study (RHS) shows that the large spike in the population leaving nonretirement at age 65 observed in the 1969-1979 RHS has fallen from 18 to 11 percentage points in the HRS and that the share leaving nonretirement at 62 has increased from 13 to 20 percentage points over time. The results presented here should help researchers improve their understanding of the structure of the dependent variable in retirement studies. Incorrect or arbitrary measurement of the retirement variable may lead to a misunderstanding of how Social Security and related policies affect retirement outcomes. Thus, the improved understanding of retirement gained from this research will be helpful to those designing retirement policies as they attempt to understand the effects of those policies. PMID:11641989
Health supplement consumption behavior is important to maintain health status. The purpose of the study was to explore the spending pattern on health supplement consumption behavior in Hong Kong older adults population. The present study was a cross-sectional survey study; and was collected from via a street-intercept interview. Participants were approached and invited to response to a questionnaire. The location for data collection was evenly distributed in Hong Kong, Kowloon, and New Territories. The questionnaire included demographic data and source of income source, spending habits on health supplement products, and whether they performed regular health check. There were 982 participants interviewed; and 46% was male and 54% was female. The participants are divided into young-old (age 50-69) and old-old group (age 70 or above). The mean age is 67.93?±?10.386. Most of the participants have regular body check; the major reason is to maintain health. Less than half of the participants spent money on health supplement products; the major reason for such purchase was to maintain health; while for not buying is, they did not think that would have any effect in their health. Also, more young-old participants have regular body check and spend more money on health supplement products; while old-old group participants were less likely to concern their health, and they were less likely to perform regular body check and purchase health supplement products. The present research reveals the pattern of the health supplement consumption behavior of young-old and old-old. Young-old group and old-old group have difference pattern according to their difference age-related health condition and the amount of spare money. Different educational program concern health consciousness and promotion strategy of regular body check and health supplement products need be tailor-made for older adults, and for young-old and old-old groups. PMID:24575397
Tse, Mimi; Chan, Ka Long; Wong, Anthony; Tam, Eric; Fan, Elaine; Yip, Gloria
... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...
The main purpose of this study is to discuss and explore the safety and health management in semiconductor industry. The researcher practically investigates and interviews the input, process and output of the safety and health management of semiconductor industry by using the questionnaires and the interview method which is developed according to the framework of the OHSAS 18001. The result shows that there are six important factors for the safety and health management in Taiwan semiconductor industry. 1. The company should make employee clearly understand the safety and health laws and standards. 2. The company should make the safety and health management policy known to the public. 3. The company should put emphasis on the pursuance of the safety and health management laws. 4. The company should prevent the accidents. 5. The safety and health message should be communicated sufficiently. 6. The company should consider safety and health norm completely. PMID:19088409
Objective To examine the association between physical activity and risk of ulcerative colitis and Crohn’s disease. Design Prospective cohort study. Setting Nurses’ HealthStudy and Nurses’ HealthStudy II. Participants 194?711 women enrolled in the Nurses’ HealthStudy and Nurses’ HealthStudy II who provided data on physical activity and other risk factors every two to four years since 1984 in the Nurses’ HealthStudy and 1989 in the Nurses’ HealthStudy II and followed up through 2010. Main outcome measure Incident ulcerative colitis and Crohn’s disease. Results During 3?421?972 person years of follow-up, we documented 284 cases of Crohn’s disease and 363 cases of ulcerative colitis. The risk of Crohn’s disease was inversely associated with physical activity (P for trend 0.02). Compared with women in the lowest fifth of physical activity, the multivariate adjusted hazard ratio of Crohn’s disease among women in the highest fifth of physical activity was 0.64 (95% confidence interval 0.44 to 0.94). Active women with at least 27 metabolic equivalent task (MET) hours per week of physical activity had a 44% reduction (hazard ratio 0.56, 95% confidence interval 0.37 to 0.84) in risk of developing Crohn’s disease compared with sedentary women with <3 MET h/wk. Physical activity was not associated with risk of ulcerative colitis (P for trend 0.46). The absolute risk of ulcerative colitis and Crohn’s disease among women in the highest fifth of physical activity was 8 and 6 events per 100?000 person years compared with 11 and 16 events per 100?000 person years among women in the lowest fifth of physical activity, respectively. Age, smoking, body mass index, and cohort did not significantly modify the association between physical activity and risk of ulcerative colitis or Crohn’s disease (all P for interaction >0.35). Conclusion In two large prospective cohorts of US women, physical activity was inversely associated with risk of Crohn’s disease but not of ulcerative colitis.
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people.\\u000a In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption\\u000a of personal health management services is one way to maintain current levels of personal health and to efficiently manage\\u000a the distribution of healthcare resources.
The most important health effects from future climate change are projected to include: increases in summer heat related mortality (deaths) and morbidity (illness); decreases in winter cold related mortality and morbidity; changes in the disease burden e.g. from vector-, water- or food-borne disease; increases in the risk of accidents and wider well being from extreme events (storms and floods). The
Paul Watkiss; Lisa Horrocks; Stephen Pye; Alison Searl; Alistair Hunt
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Many intersecting factors, including the graying of the broader society, a paradigm shift away from rehabilitation, fewer opportunities for parole, and retrospective prosecutions, contribute to an exponential increase in number of older inmates. Elderly prisoners are likely to live in small, tight quarters with other inmates; have chronic health conditions; and encounter multiple barriers to health promotion. Using focus groups, data on perceived challenges to health promotion and self-care strategies were collected from 42 male inmates 50 and older. Cost issues, prison personnel and policies, food concerns, fellow inmates, and personal barriers challenged older inmates' abilities to maintain their health in prison. However, they did engage in self-care strategies, including accessing resources and support, staying positive, managing diet and weight, engaging in physical activity, and protecting self. A key motivator for pursuing good health was to be respected and perceived as healthy and strong by fellow inmates. Development and testing of programs to enhance inmates' self-management of chronic conditions and to facilitate health promotion are in order. PMID:20795581
AIMS—To assess the health needs and provision of health care to school age children in local authority care.?METHODS—A total of 142 children aged 5 to 16 in local authority care, and 119 controls matched by age and sex were studied. Main outcome measures were routine health care, physical, emotional, and behavioural health, health threatening and antisocial behaviour, and health promotion.?RESULTS—Compared with children at home, those looked after by local authorities were significantly more likely to: experience changes in general practitioner; have incomplete immunisations; receive inadequate dental care; suffer from anxieties and difficulties in interpersonal relationships; wet the bed; smoke; use illegal drugs; and have been cautioned by police or charged with a criminal offence. They also tend to receive less health education. They were significantly more likely to have had a recent hearing or eye sight test, and reported significantly less physical ill health overall.?CONCLUSIONS—The overall health care of children who have been established in care for more than six months is significantly worse