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Sample records for 28-item general health

  1. Children: General Health

    MedlinePlus

    ... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... Kids A Directory of Medical Tests Basic Blood Chemistry Tests Blood Culture Blood Test: Complete Blood Count ...

  2. Relationship between general health of older health service users and their self-esteem in Isfahan in 2014

    PubMed Central

    Molavi, Razieh; Alavi, Mousa; Keshvari, Mahrokh

    2015-01-01

    Background: Self-esteem is known to be one of the most important markers of successful aging. Older people's self-esteem is influenced by several factors that particularly may be health related. Therefore, this study aimed to explore some important general health-related predictors of the older people's self-esteem. Materials and Methods: In this study, 200 people, aged 65 years and older, who referred to health care centers were selected through stratified random sampling method. Data were collected by using Rosenberg's self-esteem scale and the 28-item Goldberg's general health questionnaire. Data were analyzed by Pearson's coefficient tests and multiple regression analysis. Results: Findings showed that the entered predictor variables accounted for 49% of the total variance (R2) of self-esteem in the model (P < 0.001, F4,195 = 46.717). Three out of the four predictor variables including somatic signs, anxiety/insomnia, and depression, significantly predicted the self-esteem. The results emphasized on the determinant role of both physical (somatic signs) and mental (anxiety/insomnia and depression) aspects of health in older patients’ self-esteem. Conclusions: The significant general health-related predictors found in the present study emphasize on some of the significant points that should be considered in planning for improving older patients’ self-esteem. PMID:26793259

  3. General Health Among Parents Who Lost Their Children in the Bam Earthquake

    PubMed Central

    Rashidinejad, Masoumeh; Dehghan, Mahlagha; Tirgari, Batool; Rafiei, Hossein; Iranmanesh, Sedigheh

    2015-01-01

    Aim: Bam earthquake and its profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. This study aimed to investigate general health of parents who lose their children in Bam earthquake 10 years after the earthquake. Method: General health of 166 parents who lost their children in Bam earthquake was assessed using a translated version of General Health Questionnarie-28 items. Results: The mean score of GHQ was 25.63 ± 15.28. Among all domains, the higher mean score belonged to the category of “anxiety/insomnia” and the lower one belonged to the category of “severe depression. The results revealed significant correlation between total GHQ mean score and gender as well as educational level (0.003) Conclusion: Providing reflective narrative environments in which survivors can express their own experiences and feelings about earthquake, their loss and how they cope with it seems to be as an effective approach to identify their psychosocial situation and its influential factors. In such narrative environments special attention should be given to older participants, females and those who are single. PMID:26156934

  4. Surgeon General's Family Health History Initiative

    MedlinePlus

    ... Versions Source Code The Surgeon General's Family Health History Initiative To help focus attention on the importance of family history, the Surgeon General, in cooperation with other agencies ...

  5. Psychometrical assessment and item analysis of the General Health Questionnaire in victims of terrorism.

    PubMed

    Delgado-Gomez, David; Lopez-Castroman, Jorge; de Leon-Martinez, Victoria; Baca-Garcia, Enrique; Cabanas-Arrate, Maria Luisa; Sanchez-Gonzalez, Antonio; Aguado, David

    2013-03-01

    There is a need to assess the psychiatric morbidity that appears as a consequence of terrorist attacks. The General Health Questionnaire (GHQ) has been used to this end, but its psychometric properties have never been evaluated in a population affected by terrorism. A sample of 891 participants included 162 direct victims of terrorist attacks and 729 relatives of the victims. All participants were evaluated using the 28-item version of the GHQ (GHQ-28). We examined the reliability and external validity of scores on the scale using Cronbach's alpha and Pearson correlation with the State-Trait Anxiety Inventory (STAI), respectively. The factor structure of the scale was analyzed with varimax rotation. Samejima's (1969) graded response model was used to explore the item properties. The GHQ-28 scores showed good reliability and item-scale correlations. The factor analysis identified 3 factors: anxious-somatic symptoms, social dysfunction, and depression symptoms. All factors showed good correlation with the STAI. Before rotation, the first, second, and third factor explained 44.0%, 6.4%, and 5.0% of the variance, respectively. Varimax rotation redistributed the percentages of variance accounted for to 28.4%, 13.8%, and 13.2%, respectively. Items with the highest loadings in the first factor measured anxiety symptoms, whereas items with the highest loadings in the third factor measured suicide ideation. Samejima's model found that high scores in suicide-related items were associated with severe depression. The factor structure of the GHQ-28 found in this study underscores the preeminence of anxiety symptoms among victims of terrorism and their relatives. Item response analysis identified the most difficult and significant items for each factor. PMID:23205624

  6. General Law on Health, 26 December 1983.

    PubMed

    1987-01-01

    This document summarizes provisions of Mexico's 1984 General Law on Health. The law sets forth the objectives of the right to health protection as well as the objectives of the National Health System. Basic health services are defined as: 1) health education and the promotion of sanitation; 2) prevention and control of priority communicable diseases, the most frequent noncommunicable diseases, and accidents; 3) medical care; 4) maternal and child care; 5) family planning; 6) mental health; 7) the prevention and control of oral diseases; 8) the availability of medicaments and other essential supplies; 9) promotion of improved nutrition; and 10) social welfare for at-risk groups. The provisions in chapter 5 prioritize and define maternal and child care and call for protection of minors, activities to support the family and contribute to maternal and child health, appropriate standards of school hygiene, and health services for schoolchildren. Chapter 6 prioritizes delivery of family planning (FP) services to minors and adolescents. This chapter penalizes anyone performing sexual sterilization against a patient's will or unduly influencing a person to undergo sterilization. FP services are to include: 1) sex education, 2) care and surveillance of FP acceptors, 3) advisory functions, 4) research activities, 5) logistical and storage services, and 6) data collection. Additional chapters discuss the objectives of health education and provide that tissues may be removed from pregnant women for therapeutic purposes if the recipient is in danger of death and the removal poses no risk to the woman or the conceptus. PMID:12346764

  7. Predicting mental health problems in general practitioners.

    PubMed

    Chambers, R; Belcher, J

    1994-09-01

    A total of 704 general practitioners completed questionnaires enquiring about mental health problems (response rate = 82.0%). Excessive anxiety was reported by 31.1%, troublesome depression by 13.4%, exhaustion or stress (on three or more weekdays) by 60.7%, and sleep difficulties by 47.6%. General practitioners aged 40-49 years old were most likely to report anxiety, exhaustion or stress, sexual and sleep difficulties. Retired doctors reported mental health problems markedly less often. Predictive factors for anxiety were depression, one or more nights on-call per week, and exhaustion or stress; predictive factors for depression were anxiety, and exhaustion or stress; predictive factors for exhaustion or stress were anxiety, depression, no hobbies, paperwork on three or more evenings per week, and sleep difficulties. Gender, country of origin, being single-handed, excessive alcohol consumption, and having no coping methods were not predictive factors for mental health problems. PMID:7949065

  8. Mental Health: A Report of the Surgeon General. Executive Summary.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

    This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. It states that a review of research on mental health revealed two findings. First, the efficacy of treatment is well documented, and second, a range of treatment exists for most mental…

  9. Biological health or lived health: which predicts self-reported general health better?

    PubMed Central

    2014-01-01

    Background Lived health is a person’s level of functioning in his or her current environment and depends both on the person’s environment and biological health. Our study addresses the question whether biological health or lived health is more predictive of self-reported general health (SRGH). Methods This is a psychometric study using cross-sectional data from the Spanish Survey on Disability, Independence and Dependency Situation. Data was collected from 17,739 people in the community and 9,707 from an institutionalized population. The following analysis steps were performed: (1) a biological health and a lived health score were calculated for each person by constructing a biological health scale and a lived health scale using Samejima’s Graded Response Model; and (2) variable importance measures were calculated for each study population using Random Forest, with SRGH as the dependent variable and the biological health and the lived health scores as independent variables. Results The levels of biological health were higher for the community-dwelling population than for the institutionalized population. When technical assistance, personal assistance or both were received, the difference in lived health between the community-dwelling population and institutionalized population was smaller. According to Random Forest’s variable importance measures, for both study populations, lived health is a more important predictor of SRGH than biological health. Conclusions In general, people base their evaluation of their own health on their lived health experience rather than their experience of biological health. This study also sheds light on the challenges of assessing biological health and lived health at the general population level. PMID:24555764

  10. 21 CFR 101.14 - Health claims: general requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.14 Health claims:...

  11. 21 CFR 101.14 - Health claims: general requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.14 Health claims:...

  12. 29 CFR 1926.20 - General safety and health provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false General safety and health provisions. 1926.20 Section 1926.20 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION General Safety and...

  13. 21 CFR 101.14 - Health claims: general requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.14 Health claims:...

  14. 21 CFR 101.14 - Health claims: general requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.14 Health claims:...

  15. 21 CFR 101.14 - Health claims: general requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.14 Health claims:...

  16. General theory of paradigms in health.

    PubMed

    Mohs, E

    1991-01-01

    In Costa Rica, three sequential health paradigms have been identified over the last 50 years. The first began to develop during the 40's and has been called that of the deficiency diseases, since with a diachronic approach it placed excessive emphasis on malnutrition. The second began in 1970 and it is known as that of the infectious diseases, since through a holistic or synchronic approach, it underlined the importance of infections in high rates of morbidity and mortality. The third and last is the paradigm of the chronic diseases, it appeared in the 80's and is presently in process, doing battle with the chronic ailments, life styles, and environment, and it also utilizes a holistic approach. The recognition of these three paradigms has permitted Costa Rica a rapid advance in improving the health of its population, to the point that with a per capita outlay of $130 (US dollars), it has indices similar to those of the industrialized nations. This particular experience could be useful for other less-developed countries that are still applying the paradigm of the deficiency diseases. PMID:1805365

  17. Why General Mills mixes in health care.

    PubMed

    Blodgett, T B

    1989-01-01

    When it comes to social responsibility, most companies are content to write out checks--often in large numbers--and let it go at that. General Mills is one company that likes to establish operating ventures that involve corporate officers and champion a cause. Such a venture is Altcare, a nonprofit organization designed to find more effective and less expensive ways of caring for elderly people who are getting frail but do not require acute care. In 1983, when the company chose this area as its next project, it realized it needed help from an organization with vast experience in the geriatric field. So it enlisted a nearby organization, the Wilder Foundation, and went into partnership as Altcare. The partnership has launched a service network for victims of Alzheimer's disease, a program with three other institutions to meet the myriad needs of chronically impaired people, and an unusual residence for physically impaired people, among other ventures. Altcare looks for advances and ideas that can be replicated, and the partnership often lends money to entrepreneurs who want to launch pioneering efforts or replicate Altcare initiatives. The cost to General Mills: about $80,000 a year after taxes, plus its share of any losses in project investments incurred by Altcare. PMID:10313002

  18. Making Health Happen on Campus: A Review of a Required General Education Health Course

    ERIC Educational Resources Information Center

    Becker, Craig M.; Johnson, Hans; Vail-Smith, Karen; Maahs-Fladung, Cathy; Tavasso, Debra; Elmore, Barry; Blumell, Charla

    2008-01-01

    Revisions of general education curricula have been ongoing as universities strive to meet the general education goal of helping students succeed. The importance of health status with regard to the future health potential of college students and the impact the college years have on their health has been highlighted in the American College Health…

  19. Global health education in general preventive medicine residencies.

    PubMed

    Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H

    2015-05-01

    Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health. PMID:25891059

  20. Metacognition Beliefs and General Health in Predicting Alexithymia in Students

    PubMed Central

    Babaei, Samaneh; Varandi, Shahryar Ranjbar; Hatami, Zohre; Gharechahi, Maryam

    2016-01-01

    Objectives: The present study was conducted to investigate the role of metacognition beliefs and general health in alexithymia in Iranian students. Methods: This descriptive and correlational study included 200 participants of high schools students, selected randomly from students of two cities (Sari and Dargaz), Iran. Metacognitive Strategies Questionnaire (MCQ-30); the General Health Questionnaire (GHQ) and Farsi Version of the Toronto Alexithymia Scale (TAS-20) were used for gathering the data. Using the Pearson’s correlation method and regression, the data were analyzed. Results: The findings indicated significant positive relationships between alexithymia and all subscales of general health. The highest correlation was between alexithymia and anxiety subscale (r=0.36, P<0.01). Also, there was a significant negative relationship between alexithymia and some metacognitive strategies. The highest significant negative relationship was seen between alexithymia and the sub-scale of risk uncontrollability (r=-0.359, P < 0.01). Based on the results of multiple regressions, three predictors explained 21% of the variance (R2=0. 21, F=7.238, P<0.01). It was found that anxiety subscale of General Health significantly predicted 13% of the variance of alexithymia (β=0.36, P<0.01) and risk uncontrollability subscale of Metacognition beliefs predicted about 8% of the variance of alexithymia (β=-0.028, P<0.01). Conclusions: The findings demonstrated that metacognition beliefs and general health had important role in predicting of alexithymia in students. PMID:26383206

  1. A general health policy model: update and applications.

    PubMed Central

    Kaplan, R M; Anderson, J P

    1988-01-01

    This article describes the development of a General Health Policy Model that can be used for program evaluation, population monitoring, clinical research, and policy analysis. An important component of the model, the Quality of Well-being scale (QWB) combines preference-weighted measures of symptoms and functioning to provide a numerical point-in-time expression of well-being, ranging from 0 for death to 1.0 for asymptomatic optimum functioning. The level of wellness at particular points in time is governed by the prognosis (transition rates or probabilities) generated by the underlying disease or injury under different treatment (control) variables. Well-years result from integrating the level of wellness, or health-related quality of life, over the life expectancy. Several issues relevant to the application of the model are discussed. It is suggested that a quality of life measure need not have separate components for social and mental health. Social health has been difficult to define; social support may be a poor criterion for resource allocation; and some evidence suggests that aspects of mental health are captured by the general measure. Although it has been suggested that measures of child health should differ from those used for adults, we argue that a separate conceptualization of child health creates new problems for policy analysis. After offering several applications of the model for the evaluation of prevention programs, we conclude that many of the advantages of general measures have been overlooked and should be given serious consideration in future studies. PMID:3384669

  2. Advancing Public Health Obesity Policy Through State Attorneys General

    PubMed Central

    Brownell, Kelly D.

    2011-01-01

    Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity. PMID:21233428

  3. Telemental Health Technology in Deaf and General Mental-Health Services: Access and Use

    ERIC Educational Resources Information Center

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or…

  4. Oral Sexual Experience among Young Adolescents Receiving General Health Examinations.

    ERIC Educational Resources Information Center

    Boekeloo, Bradley O.; Howard, Donna E.

    2002-01-01

    Surveyed young adolescents receiving general health examinations regarding oral sex occurrence. Overall, 18 percent reported having oral sex, and of that 18 percent, 25 percent reported no vaginal sex. Few adolescents used barrier protection during oral sex. Most adolescents thought that penile-anal sex could transmit HIV, but only 68 percent…

  5. Predictors of Grades in General Chemistry for Allied Health Students.

    ERIC Educational Resources Information Center

    Craney, C. L.; Armstrong, R. W.

    1985-01-01

    Analyzes the relationship between allied health students' (N=304) performance in general chemistry and the American Chemical Society's Toledo Exam (Form 1974), mathematical Scholastic Aptitude Test (SAT) scores, and high school chemistry grade. Also discusses use of findings to identify students who had a high risk of receiving low grades. (JN)

  6. Countries: General, Electricity, Geography, Health, Literature: Children's, Plants.

    ERIC Educational Resources Information Center

    Web Feet, 2002

    2002-01-01

    Presents an annotated list of Web site educational resources kindergarten through eighth grade. The Web sites this month cover the following subjects: countries (general); electricity; geography; health; children's literature; and plants. Includes a list of "Calendar Connections" to Web site sources of information on Earth Day in April and other…

  7. Men's Health Promotion by General Practitioners in a Workplace Setting.

    ERIC Educational Resources Information Center

    Aoun, Samar; Johnson, Lyn

    2002-01-01

    A project to promote rural men's health through diabetes education and screening in the workplace involved 446 men aged 40-65 in Western Australia. Of the 287 men identified at high risk of developing diabetes and referred to their general practitioner, 76 percent visited their physician. However, physician's advice on lifestyle changes was…

  8. The Factor Structure of the 60 Item General Health Questionnaire.

    ERIC Educational Resources Information Center

    Layton, Clive; Rust, John

    1986-01-01

    Male school children (N=241), all aged 16 years, and 144 men facing redundancy completed the 60 item version of the General Health Qestionnaire. Data were analysed using unrotated first principal component analysis followed by oblique rotation. The unrotated first principal component accounted for much of the variance, particularly in the school…

  9. General and oral health implications of cannabis use.

    PubMed

    Cho, C M; Hirsch, R; Johnstone, S

    2005-06-01

    Cannabis, commonly known as marijuana, is the most frequently used illicit drug in Australia. Therefore, oral health care providers are likely to encounter patients who are regular users. An upward trend in cannabis use is occurring in Australia, with 40 per cent of the population aged 14 and above having used the drug. There are three main forms of cannabis: marijuana, hash and hash oil, all of which contain the main psychoactive constituent delta-9-tetrahydrocannabinol (THC). Cannabis is most commonly smoked, however it can be added to foods. THC from cannabis enters the bloodstream and exerts its effects on the body via interaction with endogenous receptors. Cannabis affects almost every system of the body, particularly the cardiovascular, respiratory and immune systems. It also has acute and chronic effects on the mental health of some users. Therefore, chronic abuse is a concern because of its negative effects on general physical and mental health. Cannabis abusers generally have poorer oral health than non-users, with an increased risk of dental caries and periodontal diseases. Cannabis smoke acts as a carcinogen and is associated with dysplastic changes and pre-malignant lesions within the oral mucosa. Users are also prone to oral infections, possibly due to the immunosuppressive effects. Dental treatment on patients intoxicated on cannabis can result in the patient experiencing acute anxiety, dysphoria and psychotic-like paranoiac thoughts. The use of local anaesthetic containing epinephrine may seriously prolong tachycardia already induced by an acute dose of cannabis. Oral health care providers should be aware of the diverse adverse effects of cannabis on general and oral health and incorporate questions about patients' patterns of use in the medical history. PMID:16050084

  10. Development and Validation of the General Health Numeracy Test (GHNT)

    PubMed Central

    Osborn, Chandra Y.; Wallston, Kenneth A.; Shpigel, Adam; Cavanaugh, Kerri; Kripalani, Sunil; Rothman, Russell L.

    2013-01-01

    Objective Since existing numeracy measures may not optimally assess ‘health numeracy’, we developed and validated the General Health Numeracy Test (GHNT). Methods An iterative pilot testing process produced 21 GHNT items that were administered to 205 patients along with validated measures of health literacy, objective numeracy, subjective numeracy, and medication understanding and medication adherence. We assessed the GHNT’s internal consistency reliability, construct validity, and explored its predictive validity. Results On average, participants were 55.0±13.8 years old, 64.9% female, 29.8% non-White, and 51.7% had incomes ≤$39K with 14.4±2.9 years of education. Psychometric testing produced a 6-item version (GHNT-6). The GHNT-21 and GHNT-6 had acceptable-good internal consistency reliability (KR-20 = 0.87 vs. 0.77, respectively). Both versions were positively associated with income, education, health literacy, objective numeracy, and subjective numeracy (all p<.001). Furthermore, both versions were associated with participants’ understanding of their medications and medication adherence in unadjusted analyses, but only the GHNT-21 was associated with medication understanding in adjusted analyses. Conclusions The GHNT-21 and GHNT-6 are reliable and valid tools for assessing health numeracy. Practice implications Brief, reliable, and valid assessments of health numeracy can assess a patient’s numeracy status, and may ultimately help providers and educators tailor education to patients. PMID:23433635

  11. Evaluating oral health promotion activity within a general dental practice.

    PubMed

    Richards, W

    2013-07-01

    The prevention of the common dental diseases is fundamental to modern day general dental practice. Oral health promotion (OHP) is therefore key to facilitating health outcomes within organisations. The literature surrounding OHP stresses the importance of evaluation in order to assess the effectiveness of OHP activities. This paper describes the evaluation of OHP within a general dental practice setting. Early attendance, the use of adult toothpastes during childhood and consequential fluorosis are investigated. A small service evaluation study of 100 consecutive patients was undertaken. The results support the ongoing promotion of early attendance and the use of toothpastes with adequate fluoride levels. There was no evidence of unsightly fluorosis in the sample studied. PMID:23887535

  12. [General aspects of planning and care in mental health].

    PubMed

    Saforcada, E

    1976-09-01

    This paper reviews some general concepts on Planning, especially in public and welfare sectors, stressing those concerning the major flaws in the argentine system of mental health. The author considers the definition of planning levels, and sets forth three: general plan, program and project. The correlative implementation is also considered. The importance of feed-back from adequate evaluation is stressed, emphasizing three aspects: a) evaluation of dynamics, rate and extent of decrease, increase or stagnation; b) assessment of efficacity of factors involved; c) control and stabilization of goals already attained. The necessity to develop a human ecology, encompassing socio-cultural and psycho-social factors is stressed, together with fostering theoretical research and the use of its results by implementation agents. Several differences among prevailing mental health actions are pointed out which allow a distinction between two typical models: clinical and sanitarist. The main differences between them lye on: standard location of working sites, nature of basic actions, field of action, hypothesis for working, including ethiological and ecological assumptions, theoretical and methodological framework. A series of criteria for evaluating sanitary techniques and strategies are set forth, among which: operative procedures, length of treatments, degree of therapeutic concentration, and general pragmatic criteria. The indicators reviewed are: degree of efficacity, covering, degree of perseverance in treatments, cultural barriers between patient and therapist, delegation of functions into special, first-rate sanitary agents, needs for the training of mental health workers. An attempt is made at developping general evaluation criteria for mental health planning, and several indicators are proposed, among which: a) cost/efficacity ratio, including in costs the use of economical, human and physical resources; b) preventive capacities of the community; c) capacities for the

  13. Health services under the General Agreement on Trade in Services.

    PubMed Central

    Adlung, R.; Carzaniga, A.

    2001-01-01

    The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215

  14. General practice and primary health care in Denmark.

    PubMed

    Pedersen, Kjeld Møller; Andersen, John Sahl; Søndergaard, Jens

    2012-03-01

    General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized by 5 key components: (1) a list system, with an average of close to 1600 persons on the list of a typical GP; (2) the GP as gatekeeper and first-line provider in the sense that a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment; (3) an after-hours system staffed by GPs on a rota basis; (4) a mixed capitation and fee-for-service system; and (5) GPs are self-employed, working on contract for the public funder based on a national agreement that details not only services and reimbursement but also opening hours and required postgraduate education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges. Practice units are fairly small: close to 2 GPs per unit plus nurses and secretaries. The units are fully computerized, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies etc. Over the past few years a decrease in solo practices has been seen and is expected to accelerate, in part because of the GP age structure, with many GPs retiring and new GPs not wanting to practice alone. This latter workforce trend is pointing toward a new model with employed GPs, particularly in rural areas. PMID:22403249

  15. The relationship between general health and lifestyle factors and oral health outcomes.

    PubMed

    Sharma, P; Busby, M; Chapple, L; Matthews, R; Chapple, I

    2016-07-22

    Aim The primary research question addressed in this paper was 'are lower than average oral health scores observed for those patients who report problems with general health and high-risk lifestyle factors?'Methods A population analysis was conducted on the first 37,330 patients, assessed by 493 dentists in the UK, to receive a Denplan PreViser Patient Assessment (DEPPA) at their dental practice. The Oral Health Score (OHS) was generated using a mixture of patient-reported factors and clinical findings and is an integrated component of DEPPA. Patients' self-reported risk factors included diabetes status, tobacco use and alcohol consumption. Patients' general health was measured by self-report, that is, a yes/no answer to the question 'have you experienced any major health problems in the last year for example a stroke, heart attack or cancer?' Multivariable linear regression analysis was employed to study the association between the OHS and general health and risk factors for patients in the DEPPA cohort.Results The mean age of participants was 54 years (range 17-101; S.D. 16 years) and the mean OHS for the group was 78.4 (range 0-100; S.D. 10). 1,255 (3%) of patients reported experiencing a major health problem in the previous year. In the fully adjusted model, diabetes, tobacco use, excessive alcohol consumption (three or more drinks per day), and poor overall health in the preceding year were all associated with a statistically significant drop in the mean OHS of patients. Having diabetes was associated with a 1.7 point (95% CI 1.3-2.1, P <0.001) drop in OHS, tobacco use was associated with a 2.7 point (95% CI 2.5-2.9, P <0.001) drop in OHS, and excessive alcohol consumption was associated with a 1.8 point (95% CI 1.3-2.4, P <0.001) drop in OHS. The mean OHS in patients who reported a major health problem in the preceding year was 0.7 points (95% CI 0.2-1.2, P = 0.006) lower than that of patients who did not report a major health problem in the preceding year

  16. The health work force, generalism, and the social contract.

    PubMed Central

    Sheldon, G F

    1995-01-01

    Since 1990, society has been evolving through a period of significant transformation. In response to an increasingly information-rich and knowledge-based environment, the work force for most of society is becoming more specialized. Medicine is one of the few areas developing a work force which emphasizes generalism. For our current needs, the transitional work force has overproduced physicians. Because the overproduction has been uneven by specialty, it is deceptive to evaluate growth collectively rather than by individual subspecialty. Future shifts in age and types of illness combined with enhanced technology will transform the public's expectations of the American health care system. The type and number of physicians that will be needed in the future will be substantially different than in the past, so current patterns in physician education may not address the population's future demands. Images Figure 1. PMID:7677453

  17. Reliability, Validity and Factor Structure of the 12-Item General Health Questionnaire among General Population

    PubMed Central

    Petkovska, Miodraga Stefanovska; Bojadziev, Marjan I.; Stefanovska, Vesna Velikj

    2015-01-01

    AIM: The aim of the study is to analyze the internal consistency; validity and factor structure of the twelve item General Health Questionnaire for the Macedonian general population. MATERIAL AND METHODS: Data came from nationally representative sample of 1603 randomly selected Macedonians all aged 18 years or older. RESULTS: The mean GHQ score in the general sample was found to be 7.9 (SD = 4.3). The results revealed a higher GHQ score among women (M = 8.91, SD = 4.5) compared to men (M = 6.89; SD = 4.2). The participants from the rural areas obtained a lower GHQ score (M = 7.55, SD = 3.8) compared to participants coming from the urban areas (M = 9.37, SD = 4.1). The principal component analysis with oblique rotation (direct oblimin) with maximum likelihood procedure solution was performed and the results yielded a three factor solution which jointly accounted for 57.17% of the total variance: Factor I named social management (items 1, 3, 4, 6, 7 and 8); Factor II stress (items 2, 5 and 9) and Factor III named self-confidence (items 10, 11 and 12). Its factor structure is in line with representative research from other population groups. CONCLUSION: The GHQ-12 can be used effectively for assessment of the overall psychological well-being and detection of non-psychotic psychiatric problems among the Macedonian population.

  18. Young People's Perceptions of Mental and Physical Health in the Context of General Wellbeing

    ERIC Educational Resources Information Center

    Singletary, Joanne H.; Bartle, Craig L.; Svirydzenka, Nadzeya; Suter-Giorgini, Nicola M.; Cashmore, Annette M.; Dogra, Nisha

    2015-01-01

    Objectives: Increased recognition of the need for health education in schools has seen advances in health literacy in recent years. Most of these have focussed on physical health, whereas education about mental health is generally lacking and focussed on tackling stigma rather than promoting good mental health. This study evaluated a pilot…

  19. Emotional Intelligence and Its Relationship With General Health Among the Students of University of Guilan, Iran

    PubMed Central

    Farrahi, Hassan; Kafi, Seyed Mousa; Karimi, Tamjid; Delazar, Robabeh

    2015-01-01

    Background: Particularly, this concept has used for examination of its empact on health of various people groups. Given the importance of students' health, this study investigated the relationship between emotional intelligence and general health. Objectives: The concept of emotional intelligence has attracted growing interest from researchers working in various fields. This study investigated the relationship between emotional intelligence and general health. Materials and Methods: In this cross-sectional study, 136 students were selected from the University of Guilan, north of Iran, using simple random sampling. The subjects completed the Schutte self-report emotional intelligence test and general health questionnaire. Results: The results showed a significant correlation between emotional intelligence and general health. Also, results indicated that emotional perception and emotional utilization are predictors of general health. Conclusions: The findings reflect that emotional intelligence can play an important role in general health. PMID:26576167

  20. Effects of Social Capital on General Health Status

    PubMed Central

    Yamaguchi, Ayano

    2014-01-01

    This paper discusses the concept of social capital as a potential factor in understanding the controversial relationship between income inequality and individual health status, arguing a positive, important role for social capital. Most of the health research literature focuses on individual health status and reveals that social capital increases individual health. However, the difficulty in measuring social capital, together with what may be the nearly impossible task of attributing causality, should relegate the concept to a more theoretical role in health research. Nonetheless, social capital receives academic attention as a potentially important factor in health research. This paper finds that the mixed results of empirical research on income inequality and health status remain a problem in the context of defining a stable relationship between socioeconomic status and health status. Clearly, further research is needed to elaborate on the income inequality and health relationship. In addition, focused, rigorous examination of social capital in a health context is needed before health researchers can comfortably introduce it as a concept of influence or significance. PMID:24762345

  1. The 12-Item General Health Questionnaire as an Effective Mental Health Screening Tool for General Korean Adult Population

    PubMed Central

    Kim, Young Ju; Cho, Maeng Je; Park, Subin; Hong, Jin Pyo; Sohn, Jee Hoon; Bae, Jae Nam; Jeon, Hong Jin; Chang, Sung Man; Lee, Hae Woo

    2013-01-01

    Objective The 12-item General Health Questionnaire (GHQ-12) has been used extensively in various settings across different cultures. This study was conducted to determine the thresholds associated with optimum sensitivity and specificity for the GHQ-12 in Korean adults. Methods Data was acquired from a sample of 6,510 Korean adults, ages 18 to 64 years old, who were selected from the 2005 Census (2,581 men and 3,929 women). Participants completed the GHQ-12 and the Korean Composite International Diagnostic Interview (K-CIDI). Receiver Operating Characteristic (ROC) curve analysis was conducted. Results The mean GHQ-12 score for the total sample was 1.63 (SD 1.98). The internal consistency of the GHQ-12 was good (Cronbach's α=0.72). Results from the ROC curve indicated that the GHQ-12 yielded greater accuracy when identifying mood and anxiety disorders than when identifying all mental disorders as a whole. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the disorder, but was mainly 2/3. Conclusion The Korean version of the GHQ-12 could be used to screen for individuals at high risk of mental disorders, namely mood and anxiety disorders. PMID:24474983

  2. [The mission of the Director General of the Ministry of Health].

    PubMed

    Abenhaim, L; Penaud, P; D'Autume, C; Slonimsky, A; Dab, W

    2000-09-01

    In France, the health and solidarity department of Employment and solidarity Ministry have just been re-organised. The Directory General of the department of Health is experiencing a complete revision of its functions and organisation. This article presents the public health context which has been taken into account for this new organisation and explains its main principles and strategic orientations. The new organisation chart is clarified. It is made up by two departments and seven under-directions. Up to now, control and administrative supervision were predominant among Health General Direction functions. They are now oriented to administrate missions prioritizing the function of health doctrines' elaboration, of programmation, animation and coordination. As the guarantor of sanitary security, the Health General Direction has also to impulse a new partnership which does not only include health professional, social and health organisation and the economic actors: citizen in general and service users in particular have to be included to promote health democracy. PMID:11142198

  3. Comparison of Health Locus of Control between Physicians and the General Public

    ERIC Educational Resources Information Center

    Tokuda, Y.; Okubo, T.; Yanai, H.; Jacobs, J.; Ohde, S.; Takahashi, O.; Omata, F.; Hinohara, S.; Fukui, T.

    2010-01-01

    Objective: Health locus of control (HLC) is associated with health behaviours. We aimed to investigate the difference of HLC to understand the potential gap in health beliefs between physicians and the general public. Design and setting: Physicians and the general public were surveyed in Japan using a cross-sectional survey. Data on the Japanese…

  4. Use and Uptake of eHealth in General Practice: A Cross-Sectional Survey and Focus Group Study Among Health Care Users and General Practitioners

    PubMed Central

    Krijgsman, Johan W; Brabers, Anne E; Jong, Judith D De; Friele, Roland D

    2016-01-01

    Background Policy makers promote the use of eHealth to widen access to health care services and to improve the quality and safety of care. Nevertheless, the enthusiasm among policy makers for eHealth does not match its uptake and use. eHealth is defined in this study as “health services delivered or enhanced through the Internet and related information and communication technologies.” Objective The objective of this study was to investigate (1) the current use of eHealth in the Netherlands by general practitioners (GPs) and health care users, (2) the future plans of GPs to provide eHealth and the willingness of health care users to use eHealth services, and (3) the perceived positive effects and barriers from the perspective of GPs and health care users. Methods A cross-sectional survey of a sample of Dutch GPs and members of the Dutch Health Care Consumer Panel was conducted in April 2014. A pre-structured questionnaire was completed by 171 GPs (12% response) and by 754 health care users (50% response). In addition, two focus groups were conducted in June 2014: one group with GPs (8 participants) and one with health care users (10 participants). Results Three-quarters of Dutch GPs that responded to the questionnaire (67.3%, 115/171) offered patients the possibility of requesting a prescription via the Internet, and half of them offered patients the possibility of asking a question via the Internet (49.1%, 84/171). In general, they did intend to provide future eHealth services. Nonetheless, many of the GPs perceived barriers, especially concerning its innovation (eg, insufficient reliable, secure systems) and the sociopolitical context (eg, lack of financial compensation for the time spent on implementation). By contrast, health care users were generally not aware of existing eHealth services offered by their GPs. Nevertheless, half of them were willing to use eHealth services when offered by their GP. In general, health care users have positive attitudes

  5. Mental Health: Culture, Race, and Ethnicity. A Supplement to "Mental Health: A Report of the Surgeon General."

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

    This supplement to "Mental Health: A Report of the Surgeon General" (1999) documents the existence of striking disparities for minorities in mental health services and the underlying knowledge base. Racial and ethnic minorities have less access to mental health services than whites, and they are less likely to receive needed care. When they…

  6. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  7. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  8. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  9. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  10. 48 CFR 873.109 - General requirements for acquisition of health-care resources.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a) Source... market research, including the determination that the acquisition involves health-care resources; (3)...

  11. 48 CFR 873.109 - General requirements for acquisition of health-care resources.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a) Source... market research, including the determination that the acquisition involves health-care resources; (3)...

  12. 48 CFR 873.109 - General requirements for acquisition of health-care resources.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a) Source... market research, including the determination that the acquisition involves health-care resources; (3)...

  13. My Family Health Portrait, A tool from the Surgeon General | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn Javascript on. My Family Health Portrait, A tool from the Surgeon General Past Issues / Winter 2010 Table of Contents My Family Health Portrait is an Internet-based tool that makes ...

  14. Generalism and the Need for Health Professional Educational Reform.

    ERIC Educational Resources Information Center

    Bulger, Roger J.

    1995-01-01

    This paper outlines forces that are intensifying change in health care delivery and describes institutional obstacles preventing medical schools' adjustment of their educational offerings. Health professions education institutions are urged to develop centers for determining regional and local workforce needs and subsequently establish regionally…

  15. Generalism and the need for health professional educational reform.

    PubMed

    Bulger, R J

    1995-01-01

    Powerful forces are intensifying change in health care delivery: population-based thinking about health care, especially emphasis on prevention; the reemergence of the biopsychosocial mode of thinking in health care; the need to increase capacity for health services research; and the knowledge that reductions may be needed in the use of high-priced physicians, the number of acute-care hospital beds, and the duplication of expensive equipment. Academic health centers are being forced to adjust their educational offerings to these realities of the service sector. Yet, institutional obstacles stand in the way of needed education reform: fragmentation of the sense of community in health professions schools, turf-related forces that separate various health professions, inflexible institutional structures that prevent adequate responses to a changing environment, an increasingly acute shortage of money to support education, and the devalued status of teaching within our institutions. Universities must develop centers to determine regional and local workforce needs and subsequently establish regionally based educational networks of academic and community health centers. Further, academic centers must demonstrate a real commitment to multiprofessional, interdisciplinary team approaches to a patient-centered system. In parallel, the institution must create a student-centered value system. PMID:7826454

  16. Factors associated with mental health, general health, and school-based service use for child psychopathology.

    PubMed Central

    Zahner, G E; Daskalakis, C

    1997-01-01

    OBJECTIVES: This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school. METHODS: Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression. RESULTS: Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8). CONCLUSIONS: Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children. PMID:9314794

  17. Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

    PubMed

    Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek

    2016-01-01

    Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance. PMID:26942630

  18. Teaching mental health skills to general practitioners and medical officers.

    PubMed

    Goldberg, David; Gask, Linda

    2002-01-01

    David Goldberg opened by describing the research that had led up to the present WPA teaching package. Early research had demonstrated that many psychological illnesses were not detected in primary care settings (Goldberg & Huxley 1980; ibid 1992), and these findings have been replicated in 14 centres round the world, with broadly similar results (Ustun & Sartorius 1995). We have found that in the UK the problem is not defects in factual knowledge, but not having clinical skills to assist in the management of mental disorders in general medical settings. The clinical skills needed in primary care are seldom taught in medical schools, and cannot be learned by listening to a lecture: it is necessary to practice them after they have been demonstrated. To do this it is convenient to break complex clinical skills down into their components: these are called "micro-skills", and we will deal later with the way in which these are taught. The most powerful method for improving mental health skills in this setting is to provide doctors with feedback--either video or audio--of their interview with real patients. The emphasis of such teaching must be on the interview techniques used by the doctor, rather than the clinical problems displayed by the particular patient being interviewed (Gask et al 1991). The problem with this is that video-feedback teaching of the necessary type is not always available, so we have developed videotapes that we can send out to distant locations, and which focus the attention of both local tutor and postgraduates on what should be learned. Because it is essential that most of the teaching is done by the live teacher rather than the videotape, there are always several "discussion points" so that postgraduates can ask questions, or describe their own way of dealing with particular situations. The videotapes are supplied together with teaching notes for the tutor, power points slides which can be adapted to suit local conditions, "role plays" to allow

  19. Green tea: A boon for periodontal and general health

    PubMed Central

    Chatterjee, Anirban; Saluja, Mini; Agarwal, Gunjan; Alam, Mahtab

    2012-01-01

    Green tea is particularly rich in health-promoting flavonoids (which account for 30% of the dry weight of a leaf), including catechins and their derivatives. The most abundant catechin in green tea is epigallocatechin-3-gallate, which is thought to play a pivotal role in the green tea's anticancer and antioxidant effects. Catechins should be considered right alongside of the better-known antioxidants like vitamins E and C as potent free radical scavengers and health-supportive for this reason. It has been suggested that green tea also promotes periodontal health by reducing inflammation, preventing bone resorption and limiting the growth of certain bacteria associated with periodontal diseases. PMID:23055579

  20. NIH's National Institute of General Medical Sciences celebrates 45 years of Discovery for Health

    MedlinePlus

    ... Alison Davis NIH's National Institute of General Medical Sciences celebrates 45 years of Discovery for Health The National Institute of General Medical Sciences (NIGMS) is the NIH institute that primarily supports ...

  1. Do Veterans Health Administration Enrollees Generalize to Other Populations?

    PubMed

    Wong, Edwin S; Wang, Virginia; Liu, Chuan-Fen; Hebert, Paul L; Maciejewski, Matthew L

    2016-08-01

    The Veterans Health Administration (VHA) has historically served a disproportionately male patient population with lower income and greater rates of mental illness than non-VHA populations. The generalizability of research based on VHA enrollees is unknown because the overlap between VHA and non-VHA populations has never been empirically examined. This study used 2013 National Health Interview Survey data to examine the extent to which VHA enrollees had similar demographic and health characteristics as individuals with Medicaid, Medicare, or private insurance coverage, based on propensity score models. A majority of male VHA enrollees were similar to Medicare beneficiaries suggesting greater generalizability of VHA studies than commonly hypothesized. Overlap declined when comparing with Medicaid enrollees or privately insured individuals, suggesting more limited generalizability of VHA studies to these populations. PMID:26589675

  2. Smoking and Health: A Report of the Surgeon General.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Rockville, MD.

    This book is divided into three sections. In the first section the health consequences of smoking are delineated. Part two contains discussions of the behavioral and biological aspects of smoking. The final section is devoted to educational opportunities for preventing addiction to tobacco. (JD)

  3. Health Care Reform and Medical Education: Forces toward Generalism.

    ERIC Educational Resources Information Center

    O'Neil, Edward H.; Seifer, Sarena D.

    1995-01-01

    Health care reforms will dramatically change the culture of medical schools in areas of patient care, research, and education programs. Academic medical centers must construct mutually beneficial partnerships that will position them to take advantage of the opportunities rather than leave them without the diversity of resources needed to make…

  4. Mental Health Computing in the 1980s: I. General Information Systems and Clinical Documentation.

    ERIC Educational Resources Information Center

    Hedlund, James L.; And Others

    1985-01-01

    This is the first of a two-part state-of-the-art review concerning current trends in mental health computing. It deals principally with general mental health information systems, the emerging role of microcomputers and general applications software, computerizing medical records, and computer support for quality assurance programs. (Author)

  5. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult...

  6. Health Benefits for Vocational Rehabilitation Consumers: Comparison of Access Rates with Workers in the General Population

    ERIC Educational Resources Information Center

    Lustig, Daniel C.; Strauser, David R.

    2010-01-01

    Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…

  7. 45 CFR 164.502 - Uses and disclosures of protected health information: General rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Uses and disclosures of protected health information: General rules. 164.502 Section 164.502 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.502 Uses...

  8. 48 CFR 873.109 - General requirements for acquisition of health-care resources.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a) Source selection authority. Contracting officers shall be the source selection authority for acquisitions of...

  9. 48 CFR 873.109 - General requirements for acquisition of health-care resources.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a) Source selection authority. Contracting officers shall be the source selection authority for acquisitions of...

  10. Overview and Implications of the Surgeon General's Report on Mental Health. Topical Discussion.

    ERIC Educational Resources Information Center

    Katz-Leavy, Judy; Bornemann, Thomas; Burns, Barbara J.; Friedman, Robert; Jenson, Peter; Osher, Trina

    This brief paper on a topical discussion session held at a conference on children's mental health about implications of the 1999 report, "Mental Health: A Report of the Surgeon General," for children. The discussion focuses primarily on the chapter in the report specifically about children and mental health with comments by four individuals who…

  11. Australian General Practitioner Uptake of a Remunerated Medicare Health Assessment for People with Intellectual Disability

    ERIC Educational Resources Information Center

    Koritsas, Stella; Iacono, Teresa; Davis, Robert

    2012-01-01

    In 2007 the Australian Commonwealth Government announced the Medicare Health Assessment for People with an Intellectual Disability as part of the Enhanced Primary Care (EPC) program (Department of Health and Ageing, 2008). The annual health assessment is a structured framework for general practitioners (GPs), which enables an annual comprehensive…

  12. Ethical issues in electronic health records: A general overview.

    PubMed

    Ozair, Fouzia F; Jamshed, Nayer; Sharma, Amit; Aggarwal, Praveen

    2015-01-01

    Electronic health record (EHR) is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions. PMID:25878950

  13. Ethical issues in electronic health records: A general overview

    PubMed Central

    Ozair, Fouzia F.; Jamshed, Nayer; Sharma, Amit; Aggarwal, Praveen

    2015-01-01

    Electronic health record (EHR) is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions. PMID:25878950

  14. Fluorine Compounds and Dental Health: Applications of General Chemistry Topics

    ERIC Educational Resources Information Center

    Pinto, Gabriel

    2009-01-01

    An example about the use of everyday phenomena in teaching general chemistry is given. Students have a greater appreciation of the principles of chemistry if they can see the relevance to their lives. Fluorine compounds in dental applications (as topical or as systemic use) provide an excellent context in which to review core content of general…

  15. The association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran

    PubMed Central

    Khiavi, Farzad Faraji; Dashti, Rezvan; Zergani, Nadia

    2016-01-01

    Introduction Job satisfaction is one of the most challenging organizational concepts, and it is the basis of management policies to increase productivity and efficiency of the organization. The general health rate may affect job satisfaction in several ways. This study aimed to determine the association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran. Methods The study population of this cross-sectional research included 100 employees of Golestan Hospital in Ahvaz, Iran. The data collection instruments were the General Health Questionnaire (28-GHQ) and the Job Descriptive Index (JDI) questionnaire. The data were analyzed using Pearson’s product-moment correlation coefficient, independent samples t-test, and ANOVA statistical tests in SPSS software. Results The mean general health was calculated as 26.19 ± 11.04, which indicated a positive psychiatric condition. Job satisfaction with a mean score of 89.67 ± 23.3 was deemed to be relatively dissatisfied. A medium negative and significant association was observed between job satisfaction and general health and its subscales (physical health, anxiety, social, and depression). Conclusions General health subscales and job satisfaction are associated. Some actions must be planned to cope with the negative factors in general health in order to increase employees’ satisfaction in university educational hospitals. PMID:27280002

  16. [Rethinking how health is promoted in the Colombian general health-related social security system (Sistema General de Seguridad Social en Salud)].

    PubMed

    Eslava-Castañeda, Juan C

    2006-12-01

    This article takes stock of how promoting health (PH) (promoción de la salud - PS) has been understood within an international setting and gives three meanings for promotion: as general policy orientation, as a set of actions and as a special dimension of sanitary work. Interest expressed in giving it a specific basis distinguishing it from prevention, transcending educational work, has emerged from the subtle differences established from such different ways of coming to terms with PH. After recognising the challenge posed by PH in the field of health, the text succinctly describes how discourse regarding PH has been introduced in Colombia and discusses how an attempt has been made to be more precise regarding its place in the general health-related social security system. Efforts currently being made in Colombia regarding making PH become a reality within the Colombian health system are then mentioned. PMID:17361582

  17. Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population.

    PubMed

    Calvo, Mona S; Uribarri, Jaime

    2013-07-01

    This review explores the potential adverse impact of the increasing phosphorus content in the American diet on renal, cardiovascular, and bone health of the general population. Increasingly, studies show that phosphorus intakes in excess of the nutrient needs of a healthy population may significantly disrupt the hormonal regulation of phosphate, calcium, and vitamin D, which contributes to disordered mineral metabolism, vascular calcification, impaired kidney function, and bone loss. Moreover, large epidemiologic studies suggest that mild elevations of serum phosphate within the normal range are associated with cardiovascular disease (CVD) risk in healthy populations without evidence of kidney disease. However, few studies linked high dietary phosphorus intake to mild changes in serum phosphate because of the nature of the study design and inaccuracies in the nutrient composition databases. Although phosphorus is an essential nutrient, in excess it could be linked to tissue damage by a variety of mechanisms involved in the endocrine regulation of extracellular phosphate, specifically the secretion and action of fibroblast growth factor 23 and parathyroid hormone. Disordered regulation of these hormones by high dietary phosphorus may be key factors contributing to renal failure, CVD, and osteoporosis. Although systematically underestimated in national surveys, phosphorus intake seemingly continues to increase as a result of the growing consumption of highly processed foods, especially restaurant meals, fast foods, and convenience foods. The increased cumulative use of ingredients containing phosphorus in food processing merits further study given what is now being shown about the potential toxicity of phosphorus intake when it exceeds nutrient needs. PMID:23719553

  18. Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits

    PubMed Central

    Milojevich, Helen M.; Lukowski, Angela F.

    2016-01-01

    Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning. PMID:27280714

  19. The effect of progressive muscle relaxation on pregnant women's general health

    PubMed Central

    Sadeghi, Azam; Sirati-Nir, Masoud; Ebadi, Abbas; Aliasgari, Matin; Hajiamini, Zahra

    2015-01-01

    Background: Pregnancy may be accompanied by serious physiological and psychological changes as it is a stressful period in a woman's life. So, this study was conducted to determine the effect of progressive muscle relaxation on pregnant women's general health. Materials and Methods: In this clinical trial, 60 primigravida women admitted to the prenatal clinic of selected hospitals in Iran constituted the study population. Using purposive sampling method, the level of general health of the women was measured with General Health Questionnaire-28 (GHQ-28). Then, the samples were randomly divided into control and experimental groups. Three 1.5–2 h relaxation training sessions were held for the experimental group. After 8 weeks, the level of general health of both groups was measured again. Finally, the collected data were analyzed using Chi-square and paired t-test (P < 0.05). Results: Total mean score of general health of the experimental group and the control group before the intervention was 35.83 (6.92) and 29.46 (8.3), respectively, and after the intervention, the respective scores were 20.2 (5.61) and 27.85 (8.24). Although after the intervention both groups showed an increased level of general health, the difference in general health between before and after intervention was significant in the experimental group (P < 0.001). Furthermore, comparison of variations in mean scores of general health level before and after intervention in the two groups showed a significant difference (P < 0.001). Conclusions: Given that the results showed the effectiveness of progressive muscle relaxation on pregnant women's general health, the prenatal clinics can include a training program for progressive muscle relaxation in the routine training programs for pregnant women. PMID:26793248

  20. Mental health and general wellness in the aftermath of Hurricane Ike.

    PubMed

    Lowe, Sarah R; Joshi, Spruha; Pietrzak, Robert H; Galea, Sandro; Cerdá, Magdalena

    2015-01-01

    Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across

  1. Epigenetics: general characteristics and implications for oral health

    PubMed Central

    Seo, Ji-Yun; Park, Yoon-Jung; Yi, Young-Ah; Hwang, Ji-Yun; Lee, In-Bog; Son, Ho-Hyun

    2015-01-01

    Genetic information such as DNA sequences has been limited to fully explain mechanisms of gene regulation and disease process. Epigenetic mechanisms, which include DNA methylation, histone modification and non-coding RNAs, can regulate gene expression and affect progression of disease. Although studies focused on epigenetics are being actively investigated in the field of medicine and biology, epigenetics in dental research is at the early stages. However, studies on epigenetics in dentistry deserve attention because epigenetic mechanisms play important roles in gene expression during tooth development and may affect oral diseases. In addition, understanding of epigenetic alteration is important for developing new therapeutic methods. This review article aims to outline the general features of epigenetic mechanisms and describe its future implications in the field of dentistry. PMID:25671208

  2. Consultations for women's health problems: factors influencing women's choice of sex of general practitioner.

    PubMed Central

    van den Brink-Muinen, A; de Bakker, D H; Bensing, J M

    1994-01-01

    AIM. This study set out to examine the degree to which women choose to visit a woman doctor for women's health problems and the determinants of this choice. The differences between women and men doctors with regard to treating women's health problems were also studied. METHOD. Data from the Dutch national survey of general practice were used. All group practices with both women and men general practitioners were selected. Analyses were restricted to consultations among women aged 15-65 years about menstruation, the menopause, vaginal discharge, breast examination and cervical smear tests. RESULts. Given the size of their female practice population, women doctors saw considerably more women with women's health problems than did their male colleagues. Women were more likely to consult a woman general practitioner if she was more available (that is, working longer hours), and younger women were more likely than older women to choose women general practitioners. Sex differences in the treatment of women's health problems were small and mainly related to the verbal part of the consultation: counselling and providing information. The doctors' availability and their certainty about the working diagnosis explained differences in the verbal aspects of consultations. Women general practitioners had longer consultations than their male colleagues mainly because more health problems were presented per consultation. CONCLUSION. In order to increase the possibility of patients choosing women general practitioners, policy should be directed towards the education of more women general practitioners and women general practitioners should be encouraged to work more days a week. PMID:8204333

  3. My Family Health Portrait, A tool from the Surgeon General | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. My Family Health Portrait, A tool from the Surgeon General ... use Why is it important to know my family medical history? Your family medical history is a ...

  4. The effect of laughter Yoga on general health among nursing students

    PubMed Central

    Yazdani, Mohsen; Esmaeilzadeh, Mojtaba; Pahlavanzadeh, Saeid; Khaledi, Firouz

    2014-01-01

    Background: Promotion and provision of individuals’ health is one of the bases for development in societies. Students’ mental health is very important in each society. Students of medical sciences universities, especially nursing students, are under various stresses in clinical environment, in addition to the stress they experience in theoretical education environment. With regard to the importance of nursing students’ general health and considering the various existing strategies to promote general health components, use of complementary treatments is more considered because of their better public acceptance, low costs, and fewer complications. One of the new strategies in this regard is laughter Yoga. The present study was conducted with an aim to define the effect of laughter Yoga on general health among nursing students. Materials and Methods: This is a quasi-experimental two-group three-step study conducted on 38 male nursing students in the nursing and midwifery school of Isfahan University of Medical Sciences in 2012. In the study group, eight 1 h sessions of laughter Yoga were held (two sessions a week), and in the control group, no intervention was conducted. The data of the present study were collected by Goldberg and Hiller's General Health Questionnaire and analyzed by SPSS version 12. Results: The findings showed a significant difference in the mean scores of general health before and after laughter Yoga intervention in the two groups of study and control. Conclusions: The findings showed that laughter Yoga had a positive effect on students’ general health and improved the signs of physical and sleep disorders, lowered anxiety and depression, and promoted their social function. Therefore, laughter Yoga can be used as one of the effective strategies on students’ general health. PMID:24554958

  5. General Health status of workers among different workplaces in Qom Province, Iran

    PubMed Central

    Koohpaei, Alireza; Khandan, Mohammad; Gaeeni, Mahdi; Momenyan, Somayeh

    2015-01-01

    Introduction In a healthy organization, psychological health and physical health are as important as production and productivity; and healthy workers have higher productivity. Regarding lack of information about workers’ general health profile in Qom Province, this study aimed to assess and compare the staffs’ general health and its components among different workplaces in 2014. Methods In a cross-sectional study, 2,276 employees working at 46 industries and organizations completed a standardized General Health Questionnaire (GHQ 28) and a demographic questionnaire. Data were analyzed using t-test, ANOVA, and Pearson product-moment correlation coefficient by IBM SPSS version 20. Results The mean age of the participants was 32.22 (±7.55) years. Seventy-nine point four percent of participants were married and the rest were single. Highest and lowest scores belonged to social dysfunction and depression, respectively. Also, total score of staffs’ general health was 17.87 ± 10.93. The results showed that, in spite of the non-relationship between general health score difference among married and single personnel (p > 0.05), there was a significant difference between men and women and among organizations and industries with regards to general health score (p < 0.05), and drivers had the most difference with others. The relationship between workers’ ages and GH was significant (p < 0.05, Pearson’s bivariate correlation coefficient = −0.05). Conclusion The findings of this study collectively indicated that participants had an acceptable condition for mental factors, such as depression, but not in viewpoints of social dysfunction. In other words, staffs’ interfaces with circumstances and personal innovation/creativity in the workplaces are at risk. Altogether, the general health score in the studied population was suitable in its entirety. PMID:26813624

  6. 45 CFR 164.502 - Uses and disclosures of protected health information: general rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Uses and disclosures of protected health information: general rules. 164.502 Section 164.502 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually...

  7. 45 CFR 164.502 - Uses and disclosures of protected health information: General rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Uses and disclosures of protected health information: General rules. 164.502 Section 164.502 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually...

  8. 45 CFR 164.502 - Uses and disclosures of protected health information: general rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Uses and disclosures of protected health information: general rules. 164.502 Section 164.502 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually...

  9. 45 CFR 164.502 - Uses and disclosures of protected health information: general rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Uses and disclosures of protected health information: general rules. 164.502 Section 164.502 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES... or may be subjected to domestic violence, abuse, or neglect by such person; or (B) Treating...

  10. [General Practitioner Sentinel Network as a Tool of [Public] Health Surveillance].

    PubMed

    Rodrigues, Ana Paula; Fonseca, Rita Carvalho; Matias-Dias, Carlos

    2016-01-01

    Current strategies of European health advocate the strengthening of the role of public health, requiring from decision-makers the ability to defend and enhance the health of individuals and populations in all policies. In the pursuit of this objective, public health should be evidence-based and so public health surveillance, seen as an important tool of public health since the nineteenth century, plays a central role in public health practice through the production and dissemination of the health information necessary for health planning and for evaluation of public health actions. Within the practice of public health estimations of disease frequency are important for outbreak control, health assessment, health needs assessment and estimation of health gains, but unfortunately these estimations are not always available for the entire population. In those cases and for diseases with high prevalence sentinel surveillance based in sentinel networks have some advantages for specific groups, namely needed of scarce resources and obtainment of quick results.The central role of family doctors in chronic disease management, their knowledge on individuals and families and their responsibilities in the management of a clear defined patients list are characteristics that make general practice an appropriate context to develop a sentinel network. In fact, in Portugal there is a general practitioner sentinel network named Rede Médicos-Sentinela working since 1989 which estimated, for the last 25 years, incidence rates of several chronic diseases, some of them targeted on national priority health programs. Thus, we consider that Rede Médicos-Sentinela can be integrated in a national surveillance system for chronic diseases in Portugal. PMID:26926891

  11. True believers? Characteristics of general practitioners in Victorian community health centres.

    PubMed

    Montalto, M; Dunt, D; Young, D

    1994-12-01

    General practitioners have been part of multidisciplinary services in Victoria Community Health Centres (CHCs) for 20 years. This model institutionalizes a high degree of integration between general practitioners and other primary care and community service personnel. Of 51 eligible full-time general practitioners in Victorian CHCs, 46 were interviewed, using a structured questionnaire. General practitioners in CHCs were younger, less experienced and more likely to be female than other general practitioners. Nearly three-quarters were salaried. The philosophy of practice and the conditions of employment were the commonest reasons for entering CHC practice. Teamwork and the conditions of employment were felt to be the biggest advantages of CHC practice, while difficulties with management and the perceived loss of professional ownership and control were the commonest disadvantages. None reported interference from the CHC management in their clinical practice. Nearly a quarter of full-time CHC general practitioners do not undertake any formal community health promotion activities. Forty-five per cent of respondents intended to leave their CHC within the next five years. Universal health insurance has diminished the impact of CHC general practice. The philosophy of CHCs and the salaried nature of the employment continues to attract general practitioners. High staff turnover is a feature of CHC general practice, in part related to young doctors making an initial, but not long-term commitment to CHC practice. However, the loss of professional control and management difficulties should be addressed, as these may contribute to the high turnover. PMID:7718658

  12. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... general public in public health medical emergencies. 880.6260 Section 880.6260 Food and Drugs FOOD AND... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  13. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... general public in public health medical emergencies. 880.6260 Section 880.6260 Food and Drugs FOOD AND... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  14. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... general public in public health medical emergencies. 880.6260 Section 880.6260 Food and Drugs FOOD AND... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  15. Comparison of General Population, Patient, and Carer Utility Values for Dementia Health States

    PubMed Central

    Mulhern, Brendan; Banerjee, Sube; Tait, Rhian; Watchurst, Caroline; Smith, Sarah C.; Young, Tracey A.; Knapp, Martin; Brazier, John E.

    2015-01-01

    Utility values to estimate quality-adjusted life years (QALYs) for use in cost-utility analyses are usually elicited from members of the general population. Public attitudes and understanding of dementia in particular may mean that values elicited from the general population may differ from patients and carers for dementia health states. This study examines how the population impacts utility values elicited for dementia health states using interviewer-administered time tradeoff valuation of health states defined by the dementia-specific preference-based measures DEMQOL-U (patient-report) and DEMQOL-Proxy-U (carer-report). Eight DEMQOL-U states were valued by 78 members of the UK general population and 71 patients with dementia of mild severity. Eight DEMQOL-Proxy-U states were valued by 77 members of the UK general population and 71 carers of patients with dementia of mild severity. Random-effects generalized least squares regression estimated the impact of population, dementia health state, and respondent sociodemographic characteristics on elicited values, finding that values for dementia health states differed by population and that the difference varied across dementia health states. Patients with dementia and carers of patients with dementia gave systematically lower values than members of the general population that were not due to differences in the sociodemographic characteristics of the populations. Our results suggest that the population used to produce dementia health state values could impact the results of cost-utility analyses and potentially affect resource allocation decisions; yet, currently, only general population values are available for usage. PMID:25385749

  16. Work, health, and welfare: the association between working conditions, welfare states, and self-reported general health in Europe.

    PubMed

    Bambra, Clare; Lunau, Thorsten; Van der Wel, Kjetil A; Eikemo, Terje A; Dragano, Nico

    2014-01-01

    This article is the first to examine the association between self-reported general health and a wide range of working conditions at the European level and by type of welfare state regime. Data for 21,705 men and women ages 16 to 60 from 27 European countries were obtained from the 2010 European Working Conditions Survey. The influence of individual-level sociodemographic, physical, and psychosocial working conditions and of the organization of work were assessed in multilevel logistic regression analyses, with additional stratification by welfare state regime type (Anglo-Saxon, Bismarckian, Eastern European, Scandinavian, and Southern). At the European level, we found that "not good" general health was more likely to be reported by workers more exposed to hazardous working conditions. Most notably, tiring working positions, job strain, and temporary job contracts were strongly associated with a higher likelihood of reporting "not good" health. Analysis by welfare state regime found that only tiring or painful working conditions were consistently associated with worse self-reported health in all regimes. There was no evidence that the Scandinavian welfare regime protected against the adverse health effects of poor working conditions. The article concludes by examining the implications for comparative occupational health research. PMID:24684087

  17. Social class in childhood and general health in adulthood: questionnaire study of contribution of psychological attributes

    PubMed Central

    Bosma, Hans; van de Mheen, H Dike; Mackenbach, Johan P

    1999-01-01

    Objective To determine the contribution of psychological attributes (personality characteristics and coping styles) to the association between social class in childhood and adult health among men and women. Design Partly retrospective, partly cross sectional study conducted in the framework of the Dutch GLOBE study. Subjects Sample of general population from south east Netherlands consisting of 2174 men and women aged 25-74 years. Baseline self reported data from 1991 provided information on childhood and adult social class, psychological attributes, and general health. Main outcome measure Self rated poor health. Results Independent of adult social class, low childhood social class was related to self rated poor health (odds ratio 1.67 (95% confidence interval 1.02 to 2.75) for subjects whose fathers were unskilled manual workers versus subjects whose fathers were higher grade professionals). Subjects whose fathers were manual workers generally had more unfavourable personality profiles and more negative coping styles. External locus of control, neuroticism, and the absence of active problem focused coping explained about half of the association between childhood social class and self rated poor health. The findings were independent of adult social class and height. Conclusions A higher prevalence of negative personality profiles and adverse coping styles in subjects who grew up in lower social classes explains part of the association between social class in childhood and adult health. This finding underlines the importance of psychological mechanisms in the examination of the negative effects of adverse socioeconomic conditions in childhood. Key messagesRegardless of adult social class, low social class in childhood is related to poor general health in adulthoodAdverse personality profiles and negative coping styles are more common in people who grew up in lower social classesPsychological attributes, such as low perceived control, explain a substantial part of

  18. Simple and Multivariate Relationships Between Spiritual Intelligence with General Health and Happiness.

    PubMed

    Amirian, Mohammad-Elyas; Fazilat-Pour, Masoud

    2016-08-01

    The present study examined simple and multivariate relationships of spiritual intelligence with general health and happiness. The employed method was descriptive and correlational. King's Spiritual Quotient scales, GHQ-28 and Oxford Happiness Inventory, are filled out by a sample consisted of 384 students, which were selected using stratified random sampling from the students of Shahid Bahonar University of Kerman. Data are subjected to descriptive and inferential statistics including correlations and multivariate regressions. Bivariate correlations support positive and significant predictive value of spiritual intelligence toward general health and happiness. Further analysis showed that among the Spiritual Intelligence' subscales, Existential Critical Thinking Predicted General Health and Happiness, reversely. In addition, happiness was positively predicted by generation of personal meaning and transcendental awareness. The findings are discussed in line with the previous studies and the relevant theoretical background. PMID:25616864

  19. Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

    PubMed Central

    Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

    2015-01-01

    Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes. PMID:25588157

  20. An overview of the prison population and the general health status of prisoners.

    PubMed

    Heidari, E; Dickinson, C; Dickson, C; Newton, T

    2014-07-11

    This article is the first in a series of four, which explore the oral and dental health of male prisoners in the United Kingdom. The series comprises: an overview of the general and oral health status of male prisoners, a discussion on how multi-disciplinary team working can be used to benefit the care of patients in prison environments and a description of the future planning of dental services for male prisoners. The oral health of prisoners is linked to their general health status, due in part to the presence of common risk factors such as smoking, drinking alcohol and in some cases use of recreational drugs, poor dietary and poor oral hygiene habits. Barriers to healthcare services can all have an effect on oral disease in this group. This paper highlights some of the common medical problems that oral healthcare providers face when treating prisoners in male UK prison establishments. PMID:25012323

  1. Work related stress, burnout, job satisfaction and general health of nurses.

    PubMed

    Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

    2015-01-01

    Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes. PMID:25588157

  2. [Clinical and functional evaluation of health status of workers exposed to infrasound, noise and general vibration].

    PubMed

    Balunov, V D; Barsukov, A F; Artamonova, V G

    1998-01-01

    The article covers complex evaluation of health state in building industry workers engaged into ferro-concrete production in St. Petersburg. The health state was considered under combined action of infrasound, noise and general vibration. Clinical and functional evaluation included medical examination by doctors, blood biochemistry and CBC, ECG, computer integral rheography, voice audiometry. Data for 62 moulders helped to assess acoustic environment at workplace and to reveal the morbidity structure. PMID:9662931

  3. Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population

    PubMed Central

    Engelen, Lucien JLPG; Berben, Sivera AA; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

    2013-01-01

    Background Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. Objective To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. Methods A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. Results The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. Conclusions The Internet is the main source of health

  4. Effects of changing exposure to neighbourhood greenness on general and mental health: A longitudinal study.

    PubMed

    Weimann, Hanna; Rylander, Lars; Albin, Maria; Skärbäck, Erik; Grahn, Patrik; Östergren, Per-Olof; Björk, Jonas

    2015-05-01

    Green neighbourhood environments have been associated with physical and psychological wellbeing in adults. Access to greenness is potentially more important in vulnerable subgroups. In this study based on longitudinal survey data from southern Sweden the cohort was divided into prognostic groups for good self-reported general (n=8891) and mental (n=9444) health. We used independent survey data to assess perceived neighbourhood greenness in 1km(2) areas, and estimated effects of changing exposure longitudinally stratified by prognostic group. The overall effect on health was small and statistically uncertain (for general health OR 1.04, 95% CI 0.98-1.10, for mental health OR 1.07, 95% CI 1.00-1.14). A more beneficial effect of increased greenness was indicated among subjects with lowest prognostic of good general health (OR 1.24, 95% CI 1.01-1.52). The study provided only weak evidence for beneficial effects of increased neighbourhood greenness triggered by changing residence. It seems that altered life circumstances, e.g. changed civil or socioeconomic status that often trigger a decision to move, are also the key determinants of the health consequences of changing residence. PMID:25754263

  5. Clustering of health behaviours in adult survivors of childhood cancer and the general population

    PubMed Central

    Rebholz, C E; Rueegg, C S; Michel, G; Ammann, R A; von der Weid, N X; Kuehni, C E; Spycher, B D

    2012-01-01

    Background: Little is known about engagement in multiple health behaviours in childhood cancer survivors. Methods: Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20–35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination. Results: The model identified four health behaviour patterns: ‘risk-avoidance', with a generally healthy behaviour; ‘moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; ‘risk-taking', engaging in several risk behaviours; and ‘smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the ‘risk-avoiding' (42% vs 44%) and the ‘risk-taking' cluster (14% vs 12%), but more survivors were in the ‘moderate drinking' (39% vs 28%) and fewer in the ‘smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy. Conclusion: A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions. PMID:22722311

  6. Effect of electromagnetic radiations from mobile phone base stations on general health and salivary function

    PubMed Central

    Singh, Kushpal; Nagaraj, Anup; Yousuf, Asif; Ganta, Shravani; Pareek, Sonia; Vishnani, Preeti

    2016-01-01

    Objective: Cell phones use electromagnetic, nonionizing radiations in the microwave range, which some believe may be harmful to human health. The present study aimed to determine the effect of electromagnetic radiations (EMRs) on unstimulated/stimulated salivary flow rate and other health-related problems between the general populations residing in proximity to and far away from mobile phone base stations. Materials and Methods: A total of four mobile base stations were randomly selected from four zones of Jaipur, Rajasthan, India. Twenty individuals who were residing in proximity to the selected mobile phone towers were taken as the case group and the other 20 individuals (control group) who were living nearly 1 km away in the periphery were selected for salivary analysis. Questions related to sleep disturbances were measured using Pittsburgh Sleep Quality Index (PSQI) and other health problems were included in the questionnaire. Chi-square test was used for statistical analysis. Results: It was unveiled that a majority of the subjects who were residing near the mobile base station complained of sleep disturbances, headache, dizziness, irritability, concentration difficulties, and hypertension. A majority of the study subjects had significantly lesser stimulated salivary secretion (P < 0.01) as compared to the control subjects. Conclusions: The effects of prolonged exposure to EMRs from mobile phone base stations on the health and well-being of the general population cannot be ruled out. Further studies are warranted to evaluate the effect of electromagnetic fields (EMFs) on general health and more specifically on oral health. PMID:27011934

  7. Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public

    PubMed Central

    Stuber, Jennifer P.; Rocha, Anita; Christian, Ann; Link, Bruce G.

    2014-01-01

    Objectives The authors compared attitudes of the U.S. general public and of mental health professionals about the competence and perceived dangerousness of people with mental health problems and the desire for social distance from them. Factors related to negative attitudes and the desire for social distance also were examined. Methods Vignettes describing individuals meeting DSM-IV criteria for major depression and schizophrenia were included in the 2006 General Social Survey (GSS) and a 2009 study of mental health professionals, and responses were descriptively compared (GSS, N=397 responses to depression vignette, N=373 responses to schizophrenia vignette; 731 mental health professionals responded to both vignettes). Regression analyses examined whether demographic and provider characteristics were associated with perceptions of less competence and perceived dangerousness of the vignette character and with respondents’ desire for social distance. Results Compared with the American public, mental health professionals had significantly more positive attitudes toward people with mental health problems. However, some providers’ conceptions about the dangerousness of people with schizophrenia and provider desire for social distance from clients in work and personal situations were concerning. Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions. Conclusions Although mental health professionals held more positive attitudes than the general public about people with mental health problems, strong stereotypes persisted in both groups, especially concerning schizophrenia. This study identified several demographic and provider characteristics that can inform intervention strategies in both groups. PMID:24430508

  8. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register

    PubMed Central

    Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund; Bech, Bodil Hammer; Vestergaard, Mogens; Flarup, Kaare Rud; Fenger-Grøn, Morten

    2016-01-01

    Background The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. Objectives To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. Materials and methods The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. Results The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18–34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. Conclusion We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research. PMID

  9. Management of animal health emergencies: general principles and legal and international obligations.

    PubMed

    Marabelli, R; Ferri, G; Bellini, S

    1999-04-01

    The Eighth Round of the General Agreement on Tariffs and Trade led to the creation of the World Trade Organization and to the adoption of the Sanitary and Phytosanitary (SPS) Agreement, thus considerably changing the rules of international trade in animals and animal products. Animal health measures may result in trade restrictions, but governments accept that these restrictions may sometimes be necessary and appropriate to ensure food safety and animal health protection. The SPS Agreement acknowledges the rights of governments to adopt measure to protect human, animal and plant health. To ensure effective animal health protection, without unjustifiable discrimination, the operational procedures of Veterinary Services must be standardised, especially those concerning disease notification, epidemiological information, certification for international trade and management of animal health emergencies. Veterinary Services must be further supported by a proper legislative framework and adequate financial resources. PMID:10190200

  10. Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran

    PubMed Central

    Golkari, Ali; Sabokseir, Aira; Sheiham, Aubrey; Watt, Richard G.

    2016-01-01

    Background: Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. Methods: This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom’s Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.  Results: Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased. Discussion: Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio

  11. The role of medical generalism in the New Zealand health system into the future.

    PubMed

    Atmore, Carol

    2015-08-01

    New Zealand hospitals are facing medical workforce shortages and an ageing population with increasing multimorbidity. To be sustainable in the future, the future medical workforce will need expertise in dealing with the complexity of people living with multiple physical and mental health issues. This will require a greater focus on generalism within the speciality colleges, and generalist doctors within the hospital settings, as well as their traditional home of community settings. Doctors' career choices will need to be matched to changing community need. The Transalpine Health Services generalist, specialist and sub-specialist workforce model developed by the West Coast and Canterbury health systems points the way to future sustainable provision of a quality patient hospital experience as close to home as possible, for people who live in provincial New Zealand, through a regional network approach. System-wide changes are suggested to support a more balanced future medical workforce. These include greater valuing of careers in generalism, aligning of incentives to promote medical careers based in generalism, developing regional networks that cross existing District Health Board boundaries to provide patient care, and application of system outcome metrics that measure quality of care and patient outcomes in an integrated health system. PMID:26365846

  12. General Education in Health Science-Focused Institutions: An Explanatory Mixed Methods Study

    ERIC Educational Resources Information Center

    Rosario, Peggy

    2012-01-01

    The purpose of this study was to describe the structure of general education curricula at baccalaureate colleges of health science in relationship to Bergquist's Career-Based Model of curriculum. Using an explanatory sequential mixed methods approach, the model was tested by examining whether the curricula were both prescriptive and specific.…

  13. Effects of a community mental health service on the practice and attitudes of general practitioners.

    PubMed Central

    Warner, R W; Gater, R; Jackson, M G; Goldberg, D P

    1993-01-01

    Recent years have seen closer links developing between general practitioners and mental health specialists. A study was undertaken in Manchester to determine the effects of a new community mental health service on the practice and attitudes of general practitioners. Ten doctors had access to the community based psychiatric team over a three year period while another 10 doctors continued to use hospital services. Those with access to the team were significantly more satisfied with the specialist support services, and were more likely to give high priority to community psychiatric nurses and psychiatric social workers working as part of a primary health care team than those without access to the service. Those with access were more willing than those without access to share with psychiatrists the care of patients with chronic neurotic disorders. The community mental health team was considered particularly helpful in reducing the burden posed by patients with neurotic and psychosocial problems, but this resulted in the general practitioners doing less counselling themselves. The study did not find that the new service had an effect on the general practitioners' ability to detect or manage psychiatric illness. PMID:8312022

  14. Statistical Properties of Generalized Gini Coefficient with Application to Health Inequality Measurement

    ERIC Educational Resources Information Center

    Lai, Dejian; Huang, Jin; Risser, Jan M.; Kapadia, Asha S.

    2008-01-01

    In this article, we report statistical properties of two classes of generalized Gini coefficients (G1 and G2). The theoretical results were assessed via Monte Carlo simulations. Further, we used G1 and G2 on life expectancy to measure health inequalities among the provinces of China and the states of the United States. For China, the results…

  15. How do life style factors relate to general health and overweight?

    PubMed

    van Strien, Tatjana; Koenders, Paul G

    2012-02-01

    In this study we examined the associations between on the one hand the life style factors: Sports, Alcohol, Nutrition, Overweight and Smoking (SANOS), the eating styles of dietary restraint, external- and emotional eating and on the other hand overweight, energy at work and perceived general health. Using a web-based life style questionnaire, responses were obtained from 3272 employees (1254 women and 2018 men) in a large banking corporation. These data were subjected to principal component factor analysis. In both sexes, the SANOS life style factors loaded on a factor that stood for good general health and energy at work, and that, in women, additionally comprised high dietary restraint. Overweight, in contrast, loaded in both sexes on a factor that comprised: restrained eating, emotional eating (highest loading) and external eating, and, in the women, additionally general health (negative loading) and energy at work (negative loading). It is concluded that the attempt made in life style programs to elevate general health perception and lower body weight may be more successful for the latter if the program is also targeted at improvement of eating behavior. PMID:22027272

  16. A Health Website Recommendation from Gold Coast General Practitioners to Their Patients: A Mixed Method Approach

    ERIC Educational Resources Information Center

    Usher, Wayne

    2011-01-01

    Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…

  17. General Practitioners' Understanding Pertaining to Reliability, Interactive and Usability Components Associated with Health Websites

    ERIC Educational Resources Information Center

    Usher, Wayne

    2009-01-01

    This study was undertaken to determine the level of understanding of Gold Coast general practitioners (GPs) pertaining to such criteria as reliability, interactive and usability components associated with health websites. These are important considerations due to the increased levels of computer and World Wide Web (WWW)/Internet use and health…

  18. Psychometrical Assessment and Item Analysis of the General Health Questionnaire in Victims of Terrorism

    ERIC Educational Resources Information Center

    Delgado-Gomez, David; Lopez-Castroman, Jorge; de Leon-Martinez, Victoria; Baca-Garcia, Enrique; Cabanas-Arrate, Maria Luisa; Sanchez-Gonzalez, Antonio; Aguado, David

    2013-01-01

    There is a need to assess the psychiatric morbidity that appears as a consequence of terrorist attacks. The General Health Questionnaire (GHQ) has been used to this end, but its psychometric properties have never been evaluated in a population affected by terrorism. A sample of 891 participants included 162 direct victims of terrorist attacks and…

  19. Effect of Daylight on Melatonin and Subjective General Health Factors in Elderly People

    PubMed Central

    KARAMI, Zohre; GOLMOHAMMADI, Rostam; HEIDARIPAHLAVIAN, Ahmad; POOROLAJAL, Jalal; HEIDARIMOGHADAM, Rashid

    2016-01-01

    Background: This paper investigated the effect of daylight on morning and night melatonin, subjective general health using GHQ questionnaire, sleepiness and alertness on elderly who lived in nursing houses. Methods: Nineteen nursing home residents participated voluntarily. They exposed to daylight from 9 to 10 a.m. and from 4 to 5 p.m. for 6 wk. The level of melatonin in the morning and at night was measured. General health of all participants was evaluated using General Health Questionnaire (GHQ) as well. Results: Daylight exposure significantly affected morning melatonin from 25.39 pg/ml to 59.77 pg/ml (P=0.001) and night melatonin were changed from 40.30pg/ml to 34.41pg/ml (P=0.081). Mean score of general health changed 36.31 to 29.89 (P=0.003). Karolinska Sleepiness Scale (KSS) and Visual Analogue Scale (VAS) showed increase sleepiness and decrease alertness from 3:00 to 7:00 a.m. Sleepiness decreased and alertness increased during 1:00 p.m. and 20:00 p.m. Conclusions: Daylight exposure could delay sleep phase and correction of circadian rhythm in elderly. Anxiety and insomnia could be improved with daylight exposure. It suggests that elders should be exposed to scheduled daylight in morning and evening for prevention and improvement of mental disorders. Adequate light should be provided for elder’s homes and nursing house. PMID:27398336

  20. [The female role as assessment of mental health of women within the general population of Cantabria].

    PubMed

    de Santiago Díaz, A; Vázquez Barquero, J L; Díez Manrique, J F

    1994-01-01

    This paper tries to analyse the relationship between traditional feminine role (marriage, motherhood and housing) and mental health in spanish women. The General Health Questionnaire 60-items (GHQ-60) was used to define "cases" in a random sample of the general population of Cantabria consisting of 630 women aged 17 and over. The rate of probable prevalence of psychiatric disorders was 26.4%. In contrast to previous studies, motherhood and traditional feminine role correlated with the lowest GHQ-60 mean scores. Occupational status was not related to mental health. Women living with husband, children, parents and/or parents-in-law scored lower on GHQ-60 than those living with husband and children. These results are discussed in the light of previous findings in the literature. At least, they reconfirm the importance of socio-cultural factors in community psychiatric disorder. PMID:7817849

  1. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Filtering facepiece respirator for use by the general public in public health medical emergencies. 880.6260 Section 880.6260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital...

  2. War Experiences and General Health Among People in Bosnia-Herzegovina and Kosovo.

    PubMed

    Ringdal, Gerd Inger; Ringdal, Kristen

    2016-02-01

    War experiences may have an extensive impact on the health status of the exposed populations. This population-based study aimed to examine the relationship between war experiences and self-reported general health in representative sample surveys from Bosnia-Herzegovina (n = 3,313) and Kosovo (n = 1,000). Data were collected with face-to-face interviews fielded in the winter of 2003-2004. Logistic regression analysis was used to compute unadjusted and adjusted odds ratios (ORs). The adjusted effects of the extensiveness of war experiences on poor health were positive in both countries, but they were statistically significant only for Bosnia-Herzegovina: OR = 1.04, 95% CI [1.00, 1.08] for Bosnia-Herzegovina and OR = 1.03, 95% CI [0.98, 1.09] for Kosovo. The strongest observed effect was found for Kosovo only: The extensiveness of war experiences was relatively strongly related to longstanding health problems, OR = 1.09, 95% CI [1.03, 1.15]. We found that war experiences may contribute to increased poorer health in the exposed populations; however, the effects 4-9 years after the war ended were modest. Hence, war experiences seemed to be more strongly related to war-related distress and posttraumatic stress disorder than to self-reported general health. PMID:26773795

  3. Relationship between fatigue and sleepiness with general health of mothers in the postpartum period

    PubMed Central

    Khayamim, Nafiseh; Bahadoran, Parvin; Mehrabi, Tayebeh

    2016-01-01

    Background: Fatigue and changes in sleep patterns are one of the impressive features in the first year after birth, which have negative effects on work, family life, and social relationships. Therefore, the objective of this research was to investigate the relationship between fatigue and Stanford sleepiness with the general health of mothers in the postpartum period. Materials and Methods: The current research is a descriptive correlational study which was performed on 190 mothers between 2 and 24 postpartum weeks, referring to the health centers of Isfahan in 2014. All mothers meeting the inclusion criteria were selected through cluster purposive sampling. Data were collected by use of four questionnaires including profile and fertility, fatigue, Stanford sleepiness, and general health. Data were analyzed by statistical tests at a significance level of ≤0.05. Results: The results showed that 5.3%, 59.5%, and 35.3% of subjects had mild, moderate, and severe fatigue, respectively. In addition, 26.3% of women showed a public health disorder, and according to Stanford sleepiness, 20.5% of subjects had sleepiness. The statistical results indicated that there were significant relationships between fatigue (P ≤ 0.001, r = 0.52) and Stanford sleepiness (P = 0.04, r = 0.14), and mothers’ general health. Conclusions: According to prevalence of fatigue and sleepiness in the postpartum period and its relationship with maternal health, application of sleep health education and appropriate counseling during pregnancy and after delivery is recommended to prevent mothers’ mental complications in order to achieve a safe pregnancy. PMID:27563322

  4. The development and application of indices of health: general methods and a summary of results.

    PubMed Central

    Sackett, D L; Chambers, L W; MacPherson, A S; Goldsmith, C H; Mcauley, R G

    1977-01-01

    A multidisciplinary group has developed a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The strategy has been found to be generally applicable, capable of application by lay interviewers, acceptable to interviewees, and amenable to index construction. Furthermore, initial evaluations of the resulting health indices suggest that they are biologically and clinically valid. These health indices have been successfully applied in a randomized trial of innovative primary care services. The comceptualization of individual sections of the health index questionnaire for each of these three functional areas, the generation of the instrument, and the evaluation of questionnaire responses for their biologic and clinical validity are summarized here. PMID:857684

  5. [General practitioners: practices and integration of mental health care in Québec].

    PubMed

    Imboua, Armelle; Fleury, Marie-Josée

    2009-01-01

    This article examines the socio-demographic profile of general practitioners (GPs), their role in the management of (transient/moderate, severe/chronic) mental health disorders in different areas (urban, semi-urban, and rural) of Quebec as well as if their clinical practice and collaboration are oriented towards integration of mental health services. This crosswise study is based on 398 GPs representative of all Quebec GPs who answered a questionnaire. The study shows that GPs play a central role in mental health. According to territories, they have different socio-demographic and practice profiles. The types of territory and the degree of severity of mental health illnesses influence the propensity of GPs to integrate mental health care. Finally, GPs practiced mostly in silo, but they support greater integration of mental health services. The authors conclude that to improve mental health services integration, more proactive incentives should be favoured by political elites, adapted to the severity of the case and environments (urban, semi-urban or rural). However, the shortage of resources that is particularly striking in rural areas as well as inadequate mechanisms for clinical decision, reduce inter-relations and seriously limit the integration of healthcare. PMID:19475194

  6. Quality of life and general health in patients with temporomandibular disorders.

    PubMed

    Resende, Camila Maria Bastos Machado de; Alves, Arthur César de Medeiros; Coelho, Lidiane Thomaz; Alchieri, Joõo Carlos; Roncalli, Angelo Giuseppe; Barbosa, Gustavo Augusto Seabra

    2013-01-01

    The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction. PMID:23459771

  7. Primary health care and general practice--a comparison between Australia and Malaysia.

    PubMed

    Ee-Ming Khoo; Kidd, Michael Richard

    2002-01-01

    The Australian and Malaysian systems of general practice were examined and compared. The issues of similarity and difference identified are discussed in this paper. Quality clinical practice and the importance of compulsory vocational training prior to entry into general practice and continuing professional development is one important area. A move towards preventive health care and chronic disease management was observed in both countries. Practice incentive programmes to support such initiatives as improved rates of immunisation and cervical smear testing and the implementation of information technology and information management systems need careful implementation. The Medicare system used in Australia may not be appropriate for general practitioners in Malaysia and, if used, a pharmaceutical benefit scheme would also need to be established. In both countries the corporatisation of medical practice is causing concern for the medical profession. Rural and aboriginal health issues remain important in both countries. Graduate medical student entry is an attractive option but workforce requirements mean that medical education will need individual tailoring for each country. Incorporating nurses into primary health care may provide benefits such as cost savings. The integration model of community centres in Malaysia involving doctors, nurses and allied health professionals, such as physiotherapists, in a single location deserves further examination. PMID:12862408

  8. Sustainable leprosy related disability care within integrated general health services: findings from Salem District, India.

    PubMed

    Madhavan, K; Vijayakumaran, P; Ramachandran, L; Manickam, C; Rajmohan, R; Mathew, Jacob; Krishnamurthy, P

    2007-12-01

    The main focus of leprosy control has been case detection and treatment delivery with relative neglect of prevention of disability. Absence of reliable data and lack of research have added to the problem. This raised concerns about the capacity of the general health system to address the needs of people living with leprosy-related disabilities. In this prospective study appropriate services for people living with leprosy-related disabilities were introduced in the form of self-care training, guidance and monitoring by the general health staff facilitated by a non-governmental organisation leprosy centre in a district in south India with a population of 3.1 million (estimated in 2005). The staff identified 1232 people with leprosy-related disabilities and trained them in self-care. Follow-up assessments indicated that 86% were found to be practising self-care regularly and all the 239 general health workers were found to be actively involved. The most heartening outcome was the healing of plantar ulcers in 70% of people at the 1-year follow up. This intervention is sustainable because of the simplicity of the procedures and the involvement of all health staff including supervisors. PMID:18309709

  9. Effect of Educational Intervention on General Health and Depression in Temporary Employees

    PubMed Central

    Mazaheri, Maryam A

    2012-01-01

    Background: Mental health disorders and depression are pervasive and costly problems for workplaces. The aim of this study was to examine the general health and depression in temporary employees and the effect of educational intervention on general health and depression in temporary employees in Isfahan steel company. Methods: A quasi-experimental design was used to examine the effect of intervention among temporary employees of Isfahan steel company. All temporary employees of blast furnaces were studied by census method. Data were collected by questionnaires including GHQ-28, BDI-II before and after a brief three-session CB educational intervention and were analyzed by SPSS12. Results: According to the GHQ-28 scores; 16.9% were suspected to psychological disorders; 3.4% also recorded severe depression. Mean depression scores decreased significantly after the intervention (CI: 3.21-6.94). General health scores also decreased significantly after the intervention (CI: .97-5.03). Conclusion: Brief cognitive behavior educational intervention can be considered as a preliminary education for employees to develop skills to cope with depression, and included in a more extensive education to attain longer-term results. PMID:22891153

  10. More missing teeth are associated with poorer general health in the rural Korean elderly.

    PubMed

    Lee, Hee-Kyung; Lee, Kyung-Dong; Merchant, Anwar T; Lee, Sung-Kook; Song, Keun-Bae; Lee, Sang Gyu; Choi, Youn-Hee

    2010-01-01

    The aim was to investigate the association between missing teeth and general health conditions in elderly Korean people. This cross-sectional study was conducted as a part of a health-screening program supported by the National Health Insurance Corporation of Korea in a local region of Sungju-gun, Gyeongsangbuk-do from 2000 to 2006. The participants were 3611 in number (1494 males and 2117 females) aged 60 years and over. The outcome variable was the number of missing teeth in the mouth determined by dental examination; general medical examination included blood pressure, body height and weight to compute body mass index (BMI). Laboratory investigations included aspartate transaminase (AST), hemoglobin (HB), fasting plasma glucose (FPG), and total cholesterol (CHOL). Demographic factors and smoking status were obtained from questionnaires by an interviewer. Multiple regression models were used as a statistical analysis. The subjects were classified into three groups according to the number of missing teeth (<8, 8-18, and >18). In unadjusted analyses individuals with more missing teeth, had poorer general health status (higher blood pressure, higher levels of AST, FPG, and CHOL, and higher BMI in females). In multiple regression models with the number of missing teeth as an outcome, systolic blood pressure, CHOL, FPG, and HB in males were statistically significant after adjusting for age and smoking. In females, systolic blood pressure, CHOL, FPG, and BMI were positively associated with the number of missing teeth. The number of missing teeth was positively related to poorer general health status such as blood pressure, FPG, CHOL, after adjusting for age and smoking in the rural elderly in Korea. PMID:19230988

  11. Management of Overweight during Childhood: A Focus Group Study on Health Professionals' Experiences in General Practice

    PubMed Central

    Larsen, Lone Marie; Ledderer, Loni; Jarbøl, Dorte Ejg

    2015-01-01

    Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health professionals considered it their responsibility to offer a management programme to overweight children. They recognised that management of overweight during childhood was a complex task that required an evidence-based strategy with the possibility of supervision. Health professionals experienced a barrier to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised that they have a special obligation, capacity, and role in the management of obesity in childhood. Implementation of future management programmes must address existing barriers beyond an evidence-based standardised strategy. PMID:26236505

  12. Self-reported mood, general health, wellbeing and employment status in adults with suspected DCD.

    PubMed

    Kirby, Amanda; Williams, Natalie; Thomas, Marie; Hill, Elisabeth L

    2013-04-01

    Developmental Coordination Disorder (DCD) affects around 2-6% of the population and is diagnosed on the basis of poor motor coordination in the absence of other neurological disorders. Its psychosocial impact has been delineated in childhood but until recently there has been little understanding of the implications of the disorder beyond this. This study aims to focus on the longer term impact of having DCD in adulthood and, in particular, considers the effect of employment on this group in relation to psychosocial health and wellbeing. Self-reported levels of life satisfaction, general health and symptoms of anxiety and depression were investigated in a group of adults with a diagnosis of DCD and those with suspected DCD using a number of published self-report questionnaire measures. A comparison between those in and out of employment was undertaken. As a group, the unemployed adults with DCD reported significantly lower levels of life satisfaction. Whilst there was no significant difference between those who were employed and unemployed on General Health Questionnaire scores; both groups reported numbers of health related issues reflective of general health problems in DCD irrespective of employment status. While both groups reported high levels of depressive symptoms and rated their satisfaction with life quite poorly, the unemployed group reported significantly more depressive symptoms and less satisfaction. Additionally, the results identified high levels of self-reported anxiety in both groups, with the majority sitting outside of the normal range using the Hospital Anxiety and Depression Scale. These findings add to the small but increasing body of literature on physical and mental health and wellbeing in adults with DCD. Furthermore, they are the first to provide insight into the possible mediating effects of employment status in adults with DCD. PMID:23417140

  13. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

    PubMed Central

    2011-01-01

    Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men) and 10 district nurses (7 women, 3 men) from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and profession differences in this

  14. Association between social capital, health-related quality of life, and mental health: a structural-equation modeling approach

    PubMed Central

    Hassanzadeh, Jafar; Asadi-Lari, Mohsen; Baghbanian, Abdolvahab; Ghaem, Haleh; Kassani, Aziz; Rezaianzadeh, Abbas

    2016-01-01

    Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, health-related quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76% (95% confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health. PMID:26935615

  15. A general method for decomposing the causes of socioeconomic inequality in health.

    PubMed

    Heckley, Gawain; Gerdtham, Ulf-G; Kjellsson, Gustav

    2016-07-01

    We introduce a general decomposition method applicable to all forms of bivariate rank dependent indices of socioeconomic inequality in health, including the concentration index. The technique is based on recentered influence function regression and requires only the application of OLS to a transformed variable with similar interpretation. Our method requires few identifying assumptions to yield valid estimates in most common empirical applications, unlike current methods favoured in the literature. Using the Swedish Twin Registry and a within twin pair fixed effects identification strategy, our new method finds no evidence of a causal effect of education on income-related health inequality. PMID:27137844

  16. Missing Oral Health-Related Data in the interRAI-HC - Associations with Selected Variables of General Health and the Effect of Multiple Imputation on the Relationship between Oral and General Health

    PubMed Central

    Lesaffre, Emmanuel

    2015-01-01

    Background Missing data within the comprehensive geriatric assessment of the interRAI suite of assessment instruments potentially imply the under-detection of conditions that require care as well as the risk of biased statistical results. Impaired oral health in older individuals has to be registered accurately as it causes pain and discomfort and is related to the general health status. Objective This study was based on interRAI-Home Care (HC) baseline data from 7590 subjects (mean age 81.2 years, SD 6.9) in Belgium. It was investigated if missingness of the oral health-related items was associated with selected variables of general health. It was also determined if multiple imputation of missing data affected the associations between oral and general health. Materials and Methods Multivariable logistic regression was used to determine if the prevalence of missingness in the oral health-related variables was associated with activities of daily life (ADLH), cognitive performance (CPS2) and depression (DRS). Associations between oral health and ADLH, CPS2 and DRS were determined, with missing data treated by 1. the complete-case technique and 2. by multiple imputation, and results were compared. Results The individual oral health-related variables had a similar proportion of missing values, ranging from 16.3% to 17.2%. The prevalence of missing data in all oral health-related variables was significantly associated with symptoms of depression (dental prosthesis use OR 1.66, CI 1.41–1.95; damaged teeth OR 1.74, CI 1.48–2.04; chewing problems OR 1.74, CI 1.47–2.05; dry mouth OR 1.65, CI 1.40–1.94). Missingness in damaged teeth (OR 1.27, CI 1.08–1.48), chewing problems (OR 1.22, CI 1.04–1.44) and dry mouth (OR 1.23, CI 1.05–1.44) occurred more frequently in cognitively impaired subjects. ADLH was not associated with the prevalence of missing data. When comparing the complete-case technique with the multiple imputation approach, nearly identical odds ratios

  17. Untreated hypertension in the UK household population - Who are missed by the general health checks?

    PubMed

    Petersen, Jakob; Benzeval, Michaela

    2016-12-01

    Hypertension is an age-related, long-term condition and a leading risk factor for premature death and disability worldwide. Due to its asymptomatic nature it can often be left undiagnosed. Long-term treatment is available, but blood pressure can also be reduced through health behaviour changes in weight control, smoking cessation, higher physical activity levels, reduced salt and alcohol intake, and healthful diets if discovered early. This paper investigates the prevalence and characteristics of those with untreated (compared to treated) hypertension who did not have a history of cardiovascular disease (CVD); a group who is in effect missed by general health checks. Untreated hypertension was studied in 8933 individuals aged 40-74 years representative of the UK household population, who were interviewed and underwent a physical health examination in their home, 2010-2012. The prevalence of untreated hypertension without a history of CVD was 7% for men, 2% for women, and 5% overall. Untreated hypertension was particularly high among the 55-64 year age group. Age and sex-adjusted analyses found strong positive associations with male gender, smoking, self-reported good-excellent health, full fat dairy preference, white bread preference, higher alcohol consumption, and living alone. Strong negative associations were found for possessing 5 + prescription drugs, statins or antiplatelets, being diagnosed with diabetes or possessing antidiabetics, and long-term limiting illness status. Notably, many reported their health as good to excellent. A fact which emphasises the importance of motivating individuals to take part in the general health checks for an asymptomatic condition such as hypertension. PMID:27413665

  18. The effect of kangaroo mother care on mental health of mothers with low birth weight infants

    PubMed Central

    Badiee, Zohreh; Faramarzi, Salar; MiriZadeh, Tahereh

    2014-01-01

    Background: The mothers of premature infants are at risk of psychological stress because of separation from their infants. One of the methods influencing the maternal mental health in the postpartum period is kangaroo mother care (KMC). This study was conducted to evaluate the effect of KMC of low birth weight infants on their maternal mental health. Materials and Methods: The study was conducted in the Department of Pediatrics of Isfahan University of Medical Sciences, Isfahan, Iran. Premature infants were randomly allocated into two groups. The control group received standard caring in the incubator. In the experimental group, caring with three sessions of 60 min KMC daily for 1 week was practiced. Mental health scores of the mothers were evaluated by using the 28-item General Health Questionnaire. Statistical analysis was performed by the analysis of covariance using SPSS. Results: The scores of 50 infant-mother pairs were analyzed totally (25 in KMC group and 25 in standard care group). Results of covariance analysis showed the positive effects of KMC on the rate of maternal mental health scores. There were statistically significant differences between the mean scores of the experimental group and control subjects in the posttest period (P < 0.001). Conclusion: KMC for low birth weight infants is a safe way to improve maternal mental health. Therefore, it is suggested as a useful method that can be recommended for improving the mental health of mothers. PMID:25371871

  19. Violence Affects Physical and Mental Health Differently: The General Population Based Tromsø Study.

    PubMed

    Friborg, Oddgeir; Emaus, Nina; Rosenvinge, Jan H; Bilden, Unni; Olsen, Jan Abel; Pettersen, Gunn

    2015-01-01

    This general population-based study examined associations between violence and mental health, musculoskeletal pain, and early disability pension. The prevalence and consequences of good vs. poor adjustment (resilience vs. vulnerability) following encounters with violence were also examined. Data were based on the sixth wave of the "Tromsø Study" (N = 12,981; 65.7% response rate, 53.4% women, M-age = 57.5 years, SD-age = 12.7 years). Self-reported data on psychological (threats) and physical violence (beaten/kicked), mental health (anxiety/depression), musculoskeletal pain (MSP), and granting of disability pension (DP) were collected. Men suffered more violent events during childhood than women did, and vice versa during adulthood. Psychological violence implied poorer mental health and slightly more MSP than physical violence. The risk of MSP was highest for violence occurring during childhood in women and during the last year for men. A dose-response relationship between an increasing number of violent encounters and poorer health was observed. About 58% of individuals reported no negative impact of violence (hence, resilience group), whereas 42% considered themselves as more vulnerable following encounters with violence. Regression analyses indicated comparable mental health but slightly more MSP in the resilience group compared to the unexposed group, whereas the vulnerable group had significantly worse health overall and a higher risk of early granting of DP. Resilience is not an all-or-nothing matter, as physical ailments may characterize individuals adapting well following encounters with violence. PMID:26317970

  20. General health care service utilisation: where, when and by whom in a socioeconomically disadvantaged population.

    PubMed

    Achat, Helen M; Thomas, Paul; Close, Glenn R; Moerkerken, Leendert R; Harris, Mark F

    2010-01-01

    This paper aimed to examine the utilisation of and preferences related to health care services by residents of a disadvantaged area and to identify factors associated with levels of current and future use. Data were collected from face-to-face structured interviews of randomly selected residents of a disadvantaged local government area in 2003-04. Information about respondents' health and socioeconomic status and patterns of use and preferred features of health care was analysed in PASW Statistic 17. Chi-square statistics were used to examine differences in utilisation by sex and simple logistic regression provided sex specific age-adjusted odds ratios about frequent visits. Most respondents (95%) attended a 'usual' general practitioner (GP) service and about two-fifths had obtained other health care in the last 12 months. The median number of visits was four and most providers offered bulk billing (83%). Less common were visits to the dentist (32%), emergency department (14%), specialists (29%) and the hospital (5%). Providers' skills and traits, physical access and bulk billing were key considerations for men and women when choosing a health care provider. Disadvantaged communities want skilled practitioners who reflect their demographic mix and are located at convenient and accessible clinics, which preferably bulk bill. Apart from GP visits, this group appears to make only moderate use of specialists and emergency departments, and little routine use of other primary health services. PMID:21128574

  1. The self-reported health of U.S. flight attendants compared to the general population

    PubMed Central

    2014-01-01

    Background Few studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies. We describe the health status of flight attendants and compare it to the U.S. population. In addition, we explore whether the prevalence of major health conditions in flight attendants is associated with length of exposure to the aircraft environment using job tenure as a proxy. Methods We surveyed flight attendants from two domestic U.S. airlines in 2007 and compared the prevalence of their health conditions to contemporaneous cohorts in the National Health and Nutrition Survey (NHANES), 2005-2006 and 2007-2008. We weighted the prevalence of flight attendant conditions to match the age distribution in the NHANES and compared the two populations stratified by gender using the Standardized Prevalence Ratio (SPR). For leading health conditions in flight attendants, we analyzed the association between job tenure and health outcomes in logistic regression models. Results Compared to the NHANES population (n =5,713), flight attendants (n = 4,011) had about a 3-fold increase in the age-adjusted prevalence of chronic bronchitis despite considerably lower levels of smoking. In addition, the prevalence of cardiac disease in female flight attendants was 3.5 times greater than the general population while their prevalence of hypertension and being overweight was significantly lower. Flight attendants reported 2 to 5.7 times more sleep disorders, depression, and fatigue, than the general population. Female flight attendants reported 34% more reproductive cancers. Health conditions that increased with longer job tenure as a flight attendant were chronic bronchitis, heart disease in females, skin cancer, hearing loss, depression and anxiety, even after adjusting for age, gender, body mass index (BMI), education, and smoking. Conclusions This study found higher rates of specific diseases in flight attendants

  2. General Purpose Data-Driven Online System Health Monitoring with Applications to Space Operations

    NASA Technical Reports Server (NTRS)

    Iverson, David L.; Spirkovska, Lilly; Schwabacher, Mark

    2010-01-01

    Modern space transportation and ground support system designs are becoming increasingly sophisticated and complex. Determining the health state of these systems using traditional parameter limit checking, or model-based or rule-based methods is becoming more difficult as the number of sensors and component interactions grows. Data-driven monitoring techniques have been developed to address these issues by analyzing system operations data to automatically characterize normal system behavior. System health can be monitored by comparing real-time operating data with these nominal characterizations, providing detection of anomalous data signatures indicative of system faults, failures, or precursors of significant failures. The Inductive Monitoring System (IMS) is a general purpose, data-driven system health monitoring software tool that has been successfully applied to several aerospace applications and is under evaluation for anomaly detection in vehicle and ground equipment for next generation launch systems. After an introduction to IMS application development, we discuss these NASA online monitoring applications, including the integration of IMS with complementary model-based and rule-based methods. Although the examples presented in this paper are from space operations applications, IMS is a general-purpose health-monitoring tool that is also applicable to power generation and transmission system monitoring.

  3. Health consequences of using smokeless tobacco: summary of the Advisory Committee's report to the Surgeon General.

    PubMed Central

    Cullen, J W; Blot, W; Henningfield, J; Boyd, G; Mecklenburg, R; Massey, M M

    1986-01-01

    On March 25, 1986, the Surgeon General of the Public Health Service released a report that detailed the results of the first comprehensive, indepth review of the relationship between smokeless tobacco use and health. This review, prepared under the auspices of the Surgeon General's Advisory Committee on the Health Consequences of Using Smokeless Tobacco, is summarized in this article. In the United States, smokeless tobacco is used predominantly in the forms of chewing tobacco and snuff. During the past 20 years, the production and consumption of these products have risen significantly in marked contrast to the decline in smokeless tobacco use during the first half of the century. National estimates indicate that more than 12 million persons age 12 and older in the United States used some form of smokeless tobacco in 1985, and half of these were regular users. The highest rates of smokeless tobacco use occurred among adolescent and young adult males. Examination of the relevant epidemiologic, experimental, and clinical data revealed that oral use of smokeless tobacco is a significant health risk. This behavior can cause cancer in humans, and the evidence is strongest for cancer of the oral cavity, particularly at the site of tobacco placement. Smokeless tobacco use can also lead to the development of noncancerous oral conditions, particularly, oral leukoplakias and gingival recession. Further, the levels of nicotine in the body resulting from smokeless tobacco can lead to nicotine addiction and dependence. PMID:3090602

  4. [Contemporary relevance of the Spanish General Health Act after twenty five years].

    PubMed

    Criado Álvarez, Juan José; Repullo Labrador, José Ramón; García Millán, Angel

    2011-10-01

    Since its enactment in 1986, the General Health Law (Law 14/1986) has undergone several changes that have consolidated a model of National Health System. The law was embodied in 113 articles, ten Additional Provisions, five transitional arrangements, two Repeal and fifteen Final Provisions, has altogether 143 articles. After reviewing all legislation that appeared from 1986 to until today we can see that there are 106 articles (74.2%) that have lost regulatory effectiveness and merit analysis or reflection. All these items can be classified into four groups, the repealed and amended 26 articles (18.2%), 33 items of obsolete group (23.1%); the group of ill-developed are 6 articles (4.2%) and the critical (controversial and under ambiguous wording) group that has 41 articles (28.6%). After a quarter century of enforcement of the Act, two thirds of it to be reviewed. This legal weakness suggest the need of a new General Health Act for the Spanish National health System, being it a central objective of a political wide agreement. PMID:22212831

  5. General practitioners’ views on polypharmacy and its consequences for patient health care

    PubMed Central

    2013-01-01

    Background Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential consequences of polypharmacy. Our study aims to detect the status quo of the health care situation in Saxony’s general practices for multimorbid patients receiving multiple medications. We will identify the most common clinical profiles as well as documented adverse drug events and reactions that occur during the treatment of patients receiving multiple medications. We will focus on exploring the motives of general practitioners for the prescription of selected drugs in individual cases where there is evidence of potential drug-drug-interactions and potentially inappropriate medications in elderly patients. Furthermore, the study will explore general practitioners’ opinions on delegation of skills to other health professions to support medical care and monitoring of patients receiving multiple medications. Methods/design This is a retrospective cross sectional study using mixed methods. Socio-demographic data as well as diagnoses, medication regimens and clinically important events will be analyzed retrospectively using general practitioners documentation in patients’ records. Based on these data, short vignettes will be generated and discussed by general practitioners in qualitative telephone interviews. Discussion To be able to improve outpatient health care management for patients receiving multiple medications, the current status quo of care, risk factors for deficient treatment and characteristics of concerned patients must be investigated. Furthermore, it is necessary to understand the physicians’ decision making process regarding treatment. PMID:23947640

  6. Measurement scales in clinical research of the upper extremity, part 1: general principles, measures of general health, pain, and patient satisfaction.

    PubMed

    Badalamente, Marie; Coffelt, Laureen; Elfar, John; Gaston, Glenn; Hammert, Warren; Huang, Jerry; Lattanza, Lisa; Macdermid, Joy; Merrell, Greg; Netscher, David; Panthaki, Zubin; Rafijah, Greg; Trczinski, Douglas; Graham, Brent

    2013-02-01

    Measurement is a fundamental cornerstone in all aspects of scientific discovery, including clinical research. To be useful, measurement instruments must meet several key criteria, the most important of which are satisfactory reliability, validity, and responsiveness. Part 1 of this article reviews the general concepts of measurement instruments and describes the measurement of general health, pain, and patient satisfaction. PMID:23351912

  7. Influence of Social Support, Self-Efficacy, and Personality on the General Health of Retirees in Lagos, Nigeria

    ERIC Educational Resources Information Center

    Adejumo, Adebayo O.

    2010-01-01

    The influence of social-support, self-efficacy, and personality on the general-health of retirees in Lagos, Nigeria was investigated. Retirees (N = 475) attending a monthly pensioners' program participated. A MANOVA revealed significant influence of social-support on two dimensions of general-health status: social dysfunction (F(1) = 12.009) p =…

  8. Linguistic Adaptation and Psychometric Properties of Tamil Version of General Oral Health Assessment Index-Tml

    PubMed Central

    Appukuttan, DP; Vinayagavel, M; Balasundaram, A; Damodaran, LK; Shivaraman, P; Gunasshegaran, K

    2015-01-01

    Background: Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population. Aim: In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI-Tml). Subjects and Methods: Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test-retest, Cronbach alpha, and split half reliability. Inter-item and item-total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20–70 years attending the outpatient department were recruited. Subjects were requested to fill a self-reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self-perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure. Results: Mean GOHAI-Tml was 52.7 (6.8, range 22–60, median 54). The mean number of negative impacts was 2 (2.4, range 0–11, median 1). The Spearman rank correlation for test-retest ranged from 0.8 to 0.9 (P < 0.001) for all the 12 items between visits. The Cronbach alpha for 265 samples was 0.8 suggesting good internal consistency and homogeneity between items. Item scale correlation ranged from 0.4 to 0.8 (P < 0.001). Concurrent and discriminant validity was established. Principal component analysis resulted in extraction of four factors which together accounted for 66.4% (7.9/12) variance. Conclusion: GOHAI-Tml has shown acceptable

  9. General health status of residents of the Selebi Phikwe Ni-Cu mine area, Botswana.

    PubMed

    Ekosse, Georges

    2005-10-01

    Residents of the Selebi Phikwe area, Botswana where nickel-copper (Ni-Cu) is being exploited often exhibit symptoms of varied degrees of ailments, sicknesses and diseases. A need to investigate their general health status was therefore eminent. Primary data was obtained by means of a questionnaire and structured interviews conducted with individuals, health service providers, business enterprises and educational Institutions. The generated data revealed common ailments, sicknesses and diseases in the area with the four most frequent health complaints being frequent coughing headaches, influenza/common colds and rampant chest pains. Research findings indicated that residents had respiratory tract-related problems, suspected to be linked to the effects of air pollution caused by the emission of sulphur dioxide (SO2) from mining and smelting activities. Residents were frequently in contact with SO2 and related gases and fumes, mineral and silica dust generated from the mining processes. No clearly demarcating differences were noticed in the health status of residents living in the control site from those in the main study area. However, sites most affected were those close to where Ni-Cu is exploited. Environmental factors resulting from mining and smelting activities, among others, could be contributory to the negative health effects occurring at Selebi Phikwe. PMID:16416754

  10. Effects of General Medical Health on Alzheimer Progression: the Cache County Dementia Progression Study

    PubMed Central

    Leoutsakos, Jeannie-Marie S.; Han, Dingfen; Mielke, Michelle M.; Forrester, Sarah N.; Tschanz, JoAnn T.; Corcoran, Chris D.; Green, Robert C.; Norton, Maria C.; Welsh-Bohmer, Kathleen A.; Lyketsos, Constantine G.

    2012-01-01

    Background Several observational studies suggested a link between health status and rate of decline among individuals with Alzheimer’s disease (AD). We sought to quantify the relationship in a population-based study of incident AD, and to compare global comorbidity ratings to counts of comorbid conditions and medications as predictors of AD progression. Methods Design Case-only cohort study arising from population-based longitudinal study of memory and aging. Setting Cache County, Utah Participants 335 individuals with incident AD followed for up to 11 years. Measurements Patient descriptors included sex, age, education, dementia duration at baseline, and APOE genotype. Measures of health status made at each visit included the GMHR (General Medical Health Rating), number of comorbid medical conditions, and number of non-psychiatric medications. Dementia outcomes included the Mini-Mental State Exam (MMSE), Clinical Dementia Rating – sum of boxes (CDR-sb), and the Neuropsychiatric Inventory (NPI). Results Health Status tended to fluctuate over time within individuals. None of the baseline medical variables (GMHR, comorbidities, non-psychiatric medications) were associated with differences in rates of decline in longitudinal linear mixed effects models. Over time, low GMHR ratings, but not comorbidities or medications, were associated with poorer outcomes (MMSE: β=−1.07 p=0.01; CDR-sb: β=1.79 p<0.001; NPI: β=4.57 p=0.01) Conclusions Given that time-varying GMHR, but not baseline GMHR, was associated with the outcomes, there is likely a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications. Since health status is a potentially modifiable risk factor, further study is warranted. PMID:22687143

  11. Integration of health systems and priority health interventions: a case study of the integration of HIV and TB control programmes into the general health system in Vietnam.

    PubMed

    Conseil, Alexandra; Mounier-Jack, Sandra; Coker, Richard

    2010-11-01

    This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integration was ultimately classified as being 'fully/predominantly integrated', 'partially integrated', 'not or predominantly not integrated'. The results showed that none of the six programme functions was fully integrated into the general health care system as a whole. They were established either in parallel, notably at higher administrative levels, or were partially integrated. The study findings also revealed that little integration across all functional levels has occurred between the two programmes. Generally international agencies and sub-national domestic stakeholders supported more integration between vertical programmes (HIV and TB) and the general health systems, while national bodies responsible for HIV and TB favoured reinforcing a more vertical and thus less integrated approach. In the absence of shared assumptions and goals, this polarization of views may result in sub-optimal effectiveness and efficiency of each of the disease programmes as well as of HIV/TB interventions. PMID:20966106

  12. Touch screen computer health assessment in Australian general practice patients: a cross-sectional study protocol

    PubMed Central

    Carey, Mariko Leanne; Sanson-Fisher, Robert William; Russell, Grant; Mazza, Danielle; Makeham, Meredith; Paul, Christine Louise; Inder, Kerry Jane; D'Este, Catherine

    2012-01-01

    Introduction Cardiovascular disease (CVD) and cancer are leading causes of death globally. Early detection of cancer and risk factors for CVD may improve health outcomes and reduce mortality. General practitioners (GPs) are accessed by the majority of the population and play a key role in the prevention and early detection of chronic disease risk factors. This cross-sectional study aims to assess the acceptability of an electronic method of data collection in general practice patients. The study will describe the proportion screened in line with guidelines for CVD risk factors and cancer as well as report the prevalence of depression, lifestyle risk factors, level of provision of preconception care, cervical cancer vaccination and bone density testing. Lastly, the study will assess the level of agreement between GPs and patients perception regarding presence of risk factors and screening. Methods and analysis The study has been designed to maximise recruitment of GPs by including practitioners in the research team, minimising participation burden on GPs and offering remuneration for participation. Patient recruitment will be carried out by a research assistant located in general practice waiting rooms. Participants will be asked regarding the acceptability of the touch screen computer and to report on a range of health risk and preventive behaviours using the touch screen computer. GPs will complete a one-page survey indicating their perception of the presence of risk behaviours in their patients. Descriptive statistics will be generated to describe the acceptability of the touch screen and prevalence of health risk behaviours. Cohen's κ will be used to assess agreement between GP and patient perception of presence of health risk behaviours. Ethics and dissemination This study has been approved by the human research committees in participating universities. Findings will be disseminated via peer-reviewed publications, conference presentations as well as practice

  13. Training Australian General Practitioners in Rural Public Health: Impact, Desirability and Adaptability of Hybrid Problem-Based Learning

    ERIC Educational Resources Information Center

    Gladman, Justin; Perkins, David

    2013-01-01

    Context and Objective: Australian rural general practitioners (GPs) require public health knowledge. This study explored the suitability of teaching complex public health issues related to Aboriginal health by way of a hybrid problem-based learning (PBL) model within an intensive training retreat for GP registrars, when numerous trainees have no…

  14. Diagnostic health risk assessment of electronic waste on the general population in developing countries' scenarios

    SciTech Connect

    Frazzoli, Chiara; Orisakwe, Orish Ebere; Dragone, Roberto; Mantovani, Alberto

    2010-11-15

    E-waste is the generic name for technological waste. Even though aspects related to e-waste environmental pollution and human exposure are known, scientific assessments are missing so far on the actual risks for health sustainability of the general population exposed to e-waste scenarios, such as illicit dumping, crude recycling and improper treatment and disposal. In fact, further to occupational and direct local exposure, e-waste scenarios may impact on the environment-to-food chain, thus eliciting a widespread and repeated exposure of the general population to mixtures of toxicants, mainly toxic chemical elements, polycyclic aromatic hydrocarbons and persistent organic pollutants. In the absence of any clear policy on e-waste flow management, the situation in the e-waste receiver countries may become quite scary; accordingly, here we address a diagnostic risk assessment of health issues potentially elicited by e-waste related mixtures of toxicants. Scientific evidence available so far (mainly from China) is discussed with special attention to the concept of health sustainability, i.e. the poor health burden heritage perpetuated through the mother-to-child dyad. Endocrine disruption and neurotoxicity are specifically considered as examples of main health burden issues relevant to perpetuation through life cycle and across generations; toxicological information are considered along with available data on environmental and food contamination and human internal exposure. The risk from exposure to e-waste related mixtures of toxicants of vulnerable subpopulation like breast-fed infants is given special attention. The diagnostic risk assessment demonstrates how e-waste exposure poses an actual public health emergency, as it may entrain significant health risks also for generations to come. Exposure scenarios as well as specific chemicals of major concern may vary in different contexts; for instance, only limited information is available on e-waste related exposures in

  15. Audit of a sexual health website email link for general practitioners.

    PubMed

    Biggs, K; Lowe, P; Walsh, J; Lagios, K

    2010-01-01

    The aim of this review was to evaluate an 'Email a Clinician' link on a medically reviewed sexual health website, which was established to allow general practitioners (GPs) to communicate remotely with sexual health clinic specialists. The website was developed in consultation with GPs and extensively promoted throughout the relevant professional primary health-care networks. Despite this, the email link appeared to fail in its objective of facilitating GP access to specialist sexual health physician opinion within five working days. An audit examining use of the email link was conducted for a one-year period, during which time 324 emails were received. Results showed that the bulk of the emails (93.2%) were spam, and only 6.8% were genuine enquiries. Of the 22 genuine emails, 21 (95%) originated from the general public and there were no enquiries from the GPs, who were the target audience of the website, resulting in removal of the email link from the site. Direct survey of local GPs to evaluate reasons for non-utilization of the link was not possible. However, discomfort with the technology, time added to existing workload, lack of direct perceived benefit and lack of immediate response have been cited as contributing factors that may limit widespread adoption of other telemedicine services. As a new generation of recently graduated GPs enters the Australian workforce, who might be expected to be skilled and comfortable with electronic medical communication, the option of a direct email link to a sexual health clinic, with a faster turnaround time, may be worth re-visiting in the future. PMID:20029066

  16. Mapping interventions that promote mental health in the general population: A scoping review of reviews.

    PubMed

    Enns, Jennifer; Holmqvist, Maxine; Wener, Pamela; Halas, Gayle; Rothney, Janet; Schultz, Annette; Goertzen, Leah; Katz, Alan

    2016-06-01

    Health policies and programs promoting mental health or preventing mental illness in the general public are under-recognized facets of primary prevention. Increasing awareness and adoption of such strategies could reduce the burden of mental illness in individuals, families, communities, and society as whole. We conducted a scoping review of reviews of interventions to promote mental health or prevent mental illness. We searched PubMed, PsycINFO, Scopus, Cochrane CENTRAL, CINAHL and ERIC from 2004 to 2014. Reviews were included if the authors indicated a systematic approach in their literature searches, and if they comprised interventions in Westernized countries targeting the general population. We identified 39 reviews that met the inclusion criteria. Mental health intervention approaches and outcomes varied across age groups and settings, and included functional, social, and cognitive measures. Most interventions aimed to prevent a specific mental illness or symptoms (depression, anxiety, burnout, or stress). Cognitive-behavioral therapy and educational components were common. School-based programs focused on outcomes involving social and academic development. Interventions for families, especially for young or disadvantaged parents, taught parenting skills to help improve the well-being of children and their care-givers. In the workplace, the focus was on managing stress, while programs for the elderly emphasized quality of life determinants. This review summarizes a wide variety of interventions to promote mental health or prevent mental illness, but the literature is primarily focused on the individual or family unit. More information is required about interventions at the community and societal levels. PMID:26896634

  17. Generalized cost-effectiveness analysis for national-level priority-setting in the health sector

    PubMed Central

    Hutubessy, Raymond; Chisholm, Dan; Edejer, Tessa Tan-Torres

    2003-01-01

    Cost-effectiveness analysis (CEA) is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease. The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs) or the coverage, efficacy and adherence rates of interventions (effectiveness). The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness. Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor. PMID:14687420

  18. Violence Affects Physical and Mental Health Differently: The General Population Based Tromsø Study

    PubMed Central

    Friborg, Oddgeir; Emaus, Nina; Rosenvinge, Jan H.; Bilden, Unni; Olsen, Jan Abel; Pettersen, Gunn

    2015-01-01

    This general population-based study examined associations between violence and mental health, musculoskeletal pain, and early disability pension. The prevalence and consequences of good vs. poor adjustment (resilience vs. vulnerability) following encounters with violence were also examined. Data were based on the sixth wave of the “Tromsø Study” (N = 12,981; 65.7% response rate, 53.4% women, M-age = 57.5 years, SD-age = 12.7 years). Self-reported data on psychological (threats) and physical violence (beaten/kicked), mental health (anxiety/depression), musculoskeletal pain (MSP), and granting of disability pension (DP) were collected. Men suffered more violent events during childhood than women did, and vice versa during adulthood. Psychological violence implied poorer mental health and slightly more MSP than physical violence. The risk of MSP was highest for violence occurring during childhood in women and during the last year for men. A dose-response relationship between an increasing number of violent encounters and poorer health was observed. About 58% of individuals reported no negative impact of violence (hence, resilience group), whereas 42% considered themselves as more vulnerable following encounters with violence. Regression analyses indicated comparable mental health but slightly more MSP in the resilience group compared to the unexposed group, whereas the vulnerable group had significantly worse health overall and a higher risk of early granting of DP. Resilience is not an all-or-nothing matter, as physical ailments may characterize individuals adapting well following encounters with violence. PMID:26317970

  19. The quiet revolution: reporting of health outcomes in general medical journals.

    PubMed

    Seymour, J; Newell, D; Shiell, A

    1997-01-01

    This study reviews the extent of evaluation of health outcomes in three general medical journals over the past decade by examining papers published in the original research section of the New England Journal of Medicine (NEJM), The Lancet, and the Medical Journal of Australia (MJA) in 1982 and 1992. Evaluations were identified and classified according to the type of comparison group and the type of outcome measures employed. They were divided into three categories: those employing a comparison group; those employing a before-and-after study design (or own comparison group); and those with no comparison group. The categories of outcome measures were mortality, clinical or intermediate measures of health state, and final outcome measures (quality of life). Results show that the proportion of papers evaluating a health services intervention remained stable over the period. However, the MJA published considerably fewer evaluations than the other journals. In the NEJM and The Lancet, 75 per cent of evaluations incorporated comparison groups, in the MJA, less than 40 per cent. Overall, the proportion of papers reporting final outcome measures increased significantly between 1982 and 1992 (p = 0.04) but the change in each journal individually did not reach statistical significance. This study indicates that the reporting of health outcomes evaluations has remained constant but there has been some change in the use of comparison groups and final outcome measures over time. PMID:10165947

  20. THE RELATIONSHIP BETWEEN EMOTIONAL INTELLIGENCE WITH RELIGIOUS COPING AND GENERAL HEALTH OF STUDENTS

    PubMed Central

    Nesami, Masoumeh Bagheri; Goudarzian, Amir Hossein; Zarei, Houman; Esameili, Pedram; Pour, Milad Dehghan; Mirani, Hesam

    2015-01-01

    Aim: This research organized to determine the relationship between Emotional Intelligence (EI) with Religious Coping and Mental Health of students at Mazandaran University of Medical Sciences. Method: This descriptive and analytical study was conducted in 2014 on 335 students at Mazandaran University of Medical Sciences. Students were selected by stratified random sampling method. The instruments to gather data were Bradberry and Greaves Standard Emotional Intelligence Questionnaire, the 12-item General Health Questionnaire, and the Pargament’s Religious Coping. Data was analyzed by SPSS 21 via descriptive and inferential statistics (Pearson and Spearman’s correlation). Results: Among 335 students under investigation, 144 students were male (43%) and 191 ones were female (57%). Their ages were ranging from 17 to 34 years old (21.02±2.014). Average EI scores, positive religious coping, negative religious coping, and mental health were 91.27, 14.91, 4.86, 5.34, respectively. Moreover, there was a direct and significant relationship between EI and positive religious coping (r=0.282, P<0.001). Conclusions: According to the results of this study, there is a direct correlation between positive religious coping and emotional intelligence. So Strengthening religious coping can promote emotional intelligence that is one component of mental health. PMID:26889101

  1. Use of marketing to disseminate brief alcohol intervention to general practitioners: promoting health care interventions to health promoters.

    PubMed

    Lock, C A; Kaner, E F

    2000-11-01

    Health research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. Thus, a dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. Social marketing techniques can be utilized to aid successful dissemination of research findings and to speed the process by which new information reaches practice. Principles of social marketing include manipulating the marketing mix of product, price, place and promotion. This paper describes the development of a marketing approach and the outcomes from a trial evaluating the effectiveness and cost-effectiveness of manipulating promotional strategies to disseminate actively a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). The promotional strategies consisted of postal marketing, telemarketing and personal marketing. The study took place in general practices across the Northern and Yorkshire Regional Health Authority. Of the 614 GPs eligible for the study, one per practice, 321 (52%) took the programme and of those available to use it for 3 months (315), 128 (41%) actively considered doing so, 73 (23%) actually went on to use it. Analysis of the specific impact of the three different promotional strategies revealed that while personal marketing was the most effective overall dissemination and implementation strategy, telemarketing was more cost-effective. The findings of our work show that using a marketing approach is promising for conveying research findings to GPs and in particular a focus on promotional strategies can facilitate high levels of uptake and consideration in this target group. PMID:11133118

  2. Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia

    PubMed Central

    Ayoub Meo, Sultan; Fahad A Al-Kheraiji, Mohammad; Fahad AlFaraj, Ziyad; abdulaziz Alwehaibi, Nasser; Adnan Aldereihim, Ahmad

    2013-01-01

    Objective: Sandstorms are metrological events and frequently occur in many regions throughout the world. Sandstorms are a main source of long-distance transport of dust, air pollution and cause various health problems. This study aimed to investigate the acute respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia. Methodology: The present descriptive study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period March 2011- June 2012. We selected 517 (308 males, 59.58%) and (209 females, 40.42%), apparently healthy volunteers with mean age 28.6± 3.14 years, who had single outside exposure to sandstorm for the period of 24±2.68 minutes. The acute respiratory and general health complaints were recorded through a comprehensive questionnaire. Results: A large proportion of the subjects who were exposed to sandstorm had complaints of cough 247 (47.77%), runny nose 264(51.06%), wheeze 173(33.46%), acute asthmatic attack 108 (20.88%), eye irritation / redness 252(48.74%), headache 179 (34.62%), body ache 199 (38.5%), sleep disturbance 157(30.36%) and psychological disturbances 194 (37.52%). Conclusion: Exposure to sandstorm causes cough, runny nose, wheeze, acute asthmatic attack, eye irritation / redness, headache, body ache, sleep and psychological disturbances. These results indicate that sandstorm is a prolific source of respiratory and general ailments. It is therefore, suggested that an unnecessary exposure to sandstorm must be avoided. PMID:24353595

  3. Is involvement in school bullying associated with general health and psychosocial adjustment outcomes in adulthood?

    PubMed

    Sigurdson, J F; Wallander, J; Sund, A M

    2014-10-01

    The aim was to examine prospectively associations between bullying involvement at 14-15 years of age and self-reported general health and psychosocial adjustment in young adulthood, at 26-27 years of age. A large representative sample (N=2,464) was recruited and assessed in two counties in Mid-Norway in 1998 (T1) and 1999/2000 (T2) when the respondents had a mean age of 13.7 and 14.9, respectively, leading to classification as being bullied, bully-victim, being aggressive toward others or non-involved. Information about general health and psychosocial adjustment was gathered at a follow-up in 2012 (T4) (N=1,266) with a respondent mean age of 27.2. Logistic regression and ANOVA analyses showed that groups involved in bullying of any type in adolescence had increased risk for lower education as young adults compared to those non-involved. The group aggressive toward others also had a higher risk of being unemployed and receiving any kind of social help. Compared with the non-involved, those being bullied and bully-victims had increased risk of poor general health and high levels of pain. Bully-victims and those aggressive toward others during adolescence subsequently had increased risk of tobacco use and lower job functioning than non-involved. Further, those being bullied and aggressive toward others had increased risk of illegal drug use. Relations to live-in spouse/partner were poorer among those being bullied. Involvement in bullying, either as victim or perpetrator, has significant social costs even 12 years after the bullying experience. Accordingly, it will be important to provide early intervention for those involved in bullying in adolescence. PMID:24972719

  4. Severity of psychiatric disorder and the 30-item general health questionnaire.

    PubMed

    Finlay-Jones, R A; Murphy, E

    1979-06-01

    The 30-item General Health Questionnaire misclassified 26 per cent of respondents in two samples of women who were interviewed by a psychiatrist using the Present State Examination. False negatives were likely to be women with chronic disorders, particularly anxiety states. False positives were likely to be distressed by severe physical illness, a recent adverse life event, or loneliness. Applying a higher threshold score to their GHQ responses would help to separate those with a diagnosable psychiatric disorder from those in states of distress. PMID:476372

  5. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction

    PubMed Central

    2012-01-01

    Background The global burden of the major vascular diseases is projected to rise and to remain the dominant non-communicable disease cluster well into the twenty first century. The Department of Health in England has developed the NHS Health Check service as a policy initiative to reduce population vascular disease risk. The aims of this study were to monitor population changes in cardiovascular disease (CVD) risk factors over the first year of the new service and to assess the value of tailored lifestyle support, including motivational interview with ongoing support and referral to other services. Methods Randomised trial comparing NHS Health Check service only with NHS Health Check service plus additional lifestyle support in Stoke on Trent, England. Thirty eight general practices and 601 (365 usual care, 236 additional lifestyle support) patients were recruited and randomised independently between September 2009 and February 2010. Changes in population CVD risk between baseline and one year follow-up were compared, using intention-to-treat analysis. The primary outcome was the Framingham 10 year CVD risk score. Secondary outcomes included individual modifiable risk measures and prevalence of individual risk categories. Additional lifestyle support included referral to a lifestyle coach and free sessions as needed for: weight management, physical activity, cook and eat and positive thinking. Results Average population CVD risk decreased from 32.9% to 29.4% (p <0.001) in the NHS Health Check only group and from 31.9% to 29.2% (p <0.001) in the NHS Health Check plus additional lifestyle support group. There was no significant difference between the two groups at either measurement point. Prevalence of high blood pressure, high cholesterol and smoking were reduced significantly (p <0.01) in both groups. Prevalence of central obesity was reduced significantly (p <0.01) in the group receiving additional lifestyle support but not in the NHS Health Check only group

  6. [Acute head injuries in primary health care--internet survey conducted with general practitioners].

    PubMed

    Luoto, Teemu M; Artsola, Minna; Helminen, Mika; Liimatainen, Suvi; Kosunen, Elise; Ohman, Juha

    2013-01-01

    Patients with head injury constitute a large population treated in primary health care. It is essential to recognize patients with traumatic brain injury among this notable population to determine the need for more specific evaluation. General practitioners (n=331) in Pirkanmaa hospital district in Finland received an email link to answer the survey. The response rate was 54.1% (n=179). Mean survey score was 20.5 points (max. 25). Only acquaintance with the national traumatic brain injury practice guidelines was associated with greater survey scores. The general practitioners' level of knowledge in managing head injuries was good. Deficiencies were found in the questions dealt with post-traumatic amnesia and the definition of traumatic brain injury. PMID:23786110

  7. General practitioners' perceptions of private health screening: too much paper, anxiety, and reassurance.

    PubMed Central

    Paynton, D; Dunleavey, J; Smith, H

    1998-01-01

    There is no evidence to support the practice of screening consultations that include general physical examinations and batteries of tests; however, many patients may choose, or be sent by their employers, to have private full health screening (FHS). General practitioners (GPs) are routinely sent the results of these screening examinations and are expected to deal with any subsequent care required. GPs recognize some positive aspects of FHS, but in our survey there was a groundswell of dislike for these examinations because of uncertainty about patient benefit (raised anxiety or false assurance) and a potential to irritate the GP. The implications for workload were minimal but resented. GPs would welcome a precise summary of significant findings and for the screening doctor to take greater responsibility for follow-up. PMID:9747551

  8. Evaluating the Relationship Between General Health Vocabulary and Student Achievement in Pharmacology

    PubMed Central

    Webb, Paul

    2014-01-01

    Objective. To determine whether achievement in pharmacology is related to students’ general health vocabulary knowledge. Methods. Students registered for the pharmacology modules in the second (n=117), third (n=54), and fourth (n=41) years of the bachelor of pharmacy degree program completed a general health vocabulary assessment. Results of the vocabulary assessments in Pharmacology 3 and Pharmacology 4 were used to determine the effects of academic progression. Grades in the summative Pharmacology 2 examination served as indicators of achievement in pharmacology. Focus group sessions were held with a convenience sample of Pharmacology 2 (n=12), Pharmacology 3 (n=10), and Pharmacology 4 (n=5) students. Results. A significant, positive correlation between Pharmacology 2 grades and vocabulary assessment scores was demonstrated. Student perceptions revealed during focus group interviews were that poor pharmacy-related vocabulary knowledge impacted their ability to learn pharmacology. Conclusion. Achievement in pharmacology correlated positively with vocabulary knowledge (p=0.031) among a South African, multilingual student cohort in a setting where English is used in teaching and thus is imperative for learning. PMID:25147394

  9. Effect of General Health Status on Chronicity of Low Back Pain in Industrial Workers.

    PubMed

    Seyedmehdi, Seyed Mohammad; Dehghan, Faezeh; Ghaffari, Mostafa; Attarchi, Mirsaeed; Khansari, Bahareh; Heidari, Bijan; Yazdanparast, Taraneh; Norouzi Javidan, Abbas; Emami Razavi, Seyed Hassan

    2016-03-01

    Recognizing patients at a higher risk of developing chronic low back pain (LBP) is important in industrial medicine. This study aimed to assess the power and quality of General Health Questionnaire (GHQ) for prediction of the odds of chronicity of acute LBP. This study was conducted on industrial workers. All subjects with acute LBP who met the inclusion criteria were enrolled. Demographic characteristics, occupational, physical, and mental parameters and the general health status of subjects were evaluated;  they were followed up for developing chronic LBP for one year. Cigarette smoking, high body mass index, job stress, physical load and high GHQ scores were found to be the risk factors for the progression of acute LBP to chronic LBP (P<0.05). Standing position while working, age, work experience, exercise, level of education, weekly work hours and shift work were not the risk factors for chronic LBP (P>0.05). High GHQ score can be a risk factor for progression of acute LBP to chronic LBP. The GHQ in combination with the Job Content Questionnaire can be used as a quick and simple screening tool for detection of subjects at high risk of chronic LBP when evaluating acute LBP in an occupational setting. PMID:27107527

  10. Mouthwash Use in General Population: Results from Adult Dental Health Survey in Grampian, Scotland

    PubMed Central

    Kawecki, Michal M.; Cunningham, Claudia; Bovaird, Iain; Morgan, Rochelle; Rhodes, Kirstin; Watkins, Ray

    2010-01-01

    ABSTRACT Objectives The purpose of this study was to determine the pattern of mouthwash use and to investigate the associated factors in general population. Material and Methods An Adult Dental Health Survey was conducted on 3,022 residents of Grampian region of Scotland (adjusted participation rate 58.2%). Participants received a questionnaire consisting of questions on oral health and behavioural factors. Results The majority of participants (38.1%) have never used mouthwash, 17.5% used mouthwash less than once a month, 19.4% used mouthwash once every few days and 25.1% used mouthwash daily. Prevalence of use decreased with age (P < 0.001). Woman were more likely to use mouthwash than men (P = 0.004). Mouthwash use decreased with decrease in the level of deprivation (P < 0.001). Never-smokers were less likely to use mouthwash (40.3%) compared to smokers (53.1%) or those who stopped smoking (46.5%) (P < 0.001). Mouthwash was used by smaller proportion of people drinking alcohol on daily basis (36.6%), than by abstainers (42.2%) (P = 0.012). There was a positive relationship between flossing or brushing pattern and mouthwash use (P < 0.001). There was statistically significant relationship between mouthwash use and reasons for the last dental visit (P = 0.009). When compared to healthy individuals, mouthwash was used by higher proportion of people reporting that they had gum disease (P = 0.001), ulcers (P = 0.001), oral infections or swelling (P = 0.002) or other problems (P = 0.025). Conclusions Mouthwash use in general population is associated with socio-demographic, health and behavioural factors. PMID:24421979

  11. Should general practitioners purchase health care for their patients? The total purchasing experiment in Britain.

    PubMed

    Wyke, Sally; Mays, Nicholas; Street, Andrew; Bevan, Gwyn; McLeod, Hugh; Goodwin, Nick

    2003-09-01

    Until relatively recently, general practitioners (GPs) have been allowed to work independently, with no requirement to consider the resource implications of their referral and prescribing decisions. In order to align the interests of GPs with the overall objectives of health systems a number of countries have introduced primary care based capitation, funds pooling and budget holding either as experiments or as an overall policy. Are these experiments and policies likely to work? This paper presents evidence from the UK total purchasing experiment, which was the first major quasi-market development in the NHS to be independently evaluated from the outset. Total purchasing gave volunteer groups of practices freedom to purchase all hospital and community health services for their patients. The evidence suggests that whilst GPs have great potential as purchasers, they also have considerable limitations. The expectation that they will be able to improve the quality of patient experience of care, or to alter the use of resources, may not be generally realised. GP-based purchasing may be more appropriate where the task is to alter the balance or location of care between hospital and extramural settings. However, budgetary incentives are not 'magic potions' which have similar effects on behaviour wherever they are introduced. Holding budgets and having independent contracts, while important pre-requisites for being taken seriously in a quasi-market, were not sufficient for effective total purchasing. The paper concludes that health systems should not only value innovation and experimentation and encourage learning from evaluative research; they should also recognise the importance of supportive circumstances for any innovation to effect real and sustained change. PMID:12941492

  12. General Health care counselling General Health care counselling R Harris A Ramsay Williams & Wilkins 114pp £15.00 0-86433-047-2.

    PubMed

    1989-06-24

    Behaviourism traditionally invokes connotations of a judgemental and controlling attitude, which is perhaps unfashionable in nursing. Nevertheless, many factors in contemporary health care (eg, the concept of 'health promotion' or 'the nursing process') are formed by a desire to change behaviour. PMID:27224793

  13. General Human Health Issues For Moon And Mars Missions: Results From The HUMEX Study

    NASA Astrophysics Data System (ADS)

    Horneck, G.; Comet, B.

    Human exploratory missions, such as the establishment of a permanently inhabited lunar base and/or human visits to Mars will add a new dimension to human space flight, concerning the distance of travel, the radiation environment, the gravity lev-els, the duration of the mission, and the level of confinement and isolation the crew will be exposed to. This will raise the significance of several health issues. Besides spaceflight specific risks, such as radiation health, gravity related effects and psy-chological issues, general health issues need to be considered. These individual risks of illness, injury or death are based on general human health statistics. The duration of the mission is the main factor in these considerations. These risk estimations are the base which have to supplemented by the risks related specifically to the nature of the expedition under consideration. Crew health and performance have to be secured during transfer flights, during lunar or Mars surface exploration, including EVAs, and upon return to Earth, as defined within the constraints of safety objectives and mass restrictions of the mission. Within the ESA Study on the Survivability and Adaptation of Humans to Long-Duration Interplanetary and Planetary Environments (so called HUMEX study), we have critically assessed the human responses, limits and needs with regard to the environments of interplanetary and planetary missions. Based on various scenarios, the crew health risks have been evaluated. The main results are as follows: (i) The state of the art shows that bone loss during the long stay in weightlessness, especially during missions to Mars, remains an unacceptable risk. Solutions to control and to prevent this risk shall be developed. (ii) The control of human physical capacity impairment under weightlessness shall be optimized. (iii) Based of the probability of occurrence of diseases and injuries and on the con-straints imposed by exploratory mission scenarios, the crew shall

  14. [Health risks of long-distance air travel. Role of the general practitioner].

    PubMed

    Bazex, Jacques; Cabanis, Emmanuel Alain

    2010-06-01

    Air transport is seeing an increase in long-distance flights (12-16 hours average flight time), greater seating capacity, and a higher proportion of elderly, and hence more fragile, passengers. The French Academy of Medicine recommends that medical care be reinforced, particularly on long-distance flights, through the following measures: (i) passengers should be informed in advance of potential risks, through a Passenger's Guide, (ii) all future passengers should be encouraged to seek health advice and information from their general practitioner, (iii) flight crew members should receive training as "in-flight medical correspondents", and (iv) airlines and plane designers should reserve a "medical space" on the plane, equipped with appropriate medical materials. PMID:21513137

  15. AUPHEP—Austrian Project on Health Effects of Particulates—general overview

    NASA Astrophysics Data System (ADS)

    Hauck, H.; Berner, A.; Frischer, T.; Gomiscek, B.; Kundi, M.; Neuberger, M.; Puxbaum, H.; Preining, O.; Auphep-Team

    AUPHEP was started in 1999 as a 5 years program to investigate the situation of the atmospheric aerosol with respect to effects on human health. At four different sites in Austria (3 urban and one rural site) an extended monitoring program was conducted for PM 1, PM 2.5 and PM 10 as well as particle number concentration for 12 months each. Beside continuous measurements using TEOM and beta attenuation high-volume sampling of PM 2.5 and PM 10 provided samples for chemical analyses of various ions, heavy metals and organic compounds. Furthermore, carbonaceous material (TC, EC, OC) year round and PAHs on selected days were analyzed. From collocated public monitoring stations also pollutant gases (SO 2, NO, NO 2, O 3, CO) and meteorological components are available. In winter and summer campaigns aerosol size spectra including chemical components were measured for at least one week each. All data are collected in a project data base (CD-ROM). While extensive data analysis will be presented in following papers, some general results are presented within this paper: annual averages for PM 1 are between 10 and 20 μg m -3, for PM 2.5 between 15 and 26 mg m -3 and for PM 10 between 20 and 38 μg m -3. Number concentrations are between 10,000 and 30,000 cm -3. Urban concentrations are usually higher in winter, rural concentrations in summer. PM 2.5 is in average around 70% of PM 10, for PM 1 this fraction is about 57%. Several studies on health effects are included in this project: a cross-sectional study on preschool and school children regarding lung function measurements and questionnaires about respiratory impairment in the surrounding area of the monitoring sites as well as time series studies on mortality and respiratory morbidity on the general population.

  16. Perspectives on Obesity and Its Treatment: Health Care Providers and the General Public in Rural West Virginia and Urban Baltimore

    ERIC Educational Resources Information Center

    Menez, Steven; Cheskin, Lawrence; Geller, Gail

    2013-01-01

    Objective: To determine and compare the perspectives of the general public and health care providers (HCPs) on obesity and its treatment in rural West Virginia (WV) and Baltimore, MD. Method: Surveys were completed in both locations by the general public (WV: "n" = 200; Baltimore: "n" = 171) and HCPs (WV: "n" = 25;…

  17. Health hazard evaluation report HETA 85-538-1667, General Telephone Company, Sherman, Texas

    SciTech Connect

    Pettigrew, G.L.

    1986-02-01

    Following an employee request, potential health problems among telephone cable splicers were investigated at the General Telephone Company Sherman, Texas. Information was collected on materials used, work procedures, and personal protective equipment employed. Materials of primary concern were petrolatum in the filled cable, petroleum distillates used as cable cleaner, and isocyanates in the two-part reenterable encapsulant. Personal air samples taken by OSHA during pouring operations with the encapsulant revealed no detectable isocyanate concentrations. Observation of a large splicing operation showed the head of the splicer was positioned over the top of the casing while pouring encapsulant components allowing potential exposure. Petrolatum was determined to be physiologically inert. Nine of 32 potentially exposed workers completed questionnaires. The most frequently reported symptoms were head congestion and headaches at work; 67% reported warts and 33% reported skin rashes. The author concludes that a health hazard to employees does not exist under normal operating conditions. Workers are advised not to use cable cleaner for personal cleanup. To avoid potential isocyanate sensitization, minimizing exposure, use of personal protective equipment, and good work practices are recommended. Cuts and abrasions among splicers may be implicated in wart formation.

  18. Health-hazard evaluation report HETA 85-423-1904, General Electric Company, Evendale, Ohio

    SciTech Connect

    Burr, G.; Singal, M.; Hartle, R.; Rondinelli, R.

    1988-06-01

    A study was made of possible health hazards at the General Electric Company, Evendale, Ohio. Workers were exposed to dusts generated during the grinding of tools and other components containing tungsten carbide. Employee exposure to cobalt, nickel, chromium, tungsten, and total and respirable dust levels were evaluated for 15 machinists working in two cutting and grinding areas. Concentrations of nickel ranged from nondetectable to 20 micrograms/cubic meter (microg/m/sup 3/), time weighted average, which exceeded the NIOSH recommended level of 15 microg/m/sup 3/). Other metals were below permissible levels. A group of 41 individuals participated in a medical study including chest x-ray and determination of blood and urine cobalt concentrations. No evidence of hard-metal disease was noted on the 38 x-rays taken. Only two of ten participants had detectable blood cobalt levels. Of 63 urine specimens, 19 showed detectable cobalt. The authors conclude that a potential hazard existed from airborne exposure to nickel in cutter/grinding areas, and that a potential health hazard from cobalt exposure existed in Building 500.

  19. [General Agreement on Trade in Services and its implications for public health].

    PubMed

    Umaña-Peña, Román; Alvarez-Dardet, Carlos

    2005-01-01

    Due to the economic importance of the service sector and its trade potential, in 1995 the World Trade Organization (WTO) launched the General Agreement on Trade in Services with the objective of liberalizing trade in services worldwide and of establishing rules and disciplines to regulate it. Until now, the Agreement has produced few case laws on its rules and some of them are in the process of being developed, which makes the Agreement ambiguous and hampers accurate forecasting of its implications. Nevertheless, some analysts consider that certain characteristics and rules represent a threat to the funding mechanisms of public services and to the sovereignty of governments to generate their own rules. Moreover, the Agreement would lead to irreversible formalization of commitments, without the possibility of returning to previous conditions in the case of failure of the market and/or private participation. In addition, the Agreement acts against exclusive monopolies and providers and to a certain extent this will affect subsidies to local providers. The ability of the European Communities Court of Justice to enforce the implementation of competitive measures in public services has produced uncertainty because of the implications for health services. The Spanish Agreement with the WTO contains many questions that remain open, representing an opportunity for the participation of the health sector in the next negotiation rounds. PMID:16483527

  20. Is the General Health Questionnaire (12 item) a culturally biased measure of psychiatric disorder?

    PubMed

    Lewis, G; Araya, R I

    1995-01-01

    There have been suggestions that some self-administered questionnaires designed to assess psychiatric disorder tend to overestimate prevalence in samples from Latin America. This phenomenon may be obscured when the General Health Questionnaire (GHQ) is used, as it is recommended that researchers determine the threshold in each setting by comparing the GHQ with a standardised interview. Reports in the literature suggest that Latin American samples have a higher threshold for case definition using the GHQ than that found in British samples. The present study confirmed this finding when comparing the 12-item GHQ in a Chilean primary care sample with a sample of primary care attenders from the United Kingdom. The increase in GHQ scores in the Chilean sample persisted after adjustment for age, sex, marital status and the score on the Revised Clinical Interview Schedule (CIS-R). The increase in scores seen in the Chilean sample was only found in that half of the GHQ that asks about negative aspects of mental health. PMID:7892614

  1. Epidemiological pattern of tattoo skin disease: a potential general health indicator for cetaceans.

    PubMed

    Van Bressem, Marie-Françoise; Van Waerebeek, Koen; Aznar, Francisco Javier; Raga, Juan Antonio; Jepson, Paul D; Duignan, Pádraig; Deaville, Rob; Flach, Leonardo; Viddi, Francisco; Baker, John R; Di Beneditto, Ana Paula; Echegaray, Mónica; Genovo, Tilen; Reyes, Julio; Felix, Fernando; Gaspar, Raquel; Ramos, Renata; Peddemors, Vic; Sanino, Gian Paolo; Siebert, Ursula

    2009-07-23

    The presence of tattoo skin disease (TSD) was examined in 1392 free-ranging and dead odontocetes comprising 17 species from the Americas, Europe, South Africa, New Zealand and Greenland. We investigated whether TSD prevalence varied with sex, age and health status. TSD was encountered in cetaceans from the Pacific and Atlantic Oceans as well as in those from the North, Mediterranean and Tasman Seas. No clear patterns related to geography and host phylogeny were detected, except that prevalence of TSD in juveniles and, in 2 species (dusky dolphin Lagenorhynchus obscurus and Burmeister's porpoise Phocoena spinipinnis), in adults was remarkably high in samples from Peru. Environmental factors and virus properties may be responsible for this finding. Sex did not significantly influence TSD prevalence except in the case of Peruvian P. spinipinnis. Generally, there was a pattern of TSD increase in juveniles compared to calves, attributed to the loss of maternal immunity. Also, in most samples, juveniles seemed to have a higher probability of suffering TSD than adults, presumably because more adults had acquired active immunity following infection. This holo-endemic pattern was inverted in poor health short-beaked common dolphins Delphinus delphis and harbour porpoises Phocoena phocoena from the British Isles, and in Chilean dolphins Cephalorhynchus eutropia from Patagonia, where adults showed a higher TSD prevalence than juveniles. Very large tattoos were seen in some adult odontocetes from the SE Pacific, NE Atlantic and Portugal's Sado Estuary, which suggest impaired immune response. The epidemiological pattern of TSD may be an indicator of cetacean population health. PMID:19750811

  2. The appropriateness of gatekeeping in the provision of reproductive health care for adolescents in Lithuania:the general practice perspective

    PubMed Central

    Jaruseviciene, Lina; Levasseur, Gwenola

    2006-01-01

    Background Adolescents' consultation of primary health care services remains problematic despite their accessibility. The reproductive health service seeking behavior of adolescents is the object of much research but little is known about how this behavior is influenced by the gatekeeping system. This study aimed to explore general practitioners' perceptions of the appropriateness of gatekeeping in adolescent reproductive health care. Methods Twenty in-depth interviews regarding factors affecting adolescent reproductive health care were carried out on a diverse sample of general practitioners and analyzed using grounded theory. Results The analysis identified several factors that shaped GPs' negative attitude to gatekeeping in adolescent reproductive health care. Its appropriateness in this field was questionable due to a lack of willingness on the part of GPs to provide reproductive health services for teenagers, their insufficient training, inadequately equipped surgeries and low perceived support for reproductive health service provision. Conclusion Since factors for improving adolescent reproductive health concern not only physicians but also the health system and policy levels, complex measures should be designed to overcome these barriers. Discussion of a flexible model of gatekeeping, encompassing both co-ordination of care provided by GPs and the possibility of patients' self-referral, should be included in the political agenda. Adolescents tend to under-use rather than over-use reproductive health services and every effort should be made to facilitate the accessibility of such services. PMID:16536876

  3. Internal consistency and factor structure of 12-item general health questionnaire in visually impaired students

    PubMed Central

    Bakhla, Ajay Kumar; Verma, Vijay; Hembram, Mahesh; Praharaj, Samir Kumar; Sinha, Vinod Kumar

    2013-01-01

    Background: As there are no instruments to measure psychological wellness or distress in visually impaired students, we studied internal consistency and factor structure of GHQ-12 in visually impaired children. Materials and Methods: Internal consistency analysis (Cronbach's alpha and item total correlation) and exploratory factor analysis (principal component analysis) were carried out to identify factor structure of 12-item general health questionnaire (GHQ-12). Results: All items of GHQ-12 were significantly associated with each other and the Cronbach's alpha coefficient for the scale was 0.7. On analysis of principal component, three-factor solution was found that accounted for 47.92% of the total variance. The factors included, ‘general well-being’, ‘depression’ and ‘cognitive’, with Cronbach's alpha coefficients being 0.70, 0.59, and 0.34, respectively. Conclusion: Our study findings suggest GHQ-12 is a reliable with adequate internal consistency scale and multidimensional factor structure in visually impaired students. PMID:25013310

  4. Sparse generalized pencil of function and its application to system identification and structural health monitoring

    NASA Astrophysics Data System (ADS)

    Mohammadi-Ghazi, Reza; Büyüköztürk, Oral

    2016-04-01

    Singularity expansion method (SEM) is a system identification approach with applications in solving inverse scattering problems, electromagnetic interaction problems, remote sensing, and radars. In this approach, the response of a system is represented in terms of its complex poles; therefore, this method not only extracts the fundamental frequencies of the system from the signal, but also provides sufficient information about system's damping if its transient response is analyzed. There are various techniques in SEM among which the generalized pencil-of-function (GPOF) is the computationally most stable and the least sensitive one to noise. However, SEM methods, including GPOF, suffer from imposition of spurious poles on the expansion of signals due to the lack of apriori information about the number of true poles. In this study we address this problem by proposing sparse generalized pencil-of-function (SGPOF). The proposed method excludes the spurious poles through sparsity-based regularization with ℓ1-norm. This study is backed by numerical examples as well as an application example which employs the proposed technique for structural health monitoring (SHM) and compares the results with other signal processing methods.

  5. Determinants of Health-Related Quality of Life in School-Aged Children: A General Population Study in the Netherlands

    PubMed Central

    Houben-van Herten, Marieke; Bai, Guannan; Hafkamp, Esther; Landgraf, Jeanne M.; Raat, Hein

    2015-01-01

    Background Health related quality of life is the functional effect of a medical condition and/or its therapy upon a patient, and as such is particularly suitable for describing the general health of children. The objective of this study was to identify and confirm potential determinants of health-related quality of life in children aged 4-11 years in the general population in the Netherlands. Understanding such determinants may provide insights into more targeted public health policy. Methods As part of a population based cross sectional study, the Child Health Questionnaire (CHQ) Parental Form 28 was used to measure health-related quality of life in school-aged children in a general population sample. Parents of 10,651 children aged 4-11 years were interviewed from January 2001 to December 2009. Results Multivariate and regression analyses demonstrated a declined CHQ Physical Summary score for children who had >1 conditions, disorders or acute health complaints and who were greater consumers of healthcare; children with a non-western immigrant background; and children whose parents did not work. Lower CHQ Psychosocial Summary score was reported for children who had >1 conditions, disorders or acute health complaints, boys, children of single parents and obese children. Conclusion The best predictors of health-related quality of life are variables that describe use of health care and the number of disorders and health complaints. Nonetheless, a number of demographic, socio-economic and family/environmental determinants contribute to a child’s health-related quality of life as well. PMID:25933361

  6. Effort-Reward Imbalance and Mental Health Problems in 1074 German Teachers, Compared with Those in the General Population.

    PubMed

    Hinz, Andreas; Zenger, Markus; Brähler, Elmar; Spitzer, Silvia; Scheuch, Klaus; Seibt, Reingard

    2016-08-01

    High degrees of premature retirement among teachers warrant investigating the occupational burden and the mental health status of this profession. A sample of 1074 German teachers participated in this study. Two samples of the general population (N = 824 and N = 792) were used as comparison groups. Work distress was assessed with the Effort-Reward-Imbalance questionnaire, and mental health problems were measured with the General Health Questionnaire (GHQ-12). Teachers reported more effort-reward imbalance (M = 0.64) compared with the general population (M = 0.57), and they perceived more mental health problems (GHQ: M = 12.1) than the comparison group (M = 9.5). School type was not associated with work stress and mental health. Teachers with leading functions perceived high degrees of effort and reward, resulting in a moderate effort-reward ratio and no heightened mental health problems. Teachers working full time reported more effort than teachers working part time, but the reward mean values of both groups were similar. This results in a somewhat unfavourable effort-reward ratio of teachers working full time. Moreover, teachers working full time reported more mental health problems. The results support the appropriateness of the effort-reward conception, applied to the profession of teachers. The higher degree of effort-reward imbalance and the level of mental health problems warrant preventive measures. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25053122

  7. Short, Subjective Measures of Numeracy and General Health Literacy in an Adult Emergency Department Setting

    PubMed Central

    Wallston, Kenneth A.; Rothman, Russell L.; Marcovitz, David E.; Storrow, Alan B.

    2014-01-01

    Objectives To evaluate the reliability and validity of brief subjective measures of numeracy and general health literacy in the adult emergency department setting. Methods A convenience sample of adult emergency department patients completed subjective measures of general health literacy (Short Literacy Screening questions, SLS) and numeracy (Subjective Numeracy Scale, SNS). These patients also completed two objective tests of literacy (the Short Test of Functional Health Literacy in Adults, S-TOFHLA; and the Rapid Estimate of Adult Literacy in Medicine, REALM) and an objective test of numeracy (WRAT4). Internal reliability of the subjective measures was assessed using Cronbach’s alpha. Construct validity of the subjective measures was assessed by correlating them against the S-TOFHLA, REALM, and WRAT4, using Spearman’s rank correlation coefficients, receiver operating characteristics (ROC) curves, and hierarchical, multiple linear regression with adjustment for patient age, gender, race, and education. Results The median age of the 207 patients surveyed was 46 (interquartile range 32, 59); twenty-seven percent were African American. Sixty-one percent of patients reported their highest level of education was high school or below. As measured by the S-TOFHLA and REALM, most patients had adequate literacy levels (89% and 80%, respectively), while 44% of patients had below average numeracy skills on the WRAT4. Median SLS was 14 (IQR 12, 15) on a scale of 3 to 15; median SNS was 36 (IQR 30, 42) on a scale of 6 to 48. The SLS and SNS had good internal reliability, with Cronbach’s alphas of 0.74 and 0.82, respectively. The SLS Spearman’s rank order correlation coefficient was 0.33 (95% confidence interval 0.20, 0.45) for the S-TOFHLA, with a standardized beta coefficient of 0.36 (p<0.05) after adjustment for patient demographics. The SLS correlation coefficient was 0.26 (95% CI 0.13, 0.38) for the REALM, with a standardized beta coefficient of 0.38 (p<0.05) after

  8. Health-related quality of life in Korean lymphoma survivors compared with the general population.

    PubMed

    Kim, Soo Hyun; Kim, Im-Ryung; Kim, So Hee; Lee, Suyeon; Ok, Onam; Kim, Won Seog; Suh, Cheolwon; Lee, Moon Hee

    2014-09-01

    The objective of this study was to evaluate the health-related quality of life (HRQOL) of lymphoma survivors, to compare it with that of the general population, and to identify its predictors in lymphoma survivors. We enrolled 837 participants (mean age, 54.6 years; mean time since diagnosis, 6.3 years) with a history of Hodgkin's lymphoma (HL) (n = 58) or non-Hodgkin's lymphoma (NHL) (n = 779) who had been treated at any of three Korean hospitals from 1989 through 2010. For controls, we selected 1,000 subjects randomly from a representative Korean population. We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Hospital Anxiety and Depression Scale. Overall, the HRQOL in both groups of survivors and the general population were comparable, but we observed clinically meaningful worse social functioning in NHL survivors (p < 0.001) and more severe fatigue in HL survivors (p < 0.001) than in the general population. Analysis of covariance revealed no clinically meaningful difference in HRQOL associated with age or sex. Survivors who received peripheral blood stem cell transplants showed clinically meaningful worse role (p = 0.001) and social (p < 0.001) functioning than those who were treated with first-line chemotherapy alone. In multivariate analyses, fatigue, depression, and financial difficulties emerged as the strongest predictors for almost all subscales of functioning and global quality of life. Interventions for alleviating fatigue, depression, and financial difficulties are needed to enhance the HRQOL of Korean lymphoma survivors. PMID:24947794

  9. Health Information Brokers in the General Population: An Analysis of the Health Information National Trends Survey 2013-2014

    PubMed Central

    Mazor, Kathleen M; Agunwamba, Amenah A; Valluri, Sruthi; Wilson, Patrick M; Sadasivam, Rajani S; Finney Rutten, Lila J

    2016-01-01

    Background Health information exchanged between friends or family members can influence decision making, both for routine health questions and for serious health issues. A health information broker is a person to whom friends and family turn for advice or information on health-related topics. Characteristics and online behaviors of health information brokers have not previously been studied in a national population. Objective The objective of this study was to examine sociodemographic characteristics, health information seeking behaviors, and other online behaviors among health information brokers. Methods Data from the Health Information National Trends Survey (2013-2014; n=3142) were used to compare brokers with nonbrokers. Modified Poisson regression was used to examine the relationship between broker status and sociodemographics and online information seeking. Results Over half (54.8%) of the respondents were consulted by family or friends for advice or information on health topics (ie, they acted as health information brokers). Brokers represented 54.1% of respondents earning <$20,000 yearly and 56.5% of respondents born outside the United States. Women were more likely to be brokers (PR 1.34, 95% CI 1.23-1.47) as were those with education past high school (PR 1.42, CI 1.22-1.65). People aged ≥75 were less likely to be brokers as compared to respondents aged 35-49 (PR 0.81, CI 0.67-0.99). Brokers used the Internet more frequently for a variety of online behaviors such as seeking health information, creating and sharing online content, and downloading health information onto a mobile device; and also reported greater confidence in obtaining health information online. Conclusions More than 50% of adults who responded to this national survey, including those with low income and those born abroad, were providing health information or advice to friends and family. These individuals may prove to be effective targets for initiatives supporting patient engagement

  10. A Cross-Sectional Survey of Childhood Trauma and Compliance With General Health Care Among Adult Primary Care Outpatients

    PubMed Central

    Jordan Bohinc, R.; Wiederman, Michael W.

    2014-01-01

    Objective: Beyond the examination of medication compliance among individuals with substance abuse or human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), few studies have examined relationships between childhood trauma and health care compliance in adulthood—the focus of the present study. Method: Using a cross-sectional approach and a self-report survey methodology, we examined 5 types of childhood trauma (ie, witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to 4 measures of general health care compliance (ie, self-rated general conscientiousness with medical treatment; 5 items pertaining to general health care compliance such as scheduling regular dental checkups, timely arrival for doctor’s appointments, and timely completion of laboratory work; 2 medication compliance items; and the Medical Outcomes Study general adherence score) among a sample of adult primary care outpatients (N = 272). Data were collected in March 2014. Results: According to findings, some health care adherence variables demonstrated relationships with the summed childhood trauma score, whereas others did not. It could be interpreted that the more subjective health care compliance variables (eg, self-rated conscientiousness with regard to medical treatment) demonstrated no relationship with a summed childhood trauma score, whereas the more objective health care compliance variables (eg, frequency of regular dental checkups, ability to remember to take all medications, Medical Outcomes Study general adherence score) did demonstrate statistically significant relationships with a summed childhood trauma score (most at P < .01). Conclusions: Patients with histories of childhood trauma demonstrate some deficits with health care compliance in comparison to those without childhood trauma. One interpretation is that the mistreated appear to believe that they are fairly compliant with health care treatment, but

  11. General human health issues for Moon and Mars missions: Results from the HUMEX study

    NASA Astrophysics Data System (ADS)

    Horneck, Gerda; Comet, Bernard

    The general health issues considered in two scenarios of human long-term exploratory missions, which include a mission to a lunar base and a mission to Mars, have been analysed. Based on statistical data from occupational and normal population groups of Western countries, the following safety objectives have been chosen: individual risk of death by illness (=natural death) during the mission shall be <2 × 10-3/year, that by injury (=accidental death) <4 × 10-4/year, and that from all causes, including spacecraft failure (taken from most exposed professions) <3 × 10-2/year. Using the classical reliability requirements for human space missions, reliability objectives have been set for each mission scenario, resulting in values compatible with the mission safety objectives. The main results are as follows: (i) based of the probability of occurrence of diseases and injuries and on the constraints imposed by exploratory mission scenarios, the crew shall have a full autonomy in terms of medical and surgical diagnostics and care means and competency; (ii) the control of the toxic and biological risks in a confined environment for a so long exposure shall be carefully analyzed and the technical solutions shall master these risks; (iii) the state of the art shows that bone loss during the long stay in weightlessness, especially during missions to Mars, remains an unacceptable risk. Solutions to control and to prevent this risk shall be developed; (iv) the control of human physical capacity impairment under weightlessness shall be optimised. A roadmap in the field of health care has been elaborated for a future European participation strategy towards human exploratory missions taking into account preparatory activities, such as analogue situations and ISS opportunities, and potential terrestrial applications and benefits.

  12. General population norms of the Swedish short forms of oral health impact profile.

    PubMed

    Larsson, P; John, M T; Hakeberg, M; Nilner, K; List, T

    2014-04-01

    We reported the development and psychometric evaluation of a Swedish 14-item and a five-item short form of the Oral Health Impact Profile. The 14-item version was derived from the English-language short form developed by Slade in1997. The five-item version was derived from the German-language short form developed by John et al. in 2006. Validity, reliability and normative values for the two short form summary scores were determined in a random sample of the adult Swedish population (response rate: 46%, N = 1366 subjects). Subjects with sufficient OHRQoL information to calculate a summary score (N = 1309) were on average 50·1 ± 17.4 years old, and 54% were women. Short form summary scores correlated highly with the 49-item OHIP-S (r ≥ 0.97 for OHIP-S14, r ≥ 0.92 for OHIP-S5) and with self-report of oral health (r ≥ 0.41). Reliability, measured with Cronbach's alpha (0.91 for OHIP-S14, 0.77 for OHIP-S5), was sufficient. In the general population, 50% of the subjects had ≥2 OHIP-S14 score points and 10% had ≥11 points, respectively. Among subjects with their own teeth only and/or fixed dental prostheses and with partial removable dental prostheses, 50% of the population had ≥2 OHIP-S14 score points, and 10% had ≥11 points. For subjects with complete dentures, the corresponding figures were 3 and 24 points. OHIP-S5 medians for subjects in the three population groups were 1, 1 and 2 points. Swedish 14-item and 5-item short forms of the OHIP have sufficient psychometric properties and provide a detailed overview about impaired OHRQoL in Sweden. The norms will serve as reference values for future studies. PMID:24447237

  13. Qualitative evaluation of general practices developing training for a range of health disciplines.

    PubMed

    Hughes, Lesley A

    2014-01-01

    This study adopted an interpretative approach, using focus groups and face-to-face interviews to evaluate the development of a five-year pilot project within general practice. The aim of the project is for these practices to offer training to a range of health disciplines from varying academic levels, develop capacity and provide interprofessional education as part of the learning ethos. Eight consortia are involved in the project, which is funded by the workforce and education directorate and the Deanery of the Yorkshire and Humber Strategic Health Authority. The evaluation was undertaken 18 months into the project, to understand the views and experiences of primary care practitioners and university educationalists, in order to identify achievements and barriers to the project's development. The study revealed positive attitudes towards the project, and that steps are being taken to engage in dialogue with universities to increase student numbers, but progress is slow. Early experiences of student nurses taking up placements in the practices reveal incompatible learning outcomes between what is expected for curriculum and learning opportunities within primary care. A common concern is the impact increased students may pose on existing support structures, and that this may compromise student learning. Concern is evident over self-belief and competencies to teach across professions, and the ambiguity over the learning outcomes for IPE and the training required to support this. It is recommended that a systems theory be adopted to provide strategic planning across clinical and education organisations to ensure that structures of communication, leadership and training adequately meet the aims of the project. The paper will be of interest to practitioners in primary care who may be considering expanding services and training, and to educationalists seeking to allocate students to placements in primary care. PMID:24423800

  14. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s

    PubMed Central

    2012-01-01

    Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist into the Australian general practice environment. Methods A sample of general practitioners, health care consumers, pharmacists and practice managers in South-East Queensland were invited to participate in focus groups or semi-structured interviews. Seeding questions common to all sessions were used to facilitate discussion. Sessions were audio recorded and transcribed verbatim. Leximancer software was used to qualitatively analyse responses. Results A total of 58 participants took part in five focus groups and eighteen semi-structured interviews. Concepts relating to six themes based on the seeding questions were identified. These included positively viewed roles such as medication reviews and prescribing, negatively viewed roles such as dispensing and diagnosing, barriers to pharmacist integration such as medical culture and remuneration, facilitators to pharmacist integration such as remuneration and training, benefits of integration such as access to the patient’s medical file, and potential funding models. Conclusions These findings and future research may aid the development of a new model of integrated primary health care services involving pharmacist practitioners. PMID:22852792

  15. Sexual Self-Concept and General Health in Rheumatoid Arthritis Patients

    PubMed Central

    Saadat, Seyed Hassan; Ramezani, Arash; Ahmadi, Khodabakhsh

    2015-01-01

    Background: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients. Objectives: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population. Patients and Methods: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant. Results: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P < 0.05). Sexual health was lower in the RA population (P < 0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6 ± 4.4 vs. 12.2 ± 4.5, P = 0.024; lubrication 6.9 ± 2.1 vs. 6.2 ± 2.1, P = 0.017; orgasm 10.4 ± 2.8 vs. 9.5 ± 3.2, P = 0.37; pain 10.1 ± 2.2 vs. 10.8 ± 1.9, P = 0.013; enjoyment 23.8 ± 5.8 vs. 21.3 ± 7.5, P = 0.009 and partner related 8.5 ± 1.7 vs. 7.6 ± 2.4, P = 0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population. Conclusions: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients. PMID:26568849

  16. Utility Values for Advanced Soft Tissue Sarcoma Health States from the General Public in the United Kingdom

    PubMed Central

    Guest, Julian F.; Sladkevicius, Erikas; Gough, Nicholas; Linch, Mark; Grimer, Robert

    2013-01-01

    Soft tissue sarcomas are a rare type of cancer generally treated with palliative chemotherapy when in the advanced stage. There is a lack of published health utility data for locally advanced “inoperable”/metastatic disease (ASTS), essential for calculating the cost-effectiveness of current and future treatments. This study estimated time trade-off (TTO) and standard gamble (SG) preference values associated with four ASTS health states (progressive disease, stable disease, partial response, complete response) among members of the general public in the UK (n = 207). The four health states were associated with decreases in preference values from full health. Complete response was the most preferred health state (mean utility of 0.60 using TTO). The second most preferred health state was partial response followed by stable disease (mean utilities were 0.51 and 0.43, respectively, using TTO). The least preferred health state was progressive disease (mean utility of 0.30 using TTO). The utility value for each state was significantly different from one another (P < 0.001). This study demonstrated and quantified the impact that different treatment responses may have on the health-related quality of life of patients with ASTS. PMID:23576896

  17. BMI-specific waist circumference is better than skinfolds for health-risk determination in the general population.

    PubMed

    Dogra, Shilpa; Clarke, Janine; Roy, Joel; Fowles, Jonathon

    2015-02-01

    Distribution of fat is important when considering health risk; however, the value added from skinfold measurements (SKF) when using body mass index (BMI) refined by waist circumference (WC) is not well understood. The purpose of this study was to assess the utility of SKF compared with WC in determination of health risk in the general population. Data from the Canadian Health Measures Survey (cycles 1 and 2; N = 5217) were used. Health outcomes included directly measured blood pressure, cholesterol, glycated haemoglobin, lung function, self-reported health, and chronic conditions. Technical errors of measurements (TEM), sensitivity, and specificity analysis and linear regressions were conducted. Data indicated that TEM for SKF was above the acceptable 5% in most age and sex categories. Sensitivity and specificity of chronic conditions was not improved with the inclusion of SKF in models containing WC (in those aged 45-69 years) and SKF did not explain any additional variance in regression models containing WC. Health outcomes for those in the normal weight and overweight BMI category were significantly worse in those classified as high risk based on WC, whereas SKF did not consistently discriminate risk. In conclusion, evidence-based WC cut-points were shown to identify health risk, particularly in normal weight and overweight individuals. Thus, BMI refined by WC appears to be more appropriate than SKF for assessment of body composition when determining health risk in the general population. PMID:25591950

  18. The immune system, natural autoantibodies and general homeostasis in health and disease.

    PubMed

    Poletaev, A; Boura, P

    2011-10-01

    It is generally accepted that the destination of the immune system is not only to discriminate between self and non-self but also to mount responses against non-self. During the last decades, it became evident that weak self-reactivity is a necessary condition for immune homeostasis. Natural self reactivity and the internal image created by autoantibodies, participate greatly to the maintenance of homeostasis. Under conditions of increased or altered antigenic pressure, the homeostatic status is disrupted and the organism becomes vulnerable to the emergence of diseases. "Immunculus" is the self-reactive and interconnected entity of the immune system, provided by a complicated network of natural autoantibobies of different specificity, as a mosaic picture. Quantitative changes in each part of the image are related to variations of expression of relative antigens. The immune system takes in account image information from the continuous screening of the antigenic status and compares between presented state and the desired (optimal) one. Substantial and prolonged deviations from the optimal state, triggers the induction of compensatory and reparative processes, aiming to restore molecular and functional homeostasis. So, natural autoimmunity through the ability of natural a-Abs to induce mechanisms of natural and acquired immunity, aims to prevent pathogenic processes and maintain or restore health status. PMID:24391407

  19. The World Health Organisation. Interview with the director general. Interview by Fiona Godlee.

    PubMed Central

    Nakajima, H.

    1995-01-01

    Dr Hiroshi Nakajima was elected director general of WHO in 1988. Born in Japan, he trained as a psychiatrist before joining WHO in 1973. He was WHO's regional director for the Western Pacific from 1979 to 1988. His term of office has been marked by criticism of his management style and allegations of misuse of WHO's funds. I spoke to him at WHO's headquarters in Geneva in July. I have presented the interview in the form of questions and answers. It would be misleading, however, not to make clear that in doing so I have transcribed conversation which was at times extremely difficult to follow. I feel that it is important to emphasise this in the context of an interview with an international leader, one of whose primary tasks must be to communicate his views on health to people across the world. The interviews gave me first hand experience of the difficulties in communication that staff, diplomats, and others, including Japanese leaders, have consistently commented on since Dr Nakajima took office. Images p583-a p584-a p585-a p586-a PMID:7888938

  20. Mental health problems of undocumented migrants in the Netherlands: A qualitative exploration of recognition, recording, and treatment by general practitioners

    PubMed Central

    Van Bavel, Eric; Van Den Driessen Mareeuw, Francine; Macfarlane, Anne; Van Weel-Baumgarten, Evelyn; Van Den Muijsenbergh, Maria; Van Weel, Chris

    2015-01-01

    Objective. To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Design. Qualitative study design with semi-structured interviews using a topic guide. Subjects and setting. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. Results. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM’s lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. Conclusions. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs. PMID:25961462

  1. Physical Education and General Health Courses and Minority Community College Student Risk Levels for Poor Health and Leisure-Time Exercise Patterns

    ERIC Educational Resources Information Center

    Sullivan, Sally L.; Keating, Xiaofen Deng; Chen, Li; Guan, Jianmin; Delzeit-McIntyre, Linda; Bridges, Dwan

    2008-01-01

    College education is the last opportunity to educate a large segment of young adults to be physically active and develop a healthy lifestyle. This study examined minority community college student risks for cardiovascular disease, physical activity (PA) patterns, and effects of physical education and general health courses on promoting PA.…

  2. The Health Consequences of Smoking for Women. A Report of the Surgeon General 1979.

    ERIC Educational Resources Information Center

    Pinney, John M., Ed.; And Others

    This report focuses on the evidence about the health consequences of smoking for women, and is intended to serve the public health and medical communities as a unified source of existing scientific research. The major issues about tobacco use and women's health are examined, including trends in consumption, biomedical evidence, and determinants of…

  3. An international study of psychological problems in primary care. Preliminary report from the World Health Organization Collaborative Project on 'Psychological Problems in General Health Care'.

    PubMed

    Sartorius, N; Ustün, T B; Costa e Silva, J A; Goldberg, D; Lecrubier, Y; Ormel, J; Von Korff, M; Wittchen, H U

    1993-10-01

    This article describes a large longitudinal multicenter collaborative study that investigated the form, frequency, course, and outcome of psychological problems that were seen in primary health care settings in 15 different sites around the world. The research employed a two-stage sampling design in which the 12-item General Health Questionnaire was administered to 26,422 persons aged 18 to 65 years who were consulting health care services. Of these persons, 5604 were selected for detailed examinations using standardized instruments and were followed up at 3 months and 1 year to provide information on course and outcome. All assessment instruments have been translated into 13 different languages. The project has produced a database that allows for the exploration of the nature of psychological disorders experienced by patients in general medical care and their association with physical illness, illness behavior, and disability over time. PMID:8215805

  4. Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population.

    PubMed

    Müller, Juliana Dos Santos; Falcão, Ila Rocha; Couto, Maria Carolina Barreto Moreira; Viana, Wendel da Silva; Alves, Ivone Batista; Viola, Denise Nunes; Woods, Courtney Georgette; Rêgo, Rita Franco

    2016-01-01

    Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the "Physical Health" domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen's work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil's economy and food system. PMID:27164118

  5. Are health and happiness the product of wisdom? The relationship of general mental ability to educational and occupational attainment, health, and well-being.

    PubMed

    Judge, Timothy A; Ilies, Remus; Dimotakis, Nikolaos

    2010-05-01

    This study tested a structural model explaining the effects of general mental ability on economic, physical, and subjective well-being. A model was proposed that linked general mental ability to well-being using education, unhealthy behaviors (smoking and excessive drinking), occupational prestige, and health as mediating variables. The sample consisted of 398 individuals, from whom measures were collected across 4 periods. The results supported a model that includes direct and indirect (through unhealthy behaviors and occupational prestige) links from mental ability to physical well-being (i.e., health) and economic well-being. Furthermore, the results supported the relationships of economic well-being and physical well-being to subjective well-being. Overall, the study underscores the importance of general mental ability to work and nonwork outcomes, including physical, economic, and psychological well-being. PMID:20476826

  6. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies.

    PubMed

    Vosoogh Moghaddam, A; Damari, B; Alikhani, S; Salarianzedeh, Mh; Rostamigooran, N; Delavari, A; Larijani, B

    2013-01-01

    Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5(th) 5-years economical, social and cultural plan (5(th)5YDP:2011-2015), listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5(th)5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5th plan. The strategies of 5(th)5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization. PMID:23865015

  7. Sleep quality and general health status of employees exposed to extremely low frequency magnetic fields in a petrochemical complex

    PubMed Central

    2014-01-01

    Background Advances in science and technology of electrical equipment, despite increasing human welfare in everyday life, have increased the number of people exposed to Electro-Magnetic Fields (EMFs). Because of possible adverse effects on the health of exposed individuals, the EMFs have being the center of attention. This study was performed to determine possible correlation between Extremely Low Frequency Electro-Magnetic Fields (ELF EMFs) and sleep quality and public health of those working in substation units of a petrochemical complex in southern Iran. Materials and method To begin with, magnetic flux density was measured at different parts of a Control Building and two substations in accordance with IEEE std 644–1994. Subsequently, the questionnaires “Pittsburgh Sleep Quality Index” (PSQI) and “General Health Quality (GHQ)” were used to investigate relationship between ELF exposure level and sleep quality and public health, respectively. Both questionnaires were placed at disposal of a total number of 40 workers at the complex. The filled out questionnaires were analyzed by T-test, Duncan and the Chi-square tests. Results The obtained results revealed that 28% of those in case group suffered from poor health status and 61% were diagnosed with a sleep disorder. However, all members in control group were in good health condition and only 4.5% of them had undesirable sleep quality. Conclusion In spite of a significant difference between the case and control groups in terms of sleep quality and general health, no significant relationship was found between the exposure level and sleep quality and general health. It is worth noting that the measured EMF values were lower than the standard limits recommended by American Conference of Industrial Hygienists (ACGIH). However, given the uncertainties about the pathogenic effects caused by exposure to ELF EMFs, further epidemiological studies and periodic testing of personnel working in high voltage substations

  8. Anatomy of a public health agency turnaround: the case of the general health district in Mahoning County.

    PubMed

    Honoré, Peggy A; Stefanak, Matthew; Dessens, Scott

    2012-01-01

    A turnaround describes an organization's ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines. PMID:22635191

  9. Fostering participation of general practitioners in integrated health services networks: incentives, barriers, and guidelines

    PubMed Central

    de Stampa, Matthieu; Vedel, Isabelle; Bergman, Howard; Novella, Jean-Luc; Lapointe, Liette

    2009-01-01

    Background While the active participation of general practitioners (GPs) in integrated health services networks (IHSNs) plays a critical role in their success, little is known about the incentives and barriers to their actual participation. Methods Data were gathered through semi-structured interviews and a mail survey with GPs enrolled in SIPA (system of integrated care for older persons) at 2 sites in Montreal. A total of 61 GPs completed the questionnaire, from which 22 were randomly selected for the qualitative study, with active and non-active participation in the IHSN. Results The key themes associated with GP participation were clinician characteristics, consequences perceived at the outset, the SIPA implementation process, relationships with the SIPA team and professional consequences. The incentive factors reported were collaborative practices, high rates of elderly and SIPA patients in their clienteles, concerns about SIPA, the selection of frail elderly patients, close relationships with the case manager, the perceived efficacy of SIPA, and improved professional practices. Barriers to GP participation included high expectations, GP recruitment, lack of information on SIPA, difficult relationships with SIPA geriatricians and deterioration of physician-patient relationships. Four profiles of participation were identified: 2 groups of participants active in SIPA and 2 groups of participants not active in SIPA. The active GPs were familiar with collaborative practices, had higher IHSN patient rates, expressed more concerns than expectations, reported satisfactory relationships with case managers and perceived the efficacy of SIPA. Both active and non-active GPs reported quality care in the IHSN and improved professional practice. Conclusion Throughout the implementation process, the participation of GPs in an IHSN depends on numerous professional (clinician characteristics) and organizational factors (GP recruitment, relationships with case managers). Our

  10. The impact of triathlon training and racing on athletes' general health.

    PubMed

    Vleck, Veronica; Millet, Gregoire P; Alves, Francisco Bessone

    2014-12-01

    Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries 'causing cessation or reduction of training or seeking of medical aid' are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9-2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed. PMID:25292108

  11. Factorial invariance of the Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire

    PubMed Central

    Ryan, Travis A; Bailey, Alastair; Fearon, Pasco; King, John

    2013-01-01

    Objectives The UK's Improving Access to Psychological Therapies (IAPT) programme uses the Patient Health Questionnaire Depression Scale (PHQ-9; Kroenke, Spitzer, & Williams, 2001, J. Gen. Intern. Med., 16, 606) and Generalized Anxiety Disorder Scale (GAD-7; Spitzer et al., 2006, Arch. Intern. Med., 166, 1092) to assess patients' symptoms of depression and anxiety respectively. Data are typically collected via telephone or face-to-face; however, no study has statistically investigated whether the questionnaires' items operate equivalently across these modes of data collection. This study aimed to address this omission. Methods & Results Questionnaire data from patients registered with an IAPT service in London (N = 23,672) were examined. Confirmatory factor analyses suggested that unidimensional factor structures adequately matched observed face-to-face and telephone data for the PHQ-9 and GAD-7. Invariance analyses revealed that while the PHQ-9 had equivalent factor loadings and latent means across data collection methods, the GAD-7 had equivalent factor loadings but unequal latent means. In support of the scales' convergent validity, positive associations between scores on the PHQ-9 and GAD-7 emerged. Conclusions With the exception of the GAD-7's latent means, the questionnaires' factor loadings and latent means were equivalent. This suggests that clinicians may meaningfully compare PHQ-9 data collected face-to-face and by telephone; however, such comparisons with the GAD-7 should be done with caution. Practitioner points The PHQ-9 and GAD-7's factor loadings were equivalent across data collection methods. Only the PHQ-9's latent means were equivalent across data collection methods. Clinicians may be confident collecting PHQ-9 data by telephone and face-to-face and, then, comparing such data. Caution is recommended when determining clinical effectiveness using telephone and face-to-face GAD-7 data. More psychometric research is warranted. PMID:24117915

  12. Statistical process control for referrals by general practitioner at Health Insurance Organization clinics in Alexandria.

    PubMed

    Abdel Wahab, Moataza M; Nofal, Laila M; Guirguis, Wafaa W; Mahdy, Nehad H

    2004-01-01

    Quality control is the application of statistical techniques to a process in an effort to identify and minimize both random and non-random sources of variation. The present study aimed at the application of Statistical Process Control (SPC) to analyze the referrals by General Practitioners (GP) at Health Insurance Organization (HIO) clinics in Alexandria. Retrospective analysis of records and cross sectional interview to 180 GPs were done. Using the control charts (p chart), the present study confirmed the presence of substantial variation in referral rates from GPs to specialists; more than 60% of variation was of the special cause, which revealed that the process of referral in Alexandria (HIO) was completely out of statistical control. Control charts for referrals by GPs classified by different GP characteristics or organizational factors revealed much variation, which suggested that the variation was at the level of individual GPs. Furthermore, the p chart for each GP separately; which yielded a fewer number of points out of control (outliers), with an average of 4 points. For 26 GPs, there was no points out of control, those GPs were slightly older than those having points out of control. Otherwise, there was no significant difference between them. The revised p chart for those 26 GPs together yielded a centerline of 9.7%, upper control limit of 12.0% and lower control limit of 7.4%. Those limits were in good agreement with the limits specified by HIO; they can be suggested to be the new specification limits after some training programs. PMID:17265609

  13. Stability of Posttraumatic Stress Reaction Factors and Their Relation to General Mental Health Problems in Children: A Longitudinal Study

    ERIC Educational Resources Information Center

    Nygaard, Egil; Jensen, Tine K.; Dyb, Grete

    2012-01-01

    The aim of this study was to evaluate the structure of posttraumatic stress reaction factors and their relation to general mental health problems in Norwegian children exposed to the tsunami on December 26, 2004. A total of 133 children and adolescents (ages 6-17) were interviewed 10 months posttsunami using the UCLA PTSD Reaction Index, and 104…

  14. An Examination of the Relationship between General Life Stress, Racism-Related Stress, and Psychological Health among Black Men

    ERIC Educational Resources Information Center

    Pieterse, Alex L.; Carter, Robert T.

    2007-01-01

    This study explored the relationship among general life stress, racism-related stress, and psychological health in a sample of 220 Black men. Participants completed a personal data form, the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983), a modified version of the Schedule of Racist Events (H. Landrine & E. A. Klonoff,…

  15. Examining the Factor Structure and Discriminant Validity of the 12-Item General Health Questionnaire (GHQ-12) Among Spanish Postpartum Women

    ERIC Educational Resources Information Center

    Aguado, Jaume; Campbell, Alistair; Ascaso, Carlos; Navarro, Purificacion; Garcia-Esteve, Lluisa; Luciano, Juan V.

    2012-01-01

    In this study, the authors tested alternative factor models of the 12-item General Health Questionnaire (GHQ-12) in a sample of Spanish postpartum women, using confirmatory factor analysis. The authors report the results of modeling three different methods for scoring the GHQ-12 using estimation methods recommended for categorical and binary data.…

  16. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Filtering facepiece respirator for use by the general public in public health medical emergencies. 880.6260 Section 880.6260 Food and Drugs FOOD AND... with a minimum filtration efficiency classification of N95, in accordance with 42 CFR part 84. (2)...

  17. Smoking and Health, Report of the Advisory Committee to the Surgeon General of the Public Health Service.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Rockville, MD.

    Reported is a review of the literature regarding the relationships of the use of tobacco, especially the smoking of cigarettes, to the health of men and women, primarily in the United States. Topical divisions of the report are: Consumption of Tobacco Products in the United States; Chemical and Physical Characteristics of Tobacco and Tobacco…

  18. [The feminine role as a determinant of mental health among the women of the general population of Cantabria].

    PubMed

    de Santiago, A; Vázquez, J L; Díez, J F

    1993-01-01

    This paper tries to analyse the relationship between traditional feminine role (marriage, motherhood and housing) and mental health in spanish women. The General Health Questionnaire 60-items (GHQ-60) was used to define "cases" in a random sample of the general population of Cantabria consisting of 630 women aged 17 and over. The rate of probable prevalence of psychiatric disorders was 26.4%. In contrast to previous studies, motherhood and traditional feminine role correlated with the lowest GHQ-60 mean scores. Occupational status was not related to mental health. Women living with husband, children, parents and/or parents-in-law scored lower on GHQ-60 than those living with husband and children. These results are discussed in the light of previous findings in the literature. At least, they reconfirm the importance of socio-cultural factors in community psychiatric disorder. PMID:8135150

  19. The Health Service Use of Frequent Users of Telephone Helplines in a Cohort of General Practice Attendees with Depressive Symptoms.

    PubMed

    Middleton, Aves; Pirkis, Jane; Chondros, Patty; Bassilios, Bridget; Gunn, Jane

    2016-09-01

    We examined the relationship between frequent use of telephone helplines and health service use over time in a cohort of 789 general practice attendees with depressive symptoms. Telephone helpline use (no use, non-frequent use, frequent use) was measured at 3, 6, 9 and 12 months and analysed using ordered logistic regression. Sixteen participants (2 %) reported frequent use of telephone helplines. Reporting frequent use was associated with visiting multiple general practitioners, using emergency services and visiting mental health specialists in the previous 3 months. Despite this pattern of service use, there was evidence that these services were not meeting the needs of frequent users of telephone helplines, as they were also more likely to report dissatisfaction with their access to health services compared to non-frequent and non-users of telephone helplines. Our findings suggest that a model of care which addresses the complex needs of frequent users of telephone helplines is needed. PMID:26370273

  20. Oral Health Knowledge and Practices of WIC Staff at Florida WIC Program.

    PubMed

    Gold, Jaana T; Tomar, Scott

    2016-06-01

    This study was conducted to assess the oral health knowledge, practices and confidence of staff in the Special Supplemental Nutrition Program for Women, Infant and Children (WIC) by administering an anonymous self-completed survey to 39 WIC Clinic staff in Northern Florida. The survey instrument was a 28-item questionnaire adapted from previous validated surveys and covered questions on oral health knowledge, confidence and general practices related to oral health. Survey data were analyzed by descriptive statistics. The majority of WIC staff is knowledgeable about the role of the caregiver in cleaning the child's teeth and the role of bottle use in dental caries. Only 7 (25 %) of total 28 WIC staff indicated that fluoridated toothpaste could be used for children younger than 2 years of age. Only 18 (64 %) agreed that the cariogenic bacteria could be transmitted from mother to child. Nutritionists reported greater confidence compared to others in oral health tasks. Only 6 (67 %) of the nutritionists reported to counsel caregivers on the importance of regular tooth brushing. Only 4 (44 %) nutritionists reported to refer WIC clients to dental care. These results indicate that WIC staff has a limited knowledge on the age recommendations for the fluoride toothpaste use and on the transmission of the cariogenic bacteria. Many do not provide oral health counseling to caregivers. WIC staff with more education is more likely to discuss oral health issues. WIC staff is in need for oral health training and education to provide oral health counseling for at risk WIC population. PMID:26699151

  1. Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population

    PubMed Central

    Müller, Juliana dos Santos; Falcão, Ila Rocha; Couto, Maria Carolina Barreto Moreira; Viana, Wendel da Silva; Alves, Ivone Batista; Viola, Denise Nunes; Woods, Courtney Georgette; Rêgo, Rita Franco

    2016-01-01

    Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the “Physical Health” domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen’s work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil’s economy and food system. PMID:27164118

  2. A Generalized Measurement Model to Quantify Health: The Multi-Attribute Preference Response Model

    PubMed Central

    Krabbe, Paul F. M.

    2013-01-01

    After 40 years of deriving metric values for health status or health-related quality of life, the effective quantification of subjective health outcomes is still a challenge. Here, two of the best measurement tools, the discrete choice and the Rasch model, are combined to create a new model for deriving health values. First, existing techniques to value health states are briefly discussed followed by a reflection on the recent revival of interest in patients’ experience with regard to their possible role in health measurement. Subsequently, three basic principles for valid health measurement are reviewed, namely unidimensionality, interval level, and invariance. In the main section, the basic operation of measurement is then discussed in the framework of probabilistic discrete choice analysis (random utility model) and the psychometric Rasch model. It is then shown how combining the main features of these two models yields an integrated measurement model, called the multi-attribute preference response (MAPR) model, which is introduced here. This new model transforms subjective individual rank data into a metric scale using responses from patients who have experienced certain health states. Its measurement mechanism largely prevents biases such as adaptation and coping. Several extensions of the MAPR model are presented. The MAPR model can be applied to a wide range of research problems. If extended with the self-selection of relevant health domains for the individual patient, this model will be more valid than existing valuation techniques. PMID:24278141

  3. Association between playing computer games and mental and social health among male adolescents in Iran in 2014

    PubMed Central

    Mohammadi, Mehrnoosh; RezaeiDehaghani, Abdollah; Mehrabi, Tayebeh; RezaeiDehaghani, Ali

    2016-01-01

    Background: As adolescents spend much time on playing computer games, their mental and social effects should be considered. The present study aimed to investigate the association between playing computer games and the mental and social health among male adolescents in Iran in 2014. Materials and Methods: This is a cross-sectional study conducted on 210 adolescents selected by multi-stage random sampling. Data were collected by Goldberg and Hillier general health (28 items) and Kiez social health questionnaires. The association was tested by Pearson and Spearman correlation coefficients, one-way analysis of variance (ANOVA), and independent t-test. Computer games related factors such as the location, type, length, the adopted device, and mode of playing games were investigated. Results: Results showed that 58.9% of the subjects played games on a computer alone for 1 h at home. Results also revealed that the subjects had appropriate mental health and 83.2% had moderate social health. Results showed a poor significant association between the length of games and social health (r = −0.15, P = 0.03), the type of games and mental health (r = −0.16, P = 0.01), and the device used in playing games and social health (F = 0.95, P = 0.03). Conclusions: The findings showed that adolescents’ mental and social health is negatively associated with their playing computer games. Therefore, to promote their health, educating them about the correct way of playing computer games is essential and their parents and school authorities, including nurses working at schools, should determine its relevant factors such as the type, length, and device used in playing such games. PMID:27095988

  4. Negative illness perceptions associated with low mental and physical health status in general hospital outpatients in China.

    PubMed

    Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer

    2014-01-01

    In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs. PMID:23721418

  5. Surgeon General's Workshop on Violence and Public Health Report (Leesburg, Virginia, October 27-29, 1985).

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    Plenary session papers from a workshop focusing on how the health professions might provide better care for victims of violence and prevent violence itself comprise this document. Papers include: (1) "Welcome and 'Charge' to the Participants" (C. Everett Koop); (2) "Interpersonal Violence and Public Health Care: New Directions, New Challenges"…

  6. Health and Human Services Issues. United States General Accounting Office Transition Series.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's…

  7. Recruitment using mobile telephones in an Irish general population sexual health survey: challenges and practical solutions

    PubMed Central

    2012-01-01

    Background Non-coverage of households without a landline telephone is a major concern of telephone survey researchers. Sampling mobile telephone users in national surveys is vital in order to gain access to the growing proportion of households that use mobile telephones extensively or exclusively. The complex logistics of conducting surveys with mobile telephones have been discussed in the literature. This paper outlines the actual challenges encountered during a recent national sexual health survey in Ireland, which utilized a mobile telephone sampling frame to recruit approximately half of the sample. Method The 2010 Irish Contraception and Crisis Pregnancy Survey (ICCP-2010) is a nationally representative sample of adults aged 18-45 years living in Ireland (n = 3002; 1416 recruited by landline telephone and 1586 recruited by mobile telephone). The overall response rate for the survey was 69% (79% for the landline telephone strand; 61% for the mobile telephone strand). All interviews were conducted using computer-assisting telephone interviewing. Results During the 18-week fieldwork period, five main challenges relating to the use of mobile telephones were encountered: (1) explaining to respondents how random digit dialling works in relation to mobile telephones; (2) establishing the respondent's eligibility; (3) calling the respondent with the Caller ID blocked or withheld; (4) calling the respondent when they are in any number of locations or situations; and (5) explaining to respondents the importance of refusal conversion calls for the response rate calculation. Details of how the survey protocols and procedures were monitored and adapted throughout the study to ensure a high response rate are outlined. Conclusion It is undeniably more challenging to recruit respondents using mobile telephones as opposed to landline telephones. Respondents are generally not familiar with being contacted on their personal mobile telephone for the purposes of being recruited

  8. Common mental health problems in immigrants and refugees: general approach in primary care

    PubMed Central

    Kirmayer, Laurence J.; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G.; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

    2011-01-01

    Background: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. Methods: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. Results: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Interpretation: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally

  9. Predictors of general medical and psychological treatment use among a national sample of peacekeeping veterans with health problems.

    PubMed

    Elhai, Jon D; Don Richardson, J; Pedlar, David J

    2007-01-01

    We investigated general medical and psychological treatment use predictors among peacekeeping veterans with health problems, aiming to find those characteristics most associated with treatment use intensity (i.e., visit counts). One thousand one hundred and thirty-two male Canadian Forces peacekeeping veterans registered with Veterans Affairs for health problems were randomly recruited for a prospective national survey. Regression analyses for treatment use intensity controlled for age, total time deployed and health problems (covariates), and examined the incremental contribution of depression and post-traumatic stress disorder (PTSD) severity on health service use intensity. Results revealed that after controlling for covariates, the depression and PTSD model was associated with increased medical and psychological treatment use intensity. Medical use intensity was significantly predicted by married status, greater depression and health problems; psychological treatment use intensity was predicted by younger age, greater PTSD severity and health problems. This study highlights the importance of an integrated primary care-mental health service delivery model for veterans. PMID:16965892

  10. Self-reported functional and general health status among older respondents in China: the impact of age, gender, and place of residence.

    PubMed

    Wu, Bei; Yue, Yuwen; Mao, Zongfu

    2015-03-01

    This study made comparisons of self-reported functional and general health status between Chinese women and men in different age-groups in rural and urban settings and examined multiple factors relating to these health statuses in older adults. This study included a sample of 4017 respondents, aged 55 years and older, from the Hubei subsample of the Chinese National Health Service Survey III in 2003. The results illustrate that the differences in self-rated functional and general health status between genders and between urban and rural areas diminished with age. Access to health care was strongly associated with health status. The quality of the local environment, measured by access to tap water, was a significant factor for rural residents. Our study suggests that improving access to health care services and reducing environmental health risks are critical for improving physical functioning, psychological functioning, and self-rated general health for older adults in China. PMID:22199153

  11. Adolescents' wellbeing and functioning: relationships with parents' subjective general physical and mental health

    PubMed Central

    2009-01-01

    Background This study aimed at examining the relationship between parental subjective health status and adolescents' health-related quality of life (HRQoL) as well as the role of gender, socioeconomic status, presence of chronic health care needs and social support on the above interaction. Methods Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1 194) aged 11-18 years and their parents (N = 973) in 2003. Adolescents' and parents' status was assessed, together with reports of socio-economic status and level of social support. Various statistical tests were used to determine the extent to which these variables were related to each other. Results and Discussion Parental subjective mental health status was significantly correlated with adolescents' better physical and psychological wellbeing, moods and emotions, parent-child relationships, school environment and financial resources. Parental subjective physical health status was strongly associated with more positive adolescents' self-perception. Adolescents' male gender, younger age, absence of chronic health care needs, high social support, and higher family income were positively associated with better HRQoL. Conclusions This study reinforces the importance of parental subjective health status, along with other variables, as a significant factor for the adolescents' HRQoL. PMID:20003508

  12. Changes in quality of life and perceptions of general health before and after operation of wind turbines.

    PubMed

    Jalali, Leila; Bigelow, Philip; McColl, Stephen; Majowicz, Shannon; Gohari, Mahmood; Waterhouse, Ryan

    2016-09-01

    Ontario is Canada's provincial leader in wind energy, with over 4000 MW of installed capacity supplying approximately five percent of the province's electricity demand. Wind energy is now one of the fastest-growing sources of renewable power in Canada and many other countries. However, its possible negative impact on population health, as a new source of environmental noise, has raised concerns for people living in proximity to wind turbines (WTs). The aims of this study were to assess the effect of individual differences and annoyance on the self-reported general health and health-related quality of life (QOL) of nearby residents, using a pre- and post-exposure design. Prospective cohort data were collected before and after WT operations, from the individuals (n = 43) in Ontario, Canada. General health and QOL metrics were measured using standard scales, such as SF12, life satisfaction scales developed by Diener (SWLS) and the Canadian Community Health Survey (CCHS-SWL). The mean values for the Mental Component Score of SF12 (p = 0.002), SWLS (p < 0.001), and CCHS-SWL (p = 0.044) significantly worsened after WT operation for those participants who had a negative attitude to WTs, who voiced concerns about property devaluation, and/or who reported being visually or noise annoyed. PMID:27321878

  13. Implications of the World Health Organization study of mental illness in general health care for training primary care staff.

    PubMed

    Goldberg, D; Gater, R

    1996-08-01

    A substantial international study of mental disorders seen in primary care settings has shown that there are marked differences in prevalence between centres. Detection of mental disorders is better in centres using a 'personal' style of clinical service, and where there has been close collaboration between psychiatrists and general practitioners. However, even in the better centres, substantial numbers of mental disorders are missed and treatment often appears to be given regardless of diagnosis. It is argued that changes need to be made to the way in which both undergraduates and vocational trainees are taught about mental disorders, so that teaching emphasizes the psychological syndromes that general practitioners are likely to meet in their everyday work. Training packages need to be developed for primary care staff in the detection and management of mental disorders. PMID:8949331

  14. Implications of the World Health Organization study of mental illness in general health care for training primary care staff.

    PubMed Central

    Goldberg, D; Gater, R

    1996-01-01

    A substantial international study of mental disorders seen in primary care settings has shown that there are marked differences in prevalence between centres. Detection of mental disorders is better in centres using a 'personal' style of clinical service, and where there has been close collaboration between psychiatrists and general practitioners. However, even in the better centres, substantial numbers of mental disorders are missed and treatment often appears to be given regardless of diagnosis. It is argued that changes need to be made to the way in which both undergraduates and vocational trainees are taught about mental disorders, so that teaching emphasizes the psychological syndromes that general practitioners are likely to meet in their everyday work. Training packages need to be developed for primary care staff in the detection and management of mental disorders. PMID:8949331

  15. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    PubMed Central

    2013-01-01

    Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management

  16. [Stress, coping, and general health of nurses working at a care unit for patients with AIDS and hematologic diseases].

    PubMed

    Britto, Eliane da Silva; Carvalho, Ana Maria Pimenta

    2003-12-01

    Based on Lazarus and Folkman's theory about stress and coping, this research aimed at answering questions related to how nurses, who work in two specialized units of a general hospital, evaluate their working environment, their health and how they manage with stressing situations. In the unit of infectious diseases, the nurses' evaluation of their working environment did not surpass the limits of what is considered as acceptable. In the unit of hematological alterations, the results showed higher stress levels. In both units, the evaluation of their health was considered as satisfactory and the coping strategies were similar. PMID:15083795

  17. Effectiveness of an intervention for prevention and treatment of burnout in primary health care professionals

    PubMed Central

    2013-01-01

    Background Burnout syndrome is an important health problem that affects many professionals and must be addressed globally, with both organizational measures and personal interventions. Burnout of health professionals can be prevented in order to avoid personal, familial, and social consequences, as well as repercussions for patients. Methods/design This work describes a protocol for a controlled, pragmatic, randomized clinical trial in 2 parallel groups: intervention and control. All health professionals from 7 health care centers will form the intervention group, and all health professionals from 7 different health care centers will form the control group. The intervention group will receive 16 hours of training at their work place. The Maslach's burnout inventory, the Cuestionario de Desgaste Profesional Médico or the Cuestionario de Desgaste Profesional de Enfermería, and the 28-item Goldberg's General Health Questionnaire, validated for our setting, will be used as measurement tools. Change in the average scores from the Maslach's burnout inventory emotional exhaustion scale will be compared between the intervention and control groups, measured as intention-to-treat, and the intervention will be considered effective if a minimum decrease of 20% is achieved. Discussion Due to the deleterious consequences of burnout syndrome for people suffering from it and for the organization where they work, it is necessary to evaluate the effectiveness of certain interventions for its prevention. Organizational measures are important for preventing burnout syndrome, but so is providing professionals with coping strategies, as this group intervention intends to do. Trial registration ClinicalTrials.gov processed this record on June 10, 2013. ClinicalTrials.gov Identifier: NCT01870154. PMID:24237937

  18. Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness

    PubMed Central

    Protheroe, Joanne; Estacio, Emee Vida; Saidy-Khan, Sirandou

    2015-01-01

    Background Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. Aim To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. Design and setting An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. Method PILs were assessed for readability (Flesch Reading Ease and Flesch–Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. Results A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as ‘systems navigation’ (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Conclusion Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices. PMID:25733441

  19. Office of Inspector General audit report on Westinghouse Savannah River Company`s health benefit plan

    SciTech Connect

    1999-01-01

    Westinghouse Savannah River Company (Westinghouse) manages and operates the Savannah River Site, located in Aiken, South Carolina, for the US Department of Energy (Department). Westinghouse was self-insured for health benefits and contracted with Aetna Insurance to administer the plan (service payments to providers) from Calendar Year (CY) 1989 through 1996. Westinghouse`s administrative service contract with Aetna Insurance expired on December 31, 1996. Westinghouse chose Blue Cross/Blue Shield of South Carolina (BC/BS) to administer its health plan, effective January 1, 1997. After the contract was awarded to BC/BS, 47 health care providers in the Aiken area submitted their resignations as preferred providers for BC/BS. The health care providers complained that the fees received from BC/BS were less than they were previously paid through Aetna Insurance. As a result, Westinghouse instructed BC/BS to negotiate a modified fee schedule for all the health care providers in the Aiken area. The audit objective was to determine whether the health benefit costs incurred by Westinghouse under the BC/BS contract were necessary and reasonable.

  20. Efficacy of neurolinguistic programming training on mental health in nursing and midwifery students

    PubMed Central

    Sahebalzamani, Mohammad

    2014-01-01

    Background: Neurolinguistic programming (NLP) refers to the science and art of reaching success and perfection. It is a collection of the skills based on human beings’ psychological characteristics through which the individuals obtain the ability to use their personal capabilities as much as possible. This study aimed to investigate the efficacy of NLP training on mental health in nursing and midwifery students in Islamic Azad University Tehran Medical Sciences branch. Materials and Methods: In this quasi-experimental study, the study population comprised all nursing and midwifery students in Islamic Azad University, Tehran Medical branch, of whom 52 were selected and assigned to two groups through random sampling. Data collection tool was Goldberg General Health Questionnaire (28-item version). After primary evaluation, NLP training was given in five 120-min sessions and the groups were re-evaluated. The obtained data were analyzed. Results: In the nursing group, paired t-test showed a significant difference in the scores of mental health (with 39 points decrease), physical signs (with 7.96 scores decrease), anxiety (with 10.75 scores decrease), social function (with 7.05 scores decrease) and depression (with 9.38 scores decrease). In the midwifery group, it showed a significant difference in mental health (with 22.63 scores decrease), physical signs (with 6.54 scores decrease), anxiety (with nine scores decrease), and depression (with 8.38 scores decrease). Conclusions: This study showed that NLP strategies are effective in the improvement of general health and its various dimensions. Therefore, it is essential to conduct structured and executive programs concerning NLP among the students. PMID:25400679

  1. Recognising falls risk in older adult mental health patients and acknowledging the difference from the general older adult population.

    PubMed

    Wynaden, Dianne; Tohotoa, Jenny; Heslop, Karen; Al Omari, Omar

    2016-01-01

    Older adults admitted to inpatient mental health units present with complex mental health care needs which are often compounded by the challenges of living with physical co-morbidities. They are a mobile population and a high risk group for falling during hospitalisation. To address quality and safety concerns around the increased risk for falls, a qualitative research study was completed to obtain an improved understanding of the factors that increase the risk of falling in this patient cohort. Focus groups were conducted with mental health professionals working across older adult mental health services in metropolitan Western Australia. Data were analysed using content analysis and three themes emerged that were significant concepts relevant to falls risk in this patient group. These themes were (1) limitations of using generic falls risk assessment and management tools, (2) assessment of falls risk not currently captured on standardised tools, and (3) population specific causes of falls. The findings demonstrate that older adult mental health patients are a highly mobile group that experience frequent changes in cognition, behaviour and mental state. The mix of patients with organic or functional psychiatric disorders within the same environment also presents complex and unique care challenges and multi-disciplinary collaboration is central to reduce the risk of falls. As this group of patients are also frequently admitted to both general inpatient and aged care settings, the findings are relevant to the assessment and management of falls risk across all health care settings. PMID:27188045

  2. [The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

    PubMed

    Aoki, Tsutomu

    2015-01-01

    The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns. PMID:26552318

  3. Risks of phthalate exposure among the general population: implications for occupational health nurses.

    PubMed

    Pak, Victoria M; McCauley, Linda A

    2007-01-01

    Personal care items including lotions, perfumes, deodorants, shampoos, and cosmetics are sources of phthalate exposure. Women of childbearing age, children, and beauty salon workers are at greater risk for exposure. Occupational health nurses are in an ideal position to rally support for improved regulatory laws and for funding of evidence-based research that will reduce phthalate exposures and improve client health. Occupational health nurses must support the establishment and implementation of procedures for workplace safety inspections among susceptible populations. Information regarding reduction of overall phthalate exposure must be available for clients. Resources like phthalate-free product lists can be valuable tools in helping clients make informed decisions about alternatives to phthalates. PMID:17260676

  4. General vs health specialized search engine: a blind comparative evaluation of top search results.

    PubMed

    Pletneva, Natalia; Ruiz de Castaneda, Rafael; Baroz, Frederic; Boyer, Celia

    2014-01-01

    This paper presents the results of a blind comparison of top ten search results retrieved by Google.ch (French) and Khresmoi for everyone, a health specialized search engine. Participants--students of the Faculty of Medicine of the University of Geneva had to complete three tasks and select their preferred results. The majority of the participants have largely preferred Google results while Khresmoi results showed potential to compete in specific topics. The coverage of the results seems to be one of the reasons. The second being that participants do not know how to select quality and transparent health web pages. More awareness, tools and education about the matter is required for the students of Medicine to be able to efficiently distinguish trustworthy online health information. PMID:25160174

  5. Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women

    PubMed Central

    Barrios, Yasmin V.; Gelaye, Bizu; Zhong, Qiuyue; Nicolaidis, Christina; Rondon, Marta B.; Garcia, Pedro J.; Sanchez, Pedro A. Mascaro; Sanchez, Sixto E.; Williams, Michelle A.

    2015-01-01

    Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence. PMID:25635902

  6. [Latin America's general situation and its impact on maternal-child health].

    PubMed

    Quezada Aliff, T

    1989-01-01

    Latin America's current economic, social, and political situation is characterized by significantly deteriorating exchange rates, increasing inflation in most countries, and increases in unemployment and underemployment. The additional effects of the crushing external debt and its conditions of renegotiation cannot fail to effect the health of the most vulnerable population groups, women and children. The crisis is affecting middle income as well as low income groups. Latin America as a whole underwent impressive economic growth and modernization through the late 1970s. Most countries were transformed from agrarian to urban-industrial societies with growth in their secondary and tertiary sectors stimulating social mobility. But problems of unequal income distribution, increasing absolute numbers of poor including 51.3 million under 15, and insufficient demand for labor continue to plague the region. Substantial improvements were made in both health status and health care delivery through the late 1970s in most of the region, but the prolonged economic crisis of the 1980s has led among other things to decreasing governmental expenditures for social services, cuts in food subsidies, decreased social spending per capita, and deteriorating basic infrastructure and health and educational services. Declining quality and quantity of health services have been accompanied by a growing trend to private services as a way of decreasing government expenditures even further. It is possible that the health indicators currently in use do not adequately reflect the total consequences of the economic crisis. Health conditions do not depend on the situation of the moment but on a certain accumulated social capital. Moreover, massive vaccination programs and other campaigns sponsored by international and national organizations have continued despite the crisis. Limitations in the timeliness and quality of data may obscure the true gravity of the health situation. Studies in the region

  7. Assessment of Mental Health among Iranian Medical Students: A Cross-Sectional Study

    PubMed Central

    Farahangiz, Saman; Mohebpour, Fatemeh; Salehi, Alireza

    2016-01-01

    Objectives More mental morbidities were reported in medical students than their nonmedical peers, which may negatively influence their lives and future career. The aim of this study was to assess the mental health status among medical students of Shiraz University of Medical Sciences. Method Two hundred and eight 1st to 4th year Medical students took part in this cross-sectional study. General Health Questionnaire with 28 items (GHQ-28) was used for data collection. We performed descriptive statistics, Mann Whitney U test, one way ANOVA and Tukey’s post hoc and Kruskal Wallis H and Chi square test for statistical analysis. Results The mean age of participants was 20.70 ± 1.14 (mean ± SD) years. More than half of them (54.4%) had total GHQ score above the cut-off point considered as probably abnormal mental health status. Years of education, positive family history and low satisfaction of the medicine discipline affected their mental health. Third and fourth year students had significantly higher mean scores of total GHQ (p-value = 0.009) and anxiety, somatic and social subscales (p-value = 0.001, 0.004 and 0.026). Students with positive family history of mental illness and low satisfaction of field of the study significantly had higher GHQ scores (p-value = 0.012 and < 0.001 respectively). Conclusion Poor mental health prevalence is high among medical students in Shiraz. Proper changes in educational programs and other effective interventions to raise the students’ satisfaction may reduce the effect of other stress reasons and improve their mental health status. PMID:27004057

  8. 41 CFR 50-204.2 - General safety and health standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Other Nonmetallic Minerals, Including Silica Sand. (3) U.S. Department of Transportation: 49 CFR parts 171-179 and 14 CFR part 103 Hazardous material regulation—Transportation of compressed gases. (4) U.S... Labor—Title 29 CFR— Part 1501—Safety and Health Regulations for Ship Repairing. Part 1502—Safety...

  9. Using Anchoring Vignettes to Assess Group Differences in General Self-Rated Health

    ERIC Educational Resources Information Center

    Grol-Prokopczyk, Hanna; Freese, Jeremy; Hauser, Robert M.

    2011-01-01

    This article addresses a potentially serious problem with the widely used self-rated health (SRH) survey item: that different groups have systematically different ways of using the item's response categories. Analyses based on unadjusted SRH may thus yield misleading results. The authors evaluate anchoring vignettes as a possible solution to this…

  10. [Efficacy of individual smoking cessation instructions for general smokers among clients of a health center].

    PubMed

    Akahane, K; Anada, K; Arino, M; Ono, A; Tomonaga, M; Nakabayashi, M; Nishida, M; Yamakawa, N; Yoshitsugu, M; Shimo, T

    1992-04-01

    Smoking cessation instruction for individuals using a standardized smoking cessation manual and a handout developed by the authors was studied in a controlled trial among employees who visited a health center for Industrial Safety and Health Law mandated annual health examinations. Smokers in the study group were given 5-10 minutes smoking cessation instruction mainly by public health nurses and nutritionists following the above-mentioned manual and using the handouts. Subjects in both groups were interviewed by telephone to assess changes in smoking habits one month after the first contact. Smoking clients who came on Friday (132) and on Monday (93) were assigned to study and control groups, respectively. One hundred and nineteen members (90.2%) of the study group and 88 (94.6%) of the control group were successfully followed until one month after the initial contact. Seven subjects in the study group were not smoking one month after the instruction, while no one gave up smoking in the control group (p less than 0.05). It was confirmed by telephone survey that 6 of the 7 subjects who were not smoking at one month were still maintaining abstinence from smoking one year after the instruction. Smokers who did not stop smoking reported a reduction in their smoking dose in the study group. Lighter smokers reacted more readily to instruction than did heavier smokers and the knowledge level of subjects was positively associated with the success rate. PMID:1611121

  11. The Health Consequences of Smoking; A Report of the Surgeon General: 1972.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    Six times since 1964, the Public Health Service has issued formal reviews of the scientific evidence which links cigarette smoking to disease and premature death. Each successive review, including this one, has seemed to confirm and strengthen the conclusion of the 1964 Report, that cigarettes are a major cause of death and disease. In the first…

  12. 41 CFR 50-204.2 - General safety and health standards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Labor—Title 29 CFR— Part 1501—Safety and Health Regulations for Ship Repairing. Part 1502—Safety and... Other Nonmetallic Minerals, Including Silica Sand. (3) U.S. Department of Transportation: 49 CFR parts 171-179 and 14 CFR part 103 Hazardous material regulation—Transportation of compressed gases. (4)...

  13. Job insecurity and its association with health among employees in the Taiwanese general population.

    PubMed

    Cheng, Yawen; Chen, Chun-Wan; Chen, Chiou-Jong; Chiang, Tung-liang

    2005-07-01

    As employers respond to intensive global competition through the deregulation of labor, job insecurity has become a widespread problem. It has been shown to have significant health impacts in a growing number of workers, but less is known about its social distribution, the mechanisms through which it may act, and the moderating effects of gender, socioeconomic position, and company size. Utilizing data from a national survey of a representative sample of paid employees in Taiwan, we examined the prevalence of job insecurity and its associations with psychosocial work characteristics and health status. A total of 8705 men and 5986 women aged between 25 and 65 years old were studied. Information on perceived job insecurity, industrial and occupational types, psychosocial work characteristics as assessed by the Job Strain model, and various measures of health status were obtained by a self-administered questionnaire. The overall prevalence of job insecurity was high (50%). Job insecurity was more prevalent among employees with lower education attainment, in blue-collar and construction workers, those employed in smaller companies, and in older women. Insecure employees also reported lower job control, higher job demands, and poor workplace social support, as compared with those who held secure positions. Regression analyses showed that job insecurity was strongly associated with poor health, even with adjustment of age, job control, job demands, and work place social support. The deleterious effects of job insecurity appeared to be stronger in men than women, in women who held managerial or professional jobs than women in other employment grades, and in those working in larger companies than smaller ones. The findings of this study suggest that perceived job insecurity is an important source of stress, and it is accompanied with adverse psychosocial work conditions and poor health. High-risk groups were identified for further investigation. PMID:15847960

  14. Improving communication between health-care professionals and patients with limited English proficiency in the general practice setting.

    PubMed

    Attard, Melanie; McArthur, Alexa; Riitano, Dagmara; Aromataris, Edoardo; Bollen, Chris; Pearson, Alan

    2015-01-01

    Quality service provision and patient safety and satisfaction in encounters with health-care professionals relies on effective communication between the practitioner and patient. This study aimed to identify effective practices for improving communication between clinical staff in general practice and patients with limited English proficiency, and to promote their implementation in general practice. Effective interventions and strategies were identified from a review of international research. Experiences with their use in practice were explored via focus group discussions with general practitioners and practice nurses. The results suggest that, wherever possible, communication in the patient's primary language is preferable; use of a qualified medical interpreter should be promoted, and practices should have a standardised and documented procedure for accessing interpreter services. General practice staff must increase their awareness about services that are available to facilitate communication with patients with limited English proficiency, and also develop attitudes, both individual and organisational, that will maximise the effectiveness of these strategies. These findings were used to develop brief, evidence-based practice guidelines that were disseminated to focus group participants for evaluation of utility and general feedback. This evidence-based guidance is now available to assist clinical and administrative general practice staff across regional and metropolitan South Australia. PMID:24216076

  15. Association between Self-Reported General and Mental Health and Adverse Outcomes: A Retrospective Cohort Study of 19 625 Scottish Adults

    PubMed Central

    Ul-Haq, Zia; Mackay, Daniel F.; Pell, Jill P.

    2014-01-01

    Objective Self-reported general health and mental health are independent predictors of all-cause mortality. This study examines whether they are also independent predictors of incident cancer, coronary heart disease and psychiatric hospitalisation. Methods We conducted a retrospective, population cohort study by linking the 19 625 Scottish adults who participated in the Scottish Health Surveys 1995–2003, to hospital admissions, cancer registration and death certificate records. We conducted Cox proportional hazard models adjusting for potential confounders including age, sex, socioeconomic status, alcohol, smoking status, body mass index, hypertension and diabetes. Results Poor general health was reported by 1215 (6.2%) participants and was associated with cancer registrations (adjusted Hazard Ratio [HR] 1.30, 95% CI 1.10, 1.55), coronary heart disease events (adjusted HR 2.30, 95% CI 1.86, 2.84) and psychiatric hospitalisations (adjusted HR 2.42, 95% CI 1.65, 3.56). There was evidence of dose relationships and the associations remained significant after adjustment for mental health. 3172 (16%) participants had poor mental health (GHQ ≥4). After adjustment for general health, the associations between poor mental health and coronary heart disease events (adjusted HR 1.36, 95% CI 1.13, 1.63) and all-cause death (adjusted HR 1.38, 95% CI 1.23, 1.55) became non-significant, but mental health remained associated with psychiatric hospitalisations (fully adjusted HR 2.02, 95% CI 1.48, 2.75). Conclusion Self-reported general health is a significant predictor of a range of clinical outcomes independent of mental health. The association between mental health and non-psychiatric outcomes is mediated by general health but it is an independent predictor of psychiatric outcome. Individuals with poor general health or mental health warrant close attention. PMID:24705574

  16. Older patients’ perceived burdens of their health problems: a cross-sectional analysis in 74 German general practices

    PubMed Central

    Junius-Walker, Ulrike; Wiese, Birgitt; Klaaßen-Mielke, Renate; Theile, Gudrun; Müller, Christiane Annette; Hummers-Pradier, Eva

    2015-01-01

    Background Older patients often experience the burden of multiple health problems. Physicians need to consider them to arrive at a holistic treatment plan. Yet, it has not been systematically investigated as to which personal burdens ensue from certain health conditions. Objective The objective of this study is to examine older patients’ perceived burden of their health problems. Patients and methods The study presents a cross-sectional analysis in 74 German general practices; 836 patients, 72 years and older (mean 79±4.4), rated the burden of each health problem disclosed by a comprehensive geriatric assessment. Patients rated each burden using three components: importance, emotional impact, and impact on daily activities. Cluster analyses were performed to define patterns in the rating of these components of burden. In a multilevel logistic regression analysis, independent factors that predict high and low burden were explored. Results Patients had a median of eleven health problems and rated the burden of altogether 8,900 health problems. Four clusters provided a good clustering structure. Two clusters describe a high burden, and a further two, a low burden. Patients attributed a high burden to social and psychological health problems (especially being a caregiver: odds ratio [OR] 10.4, 95% confidence interval [CI] 4.4–24.4), to specific symptoms (eg, claudication: OR 2.3, 95% CI 1.3–4.0; pain: OR 2.3, 95% CI 1.6–3.1), and physical disabilities. Patients rated a comparatively low burden for most of their medical findings, for cognitive impairment, and lifestyle issues (eg, hypertension: OR 0.2, 95% CI 0.2–0.3). Conclusion The patients experienced a relatively greater burden for physical disabilities, mood, or social issues than for diseases themselves. Physicians should interpret these burdens in the individual context and consider them in their treatment planning. PMID:26124648

  17. A Self-Regulation eHealth Intervention to Increase Healthy Behavior Through General Practice: Protocol and Systematic Development

    PubMed Central

    De Bourdeaudhuij, Ilse; Verloigne, Maite; Oenema, Anke; Crombez, Geert

    2015-01-01

    Background Chronic diseases are the principal cause of morbidity and mortality worldwide. An increased consumption of vegetables and fruit reduces the risk of hypertension, coronary heart disease, stroke, and cancer. An increased fruit and vegetable (FV) intake may also prevent body weight gain, and therefore indirectly affect type 2 diabetes mellitus. Insufficient physical activity (PA) has been identified as the fourth leading risk factor for global mortality. Consequently, effective interventions that promote PA and FV intake in a large number of people are required. Objective To describe the systematic development of an eHealth intervention, MyPlan 1.0, for increasing FV intake and PA. Methods The intervention was developed following the six steps of the intervention mapping (IM) protocol. Decisions during steps were based upon available literature, focus group interviews, and pilot studies. Results Based on needs assessment (Step 1), it was decided to focus on fruit and vegetable intake and physical activity levels of adults. Based on self-regulation and the health action process approach model, motivational (eg, risk awareness) and volitional (eg, action planning) determinants were selected and crossed with performance objectives into a matrix with change objectives (Step 2). Behavioral change strategies (eg, goal setting, problem solving, and implementation intentions) were selected (Step 3). Tablet computers were chosen for delivery of the eHealth program in general practice (Step 4). To facilitate implementation of the intervention in general practice, GPs were involved in focus group interviews (Step 5). Finally, the planning of the evaluation of the intervention (Step 6) is briefly described. Conclusions Using the IM protocol ensures that a theory- and evidence-based intervention protocol is developed. If the intervention is found to be effective, a dynamic eHealth program for the promotion of healthy lifestyles could be available for use in general

  18. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    PubMed Central

    Saw, Pui San; Nissen, Lisa M; Freeman, Christopher; Wong, Pei Se; Mak, Vivienne

    2015-01-01

    Background Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia. Methods A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists’ role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in

  19. Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice

    PubMed Central

    González-Chica, David Alejandro; Mnisi, Zandile; Avery, Jodie; Duszynski, Katherine; Doust, Jenny; Tideman, Philip; Murphy, Andrew; Burgess, Jacquii; Beilby, Justin; Stocks, Nigel

    2016-01-01

    Background Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. Objectives To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Methods Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression. Results A total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8–17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1–42.1), 42.1 (95%CI 40.8–43.3) and 44.8 (95%CI 43.3–46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL. Conclusion Inadequate health literacy is a contributing factor to poor physical

  20. The Association between Physical Health and Delusional-Like Experiences: A General Population Study

    PubMed Central

    Saha, Sukanta; Scott, James; Varghese, Daniel; McGrath, John

    2011-01-01

    Objective Delusional-like experiences (DLE) are prevalent in the community. Recent community based studies have found that DLE are more common in those with depression and anxiety disorders, and in those with subclinical symptoms of depression and anxiety. Chronic physical disorders are associated with comorbid depression and anxiety; however, there is a lack of evidence about the association of DLE with common physical conditions. The aim of this study was to explore associations between the common physical disorders and DLE using a large population sample. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007, a national household survey of 8841 residents aged between 16 and 85 years. The presence of DLE, selected common physical disorders and symptoms were assessed using a modified World Mental Health Composite International Diagnostic Interview (CIDI) schedule. We examined the relationship between DLE, and physical health-related variables using logistic regression, with adjustments for potential confounding factors. Results Of the 8771, 776 (8.4%) subjects positively endorsed one or more DLE. Of the six physical disorders examined, only diabetes and arthritis were significantly associated with the endorsement of DLE. Of the seven broad physical symptoms explored, only hearing problems were consistently associated with DLE. Conclusion Delusional-like experiences are common in the Australian community, and are associated with selected chronic physical disorders and with impaired hearing. The direction of causality between these variables warrants closer research scrutiny. PMID:21541344

  1. [The narghile and its effects on health. Part I: the narghile, general description and properties].

    PubMed

    Ben Saad, H

    2009-12-01

    A narghile is a water-pipe used to smoke a tobacco preparation. As the smoker inhales, the tobacco smoke is sucked down from the bowl and then bubbles up through the water into the air of the smoke chamber and then through the hose to the smoker. Its origins are mysterious and controversial. Nevertheless it remains, under different names, an object used regularly by more than one hundred million people in the world. Since the eighties and especially nineties, its consumption has grown significantly and is now considered to be a worldwide epidemic. However, the knowledge about the effects of narghile smoke on health is partial and sometimes contradictory. Indeed, we are witnessing increasing confusion in biomedical studies and scientific debate about its health impact is unresolved. Given this situation, revealing a serious and profound lack of information about the real nature and toxicity of hookah smoke, the authors conducted this two-part study. The first part presents epidemiological data, describes the narghile and the different types of narghile tobacco and exposes the composition of narghile smoke. The second part highlights the lack of reliable data about the detrimental effects of the narghile pipe on health and especially on the cardiopulmonary function. PMID:19995660

  2. The Menstrual Cycle A Biological Marker of General Health in Adolescents

    PubMed Central

    Popat, Vaishali B.; Prodanov, Tamara; Calis, Karim A.; Nelson, Lawrence M.

    2009-01-01

    Menstruation is the cyclic, orderly sloughing of the uterine lining on account of the interactions of hormones produced by the hypothalamus, pituitary, and ovaries. There is a tendency among parents and clinicians to view oligo-amenorrhea as a normal variant in the teen years. In fact, the 95th percentile for the time interval between cycles is 90 days. Thus, it is abnormal for an adolescent to be amenorrheic for greater than 3 months, even in the early gynecologic years. Identification of abnormal menstrual patterns throughout adolescence may permit early identification of potential health concerns for adulthood. Few problems in gynecologic endocrinology are as complex or challenging to the clinician as amenorrhea. However, thorough evaluation of menstrual cycle disorders in adolescence provides a window of opportunity for early diagnosis and treatment of conditions affecting the hypothalamic-pituitary-ovarian (HPO) axis. Here we discuss a systematic approach to the evaluation and treatment of amenorrhea in adolescents who do not have androgen excess. There is strong evidence that estrogen deficiency is a risk factor for later development of osteoporosis and hip fracture. Delay in the evaluation and treatment of disordered menses in some cases may contribute to reduced bone density. Both patients and clinicians need to view the ovary as an important endocrine organ that helps maintain health, especially bone health. PMID:18574207

  3. Amino Acid Complementarity: A Biochemical Exemplar of Stoichiometry for General and Health Sciences Chemistry

    ERIC Educational Resources Information Center

    Vitz, Ed

    2005-01-01

    The standard introduction to stoichiometry and simple exemplars can motivate students to learn the stoichiometric studies and the condensation reaction that occurs between amino acids to form the peptide bond. This topic can be integrated into general chemistry courses as an alternative to inclusion of a separate biochemistry course that could be…

  4. Coping as a Predictor of Burnout and General Health in Therapists Working in ABA Schools

    ERIC Educational Resources Information Center

    Griffith, G. M.; Barbakou, A.; Hastings, R. P.

    2014-01-01

    Background: Little is known about the work-related well-being of applied behaviour analysis (ABA) therapists who work in school-based contexts and deliver ABA interventions to children with autism. Methods: A questionnaire on work-related stress (burnout), general distress, perceived supervisor support and coping was completed by 45 ABA therapists…

  5. The attitudes of pharmacists, students and the general public on mHealth applications for medication adherence

    PubMed Central

    Davies, Michael J.; Kotadia, Alysha; Mughal, Hassan; Hannan, Ashraf; Alqarni, Hamdan

    2015-01-01

    Background: During recent years mobile technology has developed tremendously and has infiltrated the healthcare field. Mobile healthcare (mHealth) applications, or apps, may be used to support patient adherence to medication thus promoting optimal treatment outcomes and reducing medication wastage. Objective: This study shall consider the opinions of United Kingdom (UK) based pharmacists, pharmacy undergraduates and members of the general public towards the use of mHealth apps to promote adherence to prescribed medication regimens. Methods: On Liverpool John Moores University (LJMU) ethical approval, the 25 item questionnaire was distributed to UK registered pharmacists within inner city Liverpool and Manchester (n=500), pharmacy undergraduates studying at LJMU (n=420) and members of the general public within Liverpool City Centre (n=400). The questions were formatted as multiple choice, Likert scales or the open answer type. The data were analysed using simple frequencies, cross tabulations and non-parametric techniques in the SPSS v22 program. Results: The number of completed questionnaires from the pharmacist, student and general public cohorts were 245, 333 and 400; respectively. The data indicated that the general public rely heavily upon daily routine to take medication as prescribed (54.1%) with mHealth app use being extremely low (1.5%); a similar trend was noted for the pharmacist / student cohorts. The age of the individual is an important consideration, with the younger generation likely to engage with mHealth apps and the older generation less so. Here, education and training are important. Pharmacists (82.3%) would be happy to deliver training packages to the public who would in turn happily receive such training (84%). Key barriers precluding mHealth app use include data reliability, security and technical difficulties. Conclusion: Adherence apps hold great promise to support the patient and their healthcare needs. In order to increase acceptance and

  6. Baseline Assessment of Campus-Wide General Health Status and Mental Health: Opportunity for Tailored Suicide Prevention and Mental Health Awareness Programming

    ERIC Educational Resources Information Center

    Hawley, Lisa D.; MacDonald, Michael G.; Wallace, Erica H.; Smith, Julia; Wummel, Brian; Wren, Patricia A.

    2016-01-01

    Objective: A campus-wide assessment examined the physical and mental health status of a midsize midwestern public university. Participants: Two thousand and forty-nine students, faculty, and staff on a single college campus were assessed in March-April 2013. Methods: Participants completed an online survey with sections devoted to demographics,…

  7. Health and economic impacts of air pollution in China: a comparison of the general equilibrium approach and human capital approach.

    PubMed

    Wan, Yue; Yang, Hong-Wei; Masui, Toshihiko

    2005-12-01

    In China, combustion of fossil fuels and biomass has produced serious air pollution that does harm to human health. Based on dose-response relationships derived from epidemiological studies, the authors calculated the number of deaths and people with health problems which were thought to be attributable to China's air pollution in the year of 2000. In order to estimate the corresponding economic impacts from the national point of view, the general equilibrium approach was selected as an analysis tool for this study. A computable general equilibrium (CGE) model was constructed involving 39 sectors and 32 commodities. The human capital approach (HCA) was also used for comparison. The economic burden of disease for people estimated by HCA was equivalent to 1.26 per thousand (ranging from 0.44 per thousand to 1.84 per thousand) of China's gross domestic product (GDP). China's GDP loss estimated by the general equilibrium approach reached 0.38 per thousand (ranging from 0.16 per thousand to 0.51 per thousand). The difference between the two approaches and the implications of the results were discussed. PMID:16544525

  8. Less indoor cleaning is associated with poor health and unhappiness in adults: Japanese General Social Survey, 2010.

    PubMed

    Shiue, Ivy

    2015-12-01

    Indoor environment is important to human health and well-being. The aim of the present study was to investigate the relationships among indoor cleaning, rubbish disposal and human health and well-being in a national and population-based setting. Data was retrieved from the Japanese General Social Survey, 2010. Information on demographics, lifestyle factors, frequency of indoor cleaning and rubbish disposal and self-reported health and well-being in Japanese adults was obtained by household interview. Analysis included chi-square test, logistic and multi-nominal regression modelling. Of 5003 Japanese adults (aged 20-89) included in the study cohort, 11.4 % (n = 566) never cleaned their living place, 39.1 % had occasional cleaning and 49.6 % had frequent cleaning. Moreover, 17.5 % (n = 869) never disposed rubbish, 24.9 % had occasional rubbish disposal and 57.6 % had frequent rubbish disposal. 15.0 % of Japanese adults claimed poor self-rated health, and 5.9 % reported unhappiness. Compared to people who frequently cleaned the living place, others tended to report poor self-rated health condition (relative risk ratios (RRR) 1.52, 95 % confidence intervals (CI) 1.24-1.85, P < 0.001) and unhappiness (RRR 1.47, 95 % CI 1.10-1.95, P < 0.001). The combined effects of never cleaning and never rubbish disposal significantly impacted on poor self-rated health (RRR 2.61, 95 % CI 1.40-4.88, P = 0.003) and unhappiness (RRR 2.72, 95 % CI 1.72-4.30, P < 0.001). Only half of the Japanese population frequently cleaned their living place and disposed rubbish. Less or never cleaning and rubbish disposal were associated with poor self-rated health, subjective happiness and potentially other health conditions. Public education on maintaining clean indoor environments to optimise psychological well-being in addition to the known physical health would be suggested. PMID:26503003

  9. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

    PubMed Central

    van Eck van der Sluijs, Jonna F; ten Have, Margreet; Rijnders, Cees A; van Marwijk, Harm WJ; de Graaf, Ron; van der Feltz-Cornelis, Christina M

    2016-01-01

    Objective The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18–64 years. We selected subjects with medically unexplained symptoms (MUS) only (MUSonly; n=177), explained physical symptoms only (PHYonly, n=1,952), combined MUS and explained physical symptoms (MUS + PHY, n=209), and controls without physical symptoms (NONE, n=4,168). We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95) for MUSonly, 1.55 (1.13, 2.12) for PHYonly, and 2.25 (1.41, 3.57) for MUS + PHY. At the specialized mental health care level, this was the case only for MUSonly subjects (adjusted odds ratio 1.65 [1.04, 2.61]). In both the primary and specialized mental health care, there were no significant differences between the four groups in the number of treatment contacts once they entered into treatment. Conclusion All sorts of physical symptoms, unexplained as well as explained, were associated with significant higher entry into primary care for mental problems. In specialized mental health care, this was true only for MUSonly. No differences were found in the number of treatment contacts. This warrants further research aimed at the content of the treatment contacts. PMID

  10. The Effectiveness of Mindfulness-Based Cognitive Group Therapy on Marital Satisfaction and General Health in Woman With Infertility.

    PubMed

    Abedi Shargh, Najmeh; Bakhshani, Nour Mohammad; Mohebbi, Mohammad Davoud; Mahmudian, Khadije; Ahovan, Masood; Mokhtari, Mojgan; Gangali, Alireza

    2016-03-01

    Infertility affects around 80 million people around the world and it has been estimated that psychological problems in infertile couples is within the range of 25-60%. The purpose of this study was to determine the effectiveness of Mindfulness-based cognitive group therapy on consciousness regarding marital satisfaction and general health in woman with infertility. Recent work is a clinical trial with a pre/posttest plan for control group. Covering 60 women who were selected by in access method and arranged randomly in interference (30) and control (30) groups. Before and after implementation of independent variable, all subjects were measured in both groups using Enrich questionnaire and marital satisfaction questionnaire. Results of covariance analysis of posttest, after controlling the scores of pretest illustrated the meaningful difference of marital satisfaction and mental health scores in interference and control groups after treatment and the fact that MBCT treatment in infertile women revealed that this method has an appropriate contribution to improvement of marital satisfaction and mental health. Necessary trainings for infertile people through consultation services can improve their mental health and marital satisfaction and significantly help reducing infertile couples' problems. PMID:26493418

  11. Invitation to attend a health check in a general practice setting: the views of a cohort of non-attenders

    PubMed Central

    Pill, Roisin; Stott, Nigel

    1988-01-01

    Two hundred and fifty-nine men and women aged 20-45 years who did not respond to an offer from their general practitioner for a health check were interviewed at home to explore the reasons for non-response. There was no support for the view that the invitation aroused anxiety or that the administrative arrangements had been a barrier to acceptance. Many subjects were not really interested (44%) or just forgot to attend (24%). Crises at work or home (26%) and current attendance at a doctor (16%) were other reasons offered, while 11% felt screening to be in appropriate. There is little that can be done to change these rates except by a shift of public opinion to more consumer demand for health checks or by more opportunistic health checks when people attend their doctors for other reasons. The dangers of marketing health checks to increase consumer demand are discussed in the light of these findings and other work. PMID:3204566

  12. Air pollution-induced health impacts on the national economy of China: demonstration of a computable general equilibrium approach.

    PubMed

    Wan, Yue; Yang, Hongwei; Masui, Toshihiko

    2005-01-01

    At the present time, ambient air pollution is a serious public health problem in China. Based on the concentration-response relationship provided by international and domestic epidemiologic studies, the authors estimated the mortality and morbidity induced by the ambient air pollution of 2000. To address the mechanism of the health impact on the national economy, the authors applied a computable general equilibrium (CGE) model, named AIM/Material China, containing 39 production sectors and 32 commodities. AIM/Material analyzes changes of the gross domestic product (GDP), final demand, and production activity originating from health damages. If ambient air quality met Grade II of China's air quality standard in 2000, then the avoidable GDP loss would be 0.38%o of the national total, of which 95% was led by labor loss. Comparatively, medical expenditure had less impact on national economy, which is explained from the aspect of the final demand by commodities and the production activities by sectors. The authors conclude that the CGE model is a suitable tool for assessing health impacts from a point of view of national economy through the discussion about its applicability. PMID:16121834

  13. The Effectiveness of Mindfulness-Based Cognitive Group Therapy on Marital Satisfaction and General Health in Woman With Infertility

    PubMed Central

    Shargh, Najmeh Abedi; Bakhshani, Nour Mohammad; Mohebbi, Mohammad Davoud; Mahmudian, Khadije; Ahovan, Masood; Mokhtari, Mojgan; Gangali, Alireza

    2016-01-01

    Infertility affects around 80 million people around the world and it has been estimated that psychological problems in infertile couples is within the range of 25-60%. The purpose of this study was to determine the effectiveness of Mindfulness-based cognitive group therapy on consciousness regarding marital satisfaction and general health in woman with infertility. Recent work is a clinical trial with a pre/posttest plan for control group. Covering 60 women who were selected by in access method and arranged randomly in interference (30) and control (30) groups. Before and after implementation of independent variable, all subjects were measured in both groups using Enrich questionnaire and marital satisfaction questionnaire. Results of covariance analysis of posttest, after controlling the scores of pretest illustrated the meaningful difference of marital satisfaction and mental health scores in interference and control groups after treatment and the fact that MBCT treatment in infertile women revealed that this method has an appropriate contribution to improvement of marital satisfaction and mental health. Necessary trainings for infertile people through consultation services can improve their mental health and marital satisfaction and significantly help reducing infertile couples’ problems. PMID:26493418

  14. Association between urinary lead and bone health in a general population from Taiwan.

    PubMed

    Tsai, Tsung-Lin; Pan, Wen-Harn; Chung, Yu-Teh; Wu, Trong-Neng; Tseng, Ying-Chih; Liou, Saou-Hsing; Wang, Shu-Li

    2016-09-01

    Lead accumulates in adult bones for many decades; previous studies have shown lead's detrimental effects on osteoblast and osteoclast activity in association with bone remodeling. Osteoporosis is a disease of the bones resulting in low bone mass that induces fragile bones and hence susceptibility of fracture. We estimated the association between urinary lead (U-Pb) levels and bone health in adults participating in the third Nutrition and Health Survey in Taiwan (NAHSIT) from 2005 to 2008. A total of 398 participants were divided into normal (T-score>-1), osteopenic (T-score between -1 and -2.5), or osteoporotic (T-score<-2.5) groups according to the results of bone mineral density (BMD) measurements. Heavy metals were measured in urine specimens using inductively coupled plasma-mass spectrometry. In the multivariable logistic regression analysis, age (OR=1.08; 95% CI=1.05-1.10), former smokers (OR=2.95; 95% CI=1.22-7.11) and higher U-Pb levels than upper tertile (OR=2.30; 95% CI=1.19-4.48) were associated with osteopenia/osteoporosis. Furthermore, age (OR=1.06; 95% CI=1.02-1.10) and higher U-Pb levels (OR=2.81; 95% CI=1.13-6.97) were significantly associated with osteopenia and osteoporosis in women. These results suggest that adults, particularly in women, with higher U-Pb levels may have increased odds of osteopenia and osteoporosis. PMID:26152405

  15. Occupational hazard exposure and general health profile of welders in rural Delhi

    PubMed Central

    Chauhan, Anuradha; Anand, Tanu; Kishore, Jugal; Danielsen, Tor Erik; Ingle, Gopal Krishna

    2014-01-01

    Background: Welding is a common industrial process associated with various health hazards. The aspect of duration of hazard exposure among welders at their workplace has been studied to limited extent in India. Objective: To assess the duration of occupational hazard exposure and its association with symptoms among the welders. Materials and Methods: A cross-sectional study was conducted amongst 106 welders in North Delhi. Data was collected using a questionnaire containing items to assess the socio-demographic profile, their medical history and individual hazard exposure. Results: Majority of them were involved in skilled/semi-skilled job (n = 99; 93%). The predominant nature of work for majority was manual. More than half reported their work to be physically hard (n = 56; 53%), involves much lifting of weight (n = 61; 57%), and is dangerous (n = 59; 56%). Dust/smoke followed by noise was reported to be most common hazards at the workplace by them. Most of them were suffering from eye related symptoms (n = 63; 59%) followed by skin conditions (n = 28; 26%). Skin diseases were reported to be significantly common among group of welders who were exposed to dust and radiation for ≥4 hours in a day (P < 0.05). Conclusions: Nearly half of the welders found their job to be dangerous and were being exposed to at least one hazardous substance at their workplace. Majority of them complained of eye symptoms. There is a need for health and safety training of this economically productive group. PMID:25006312

  16. Unlimited access to health care - impact of psychosomatic co-morbidity on utilisation in German general practices

    PubMed Central

    2011-01-01

    Background The effect of psychosomatic co-morbidity on resource use for systems with unlimited access remains unclear. The aim of this study was to evaluate the impact on practice visits, referrals and periods of disability in German general practices and to identify predictors of health care utilisation. Methods Cross sectional observational study in 13 practices in Upper Bavaria. Patients were included consecutively and filled in the Patients Health Questionnaire (PHQ). Numbers of practice visits, referrals and periods of disability within the last twelve months and permanent mental and somatic diagnoses were extracted manually by review of the computerised charts. Physicians in Germany are obliged to document repetitive reasons of encounter as permanent diagnoses in terms of ICD-10-codes. These ICD-10-codes are used for legitimisation of reimbursement in German general practices. Results 1005 patients were included (58.6% female). On average, patients had 15.3 (sd 16.3) practice contacts, 3.8 (sd 4.2) referrals and 7.5 (sd 23.1) days of disability per year. The mean number of coded permanent diagnoses was 0.4 (sd 0.7) for mental and 4.0 (sd 4.0) for somatic diagnoses. Patients with mental diagnoses scored higher in depression, anxiety, panic and somatoform disorder scales of PHQ. Frequent practice visits were associated stronger with coded permanent mental diagnoses (OR 20.0; 95%CI 7.5-53.9) than with coded permanent somatic diagnoses (OR 14.4; 95%CI 5.9-35.4). Frequent referrals were associated stronger with somatic diagnoses (OR 4.9; 95%CI 2.0-11.9) than with mental diagnoses (OR 3.6; 95%CI 1.4-9.8). Periods of disability were predicted by mental diagnoses (OR 5.0; 95%CI 1.6-15.8) but not by somatic diagnoses (OR 2.5; 95%CI 0.7-8.1). Conclusions Psychosomatic co-morbidity has a stronger impact on health care utilisation in German general practices with respect to practice visits and periods of disability whereas somatic disorders play a stronger role for

  17. Consultations in general practices with and without mental health nurses: an observational study from 2010 to 2014

    PubMed Central

    Magnée, Tessa; de Beurs, Derek P; de Bakker, Dinny H; Verhaak, Peter F

    2016-01-01

    Objectives To investigate care for patients with psychological or social problems provided by mental health nurses (MHNs), and by general practitioners (GPs) with and without MHNs. Design An observational study with consultations recorded by GPs and MHNs. Setting Data were routinely recorded in 161–338 Dutch general practices between 2010 and 2014. Participants All patients registered at participating general practices were included: 624 477 patients in 2010 to 1 392 187 patients in 2014. Outcome measures We used logistic and Poisson multilevel regression models to test whether GPs recorded more patients with at least one consultation for psychological or social problems and to analyse the number of consultations over a 5-year time period. We examined the additional effect of an MHN in a practice, and tested which patient characteristics predicted transferral from GPs to MHNs. Results Increasing numbers of patients with psychological or social problems visit general practices. Increasing numbers of GPs collaborate with an MHN. GPs working in practices with an MHN record as many consultations per patient as GPs without an MHN, but they record slightly more patients with psychological or social problems (OR=1.05; 95% CI 1.02 to 1.08). MHNs most often treat adult female patients with common psychological symptoms such as depressive feelings. Conclusions MHNs do not seem to replace GP care, but mainly provide additional long consultations. Future research should study to what extent collaboration with an MHN prevents patients from needing specialised mental healthcare. PMID:27431902

  18. [Hypolipidemic and antihypertensive therapy in diabetic patients in the Czech Republic: notes on the VZP (General Health Insurance Company) Data].

    PubMed

    Šnejdrlová, Michaela; Češka, Richard; Janíčková-Žďárská, Denisa; Honěk, Petr; Dušek, Pavel; Pavlík, Tomáš; Kvapil, Milan

    2015-11-01

    Diabetes mellitus and in particular type 2 diabetes mellitus is one of the most important risk factors of cardiovascular disease. To influence cardiovascular risk there is enormous important not only positive influence of glycemia, but also the treatment of diabetic dyslipidemia and hypertension. The present work provides an analysis of lipid-lowering and antihypertensive therapy for all diabetics registered with General Health Insurance Company in the period 2010-2013. In this time 866,570 patients with diabetes mellitus registered with General Health Insurance Company were treated, the majority of them were diabetics independent on insulin. Approximately half of the patients were observed by dialectologists and half of them by the doctors of other specialization. Out of antihypertensive medi-cation, patients were most often treated by drugs that affect the renin-angiotensin system, as well as beta-blockers and diuretics. Prescription of the lipid-lowering therapy, especially prescription of statins, in accordance with the guidelines, is increasing, but remains insufficient (at 2013 43.6% diabetics treated by dialectologists and 51.3% diabetics treated by GP´s didn´t have lipid lowering therapy). Inadequate use of combination lipid-lowering therapy was recorded too, still represented mainly by combination of statin and fibrate, but in coming years we expect (based on the positive results of the subanalysis IMPROVE-IT study), an increase of combination therapy statin and ezetimibe. PMID:26652963

  19. Transforming the blood glucose meter into a general healthcare meter for in vitro diagnostics in mobile health.

    PubMed

    Lan, Tian; Zhang, Jingjing; Lu, Yi

    2016-01-01

    Recent advances in mobile network and smartphones have provided an enormous opportunity for transforming in vitro diagnostics (IVD) from central labs to home or other points of care (POC). A major challenge to achieving the goal is a long time and high costs associated with developing POC IVD devices in mobile Health (mHealth). Instead of developing a new POC device for every new IVD target, we and others are taking advantage of decades of research, development, engineering and continuous improvement of the blood glucose meter (BGM), including those already integrated with smartphones, and transforming the BGM into a general healthcare meter for POC IVDs of a wide range of biomarkers, therapeutic drugs and other analytical targets. In this review, we summarize methods to transduce and amplify selective binding of targets by antibodies, DNA/RNA aptamers, DNAzyme/ribozymes and protein enzymes into signals such as glucose or NADH that can be measured by commercially available BGM, making it possible to adapt many clinical assays performed in central labs, such as immunoassays, aptamer/DNAzyme assays, molecular diagnostic assays, and enzymatic activity assays onto BGM platform for quantification of non-glucose targets for a wide variety of IVDs in mHealth. PMID:26946282

  20. A face for all seasons: Searching for context-specific leadership traits and discovering a general preference for perceived health

    PubMed Central

    Spisak, Brian R.; Blaker, Nancy M.; Lefevre, Carmen E.; Moore, Fhionna R.; Krebbers, Kleis F. B.

    2014-01-01

    Previous research indicates that followers tend to contingently match particular leader qualities to evolutionarily consistent situations requiring collective action (i.e., context-specific cognitive leadership prototypes) and information processing undergoes categorization which ranks certain qualities as first-order context-general and others as second-order context-specific. To further investigate this contingent categorization phenomenon we examined the “attractiveness halo”—a first-order facial cue which significantly biases leadership preferences. While controlling for facial attractiveness, we independently manipulated the underlying facial cues of health and intelligence and then primed participants with four distinct organizational dynamics requiring leadership (i.e., competition vs. cooperation between groups and exploratory change vs. stable exploitation). It was expected that the differing requirements of the four dynamics would contingently select for relatively healthier- or intelligent-looking leaders. We found perceived facial intelligence to be a second-order context-specific trait—for instance, in times requiring a leader to address between-group cooperation—whereas perceived health is significantly preferred across all contexts (i.e., a first-order trait). The results also indicate that facial health positively affects perceived masculinity while facial intelligence negatively affects perceived masculinity, which may partially explain leader choice in some of the environmental contexts. The limitations and a number of implications regarding leadership biases are discussed. PMID:25414653

  1. A face for all seasons: Searching for context-specific leadership traits and discovering a general preference for perceived health.

    PubMed

    Spisak, Brian R; Blaker, Nancy M; Lefevre, Carmen E; Moore, Fhionna R; Krebbers, Kleis F B

    2014-01-01

    Previous research indicates that followers tend to contingently match particular leader qualities to evolutionarily consistent situations requiring collective action (i.e., context-specific cognitive leadership prototypes) and information processing undergoes categorization which ranks certain qualities as first-order context-general and others as second-order context-specific. To further investigate this contingent categorization phenomenon we examined the "attractiveness halo"-a first-order facial cue which significantly biases leadership preferences. While controlling for facial attractiveness, we independently manipulated the underlying facial cues of health and intelligence and then primed participants with four distinct organizational dynamics requiring leadership (i.e., competition vs. cooperation between groups and exploratory change vs. stable exploitation). It was expected that the differing requirements of the four dynamics would contingently select for relatively healthier- or intelligent-looking leaders. We found perceived facial intelligence to be a second-order context-specific trait-for instance, in times requiring a leader to address between-group cooperation-whereas perceived health is significantly preferred across all contexts (i.e., a first-order trait). The results also indicate that facial health positively affects perceived masculinity while facial intelligence negatively affects perceived masculinity, which may partially explain leader choice in some of the environmental contexts. The limitations and a number of implications regarding leadership biases are discussed. PMID:25414653

  2. Health status of Greek thyroid cancer patients after radioiodine administration compared to a demographically matched general population sample.

    PubMed

    Karapanou, Olga; Papadopoulos, Angelos; Vlassopoulou, Barbara; Vassilopoulos, Charalambos; Pappa, Evelina; Tsagarakis, Stylianos; Niakas, Dimitris

    2012-01-01

    The impact of radioiodine-131 ((131)I) treatment on thyroid cancer patients' quality of life is controversial. We conducted a cross-sectional study of 60 patients aged 18-73 years old who had recently underwent near total thyroidectomy due to papillary thyroid cancer and were scheduled for (131)I treatment. On admission to our department, prior to (131)I administration patients underwent clinical and laboratory investigation including routine clinical biochemistry, thyroid stimulating hormone (TSH) and thyroglobulin (Tg) measurements. Health-related quality of life (HRQoL) was estimated by the SF-36 Health Survey a generic instrument which consisted from eight scales (four for physical and four for mental health). After (131)I administration patients were discharged and approximately 6 months later they were re-evaluated. Our results showed that HRQoL in thyroid cancer patients receiving (131)I treatment is independent of age/gender and thyroid cancer-related variables. All SF-36 scales significantly improved six months after administration (P<0.05). Compared to Greek general population, before (131)I administration all scales were significantly lower (P<0.05). Six months post (131)I administration, scales were significantly lower for physical functioning (P=0.02), physical role (P=0.01), social functioning (P=0.03) and emotional role limitations (P=0.04), whereas the remaining SF-36 scales were comparable to the general population. In conclusion, hypothyroidism and anxiety for the outcome of their disease before (131)I treatment exert a negative impact on thyroid cancer patients. Quality of life improvement post (131)I is mainly attributed to the resumption of euthyroidism and familiarization with treatment and followup procedures rather than (131)I treatment itself. There was no significant difference between patients receiving lower (2220-3700MBq) and higher (3700-7400MBq) dosage. PMID:22741146

  3. "Aging males" symptoms and general health of adult males: a cross-sectional study.

    PubMed

    Yuen, John W; Ng, Chi-Fai; Chiu, Peter Ka Fung; Teoh, Jeremy Yuen Chun; Yee, C H

    2016-06-01

    A cross-sectional study was conducted to explore the prevalence and severity of health-related complaints perceived by adult males of Hong Kong by using the Hong Kong Traditional Chinese versions of the Aging males' symptoms (AMS) scale and the 5-dimensional and 3-level European Quality of life (EQ-5D-3L) questionnaire. A total of 825 adult males aged 40 years or above were surveyed, and observed that 80% of the population was living with little-to-mild levels of aging symptoms with mean total scores ranged between 26.02 ± 7.91 and 32.99 ± 7.91 in different age groups. Such symptoms were correlated with age, especially for the somato-vegetative and sexual symptoms. The most severe AMS symptoms were observed in the oldest age group at 70 years or above, with 76%, 34% and 70% living with moderate-to-severe levels of somato-vegetative, psychological and sexual symptoms, respectively. The result was highly correlated with the EQ-5D-3L questionnaire. Secondly, the Hong Kong Aging males' symptoms (AMS) scale was shown to have good reliability with test-retest coefficient at 0.79 (ranged 0.66-0.87) and Cronbach's alpha coefficient at 0.88 (ranged 0.70-0.84). In summary, the population of Hong Kong male adults was commonly living with little-to-mild levels of aging symptoms, whereas their severity was correlated with age. PMID:27068128

  4. Ethical principles and the rationing of health care: a qualitative study in general practice

    PubMed Central

    Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

    2005-01-01

    Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

  5. Childhood cognitive ability and adult mental health in the British 1946 birth cohort

    PubMed Central

    Hatch, Stephani L.; Jones, Peter B.; Kuh, Diana; Hardy, Rebecca; Wadsworth, Michael E.J.; Richards, Marcus

    2007-01-01

    We examined whether childhood cognitive ability was associated with two mental health outcomes at age 53 years: the 28 item General Health Questionnaire (GHQ-28) as a measure of internalising symptoms of anxiety and depression, and the CAGE screen for potential alcohol abuse as an externalising disorder. A total of 1875 participants were included from the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort. The results indicated that higher childhood cognitive ability was associated with reporting fewer symptoms of anxiety and depression GHQ-28 scores in women, and increased risk of potential alcohol abuse in both men and women. Results were adjusted for educational attainment, early socioeconomic status (SES) and adverse circumstances, and adult SES, adverse circumstances, and negative health behaviours. After adjusting for childhood cognitive ability, greater educational attainment was associated with reporting greater symptoms of anxiety and depression on the GHQ-28. Although undoubtedly interrelated, our evidence on the diverging effects of childhood cognitive ability and educational attainment on anxiety and depression in mid-adulthood highlights the need for the two to be considered independently. While higher childhood cognitive ability is associated with fewer internalising symptoms of anxiety and depression in women, it places both men and women at higher risk for potential alcohol abuse. Further research is needed to examine possible psychosocial mechanisms that may be associated with both higher childhood cognitive ability and greater risk for alcohol abuse. In addition, the underlying mechanisms responsible for the gender-specific link between childhood cognitive ability and the risk of experiencing internalising disorders in mid-adulthood warrants further consideration. PMID:17397976

  6. Ethnicity, health and medical care: towards a critical realist analysis of general practice in the Korean community in Sydney.

    PubMed

    Han, Gil-Soo; Davies, Carmel

    2006-11-01

    This paper investigates the use and provision of biomedicine among Korean-Australian men on the basis of interview data from all of the eight Korean-speaking doctors practising in the Korean community in Sydney in 1995. From the viewpoint of these general practitioners, an analysis is made of the processes Korean men go through in adjusting to a new country, being involved in constant hard manual work and long working hours, and explores how they make use of all available resources to stay healthy. The Korean men have fully utilized the 'freely' available medical services under government-subsidized Medicare, bearing in mind that health is a capacity to work under the current environment, although illegal migrants restrained themselves from using it until they obtained legal status. Korean-speaking medical practitioners have been able to provide their fellow Koreans with 'culturally appropriate' health care, with the key factor being the absence of a language barrier. The level of patient satisfaction is high, possibly due to the excellent understanding the doctors have of the social aspects of illnesses, although the doctors do not go beyond curative medicine in their practice. However, the increasing number of Korean-speaking doctors in the small Korean community means that there is competition for patients. Consequently, the medical care is highly entrepreneurial. Referral by Korean doctors to practitioners of Korean herbal medicine is also a notable feature of the health care sector of the Korean community, especially as this offers Korean patients 'satisfactory' health relief for problems that are not easily relieved by doctors in the biomedical system. PMID:17060035

  7. Health care professionals’ perceptions towards lifelong learning in palliative care for general practitioners: a focus group study

    PubMed Central

    2014-01-01

    Background There is a growing need for palliative care. The majority of palliative patients prefer their general practitioner (GP) to organize their palliative home care. General practitioners need a range of competences to perform this task. However, there has been no general description so far of how GPs keep these competences up-to-date. The present study explores current experiences, views and preferences towards training and education in palliative care among GPs, palliative home-care professionals and professionals from organizations who provide training and education. Methods Five focus groups were brought together in Belgium, with a total of 29 participants, including members of the three categories mentioned above. They were analysed using a constant comparison method. Results The analysis revealed that undergraduate education and continuing medical education (CME) while in practice, is insufficient to prepare GPs for their palliative work. Workplace learning (WPL) through collaboration with specialized palliative home-care nurses seems to be a valuable alternative. Conclusions The effectiveness of undergraduate education might be enhanced by adding practical experience. Providers of continuing medical education should look to organize interactive, practice-based and interprofessional sessions. Therefore, teachers need to be trained to run small group discussions. In order to optimize workplace learning, health care professionals should be trained to monitor each other’s practice and to provide effective feedback. Further research is needed to clarify which aspects of interprofessional teamwork (e.g. professional hierarchy, agreements on tasks and responsibilities) influence the effectiveness of workplace learning. PMID:24552145

  8. Quantitative study evaluating perception of general public towards role of pharmacist in health care system of Pakistan.

    PubMed

    Jin, Xianglan; Azhar, Saira; Murtaza, Ghulam; Xue, Feiran; Mumtaz, Amara; Niu, Huanmin; Taha, Asia; Zhang, Yunling

    2014-01-01

    To investigate general public perception towards the role of pharmacist in developing countries' healthcare system was the main aim of this study, which would be the basic foundation for researching the treatment pattern of cognitive disorder after stroke in communities. The study population (sample size = 385) consisted of general public from Islamabad, Faisalabad and Lahore, Pakistan. Main sections of the questionnaire comprised of series of statements pertaining to consumer's perception and experience with the pharmacists. The response rate of study was 77.1%. A majority (80.1%) of the consumers knows who is pharmacist; 49.8% (n = 148) of the respondents found the pharmacist working in the pharmacies; 74.1% (n = 220) believed that pharmacist can guide them regarding their medicine. With respect to government efforts to improve services provided by community pharmacies, less percentage (31.0%) of the consumers were satisfied. Half of the respondents (59.9%) were expecting from the pharmacists to be knowledgeable drug therapy experts, whereas 61.3% (n = 182) expect from the pharmacists to educate them regarding safe and appropriate use of medication. The findings of this study conclude that the quality of pharmaceutical services provided is very low in Pakistan. There is a gap between the public and the pharmacist, which can only be filled by creating awareness among public regarding the pharmacist's role in healthcare system and by focusing on how services provided by the pharmacists can add improvement to general public health. PMID:25362816

  9. Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui

    2009-01-01

    Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…

  10. Social safety, self-rated general health and physical activity: changes in area crime, area safety feelings and the role of social cohesion.

    PubMed

    Ruijsbroek, Annemarie; Droomers, Mariël; Groenewegen, Peter P; Hardyns, Wim; Stronks, Karien

    2015-01-01

    The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated whether social cohesion protects the residents against the negative impact of unsafe areas on health and PA. Multilevel logistic regression analyses were performed on Dutch survey data, including 47,926 respondents living in 2974 areas. An increase in area level unsafety feelings between 2009 and 2011 was associated with more people reporting poor general health in 2012 in that area, but was not related to PA. Changes in reported area crime were not related to either poor general health or PA. The social cohesion in the area did not modify the effect of changes in social safety on health and PA. The results suggest that tackling feelings of unsafety in an area might contribute to the better general health of the residents. Because changes in area social safety were not associated with PA, we found no leads that such health benefits were achieved through an increase in physical activity. PMID:25463916

  11. The 2014 Surgeon General's report: commemorating the 50th Anniversary of the 1964 Report of the Advisory Committee to the US Surgeon General and updating the evidence on the health consequences of cigarette smoking.

    PubMed

    Alberg, Anthony J; Shopland, Donald R; Cummings, K Michael

    2014-02-15

    The question of whether cigarette smoking was associated with lung cancer was central to the expansion of epidemiology into the study of chronic diseases in the 1950s. The culmination of this era was the 1964 report of the Advisory Committee to the Surgeon General, a landmark document that included an objective synthesis of the evidence of the health consequences of smoking according to causal criteria. The report concluded that cigarette smoking was a cause of lung cancer in men and sufficient in scope that "remedial action" was warranted at the societal level. The 2014 Surgeon General's report commemorates the 50th anniversary of the 1964 report. The evidence on the health consequences of smoking has been updated many times in Surgeon General's reports since 1964. These have summarized our increasingly greater understanding of the broad spectrum of the deleterious health effects of exposure to tobacco smoke across most major organ systems. In turn, this evidence has been translated into tobacco control strategies implemented to protect the public's health. The Surgeon General report process is an enduring example of evidence-based public health in practice. Substantial progress has been made, but cigarette smoking remains one of the most pressing global health issues of our time. PMID:24436362

  12. The State of Regulation in England: From the General Social Care Council to the Health and Care Professions Council

    PubMed Central

    McLaughlin, Kenneth; Leigh, Jadwiga; Worsley, Aidan

    2016-01-01

    In this paper, we analyse the way in which social work, as a profession, has coped with and responded to the various forms of regulation to which it has been subject in England. First, we briefly detail the rise of external regulation of the professions, discussing both the rationale for, and criticisms of, such developments. Second, we take a closer look at developments within social work and the operation of the General Social Care Council (GSCC)'s conduct proceedings from its inception in 2001 until its dissolution in 2012. Third, we focus on the Health and Care Professions Council (HCPC) and consider how it has begun its regulation of social workers since it took on this responsibility from August 2012. We conclude by outlining some of the concerns we have as well as discussing reasons as to why we feel this area of work needs to be explored further. PMID:27559200

  13. Communicating about race and health: a content analysis of print advertisements in African American and general readership magazines.

    PubMed

    Godbold Kean, Linda; Prividera, Laura C

    2007-01-01

    A content analysis was conducted to investigate advertisements for consumption products (food, beverages, vitamins, and supplements) in a major magazine aimed at an African American female population as compared to one with a more general female readership. All advertisements for consumption products from Essence and Cosmopolitan magazines from January 2004 to December 2004 were included in the study. The data revealed that the 3 most advertised products in Essence were individual food items, nonalcoholic beverages, and fast food. In Cosmopolitan individual food items, alcoholic beverages, and weight loss products were most advertised. Both magazines included a number of ads making health claims regarding the products. Cosmopolitan had more weight loss claims in the magazine's advertisements than did Essence. The results indicated that marketing of consumption products differs based on the magazine's target population in regard to race. PMID:17567260

  14. Comparison of the health-related quality of life between epileptic patients with partial and generalized seizure

    PubMed Central

    Ashjazadeh, Nahid; Yadollahikhales, Golnaz; Ayoobzadehshirazi, Anaheed; Sadraii, Nazanin; Hadi, Negin

    2014-01-01

    Background: Epilepsy is defined as recurrent unprovoked febrile seizures, which cause disability in patients. This study aims to assess the health-related quality-of-life (QOL) in epileptic patients in Fars Province, southern Iran. Methods:One-hundred epileptic patients, above 18 years, referred to Shiraz University of Medical Sciences affiliated clinics, were included. The QOL of patients with generalized and partial seizure were assessed using the Iranian valid and reliable Sf-36 questionnaire. Patients’ socio-demographic and their disease features were also compared with each other using a questionnaire. Results: In partial epilepsy group (n = 24), the married patients in social functioning (SF) aspect of QOL (64.42 ± 14.29) (P = 0.024), the patients on antiepileptic drugs (AEDs) monotherapy in both physical functioning (PF) (88.75 ± 11.57) (P = 0.030) and SF (75.00 ± 6.68) (P = 0.022) aspects, the employed patients in PF aspect of QOL (P = 0.023) (91.87 ± 8.83) and those with high income in mental health aspect of QOL (P = 0.036 and correlation coefficient = 0.413) got better scores compared with the partial epileptic patients who were single, on polytherapy, unemployed and had low to moderate income. In generalized epilepsy group (n = 76), patients on AEDs monotherapy in PF aspect of QOL (P = 0.025) (78.33 ± 24.36) and employed patients in vitality aspect (P = 0.023) (57.00 ± 28.25) had better scores. Data were analyzed using SPSS for windows. Conclusion: Epilepsy can affect patient’s life in a number of ways such as their lives, marriage, occupation, and education. We can encourage patients to find a partner, continue higher education and try to find a job. PMID:25295153

  15. Scared to lose control? General and health locus of control in females with a phobia of vomiting.

    PubMed

    Davidson, Angela L; Boyle, Christopher; Lauchlan, Fraser

    2008-01-01

    The term emetophobia (i.e., a fear of vomiting) exists as rather an elusive predicament, often eluding conventional treatment. The present study involved 149 participants, consisting of 51 emetophobics, 48 phobic controls (i.e. those who suffered from a different phobia), and 50 nonphobic controls. Participants were administered the Rotter (1966) Locus of Control Scale and the Health Locus of Control Scale by B.S. Wallston, Wallston, Kaplan, and Maides (1976). Significant differences were found among the three groups; specifically, that emetophobics had a significantly higher internal Locus of Control Scale score with regard to both general and health-related issues than did the two control groups. It is suggested that vomiting phobics may have a fear of losing control, and that their vomiting phobia is reflective of this alternative, underlying problem. More research is required to explore the association between emetophobia and issues surrounding control; however, the current study suggests that it may be helpful for therapists to consider this aspect when treating a patient with vomiting phobia. PMID:18161045

  16. Health assessment for General Tire and Rubber Company, Mayfield, Kentucky, Region 4. CERCLIS No. KYD006371074. Preliminary report

    SciTech Connect

    Not Available

    1990-06-08

    The General Tire Rubber Co. (Mayfield Landfill) site, about 58 acres, is about 3 miles north of Mayfield, Kentucky, in central Graves County. The site has been proposed (Update 7) by the U.S. Environmental Protection Agency for addition to the National Priorities List. The site vicinity is a combined rural and residential setting. Wastes, in bulk and in containers, were disposed of at the site in trenches, and the landfill was capped when the facility was closed in 1984. Reportedly, wastes were principally rubber, fabric, wood, and paper but included oils, floor sweepings, 1,1,1-trichloroethane, naphtha, and toluene. Surface soils, sediment, surface water, subsurface gases, and ambient air may be substantive environmental pathways; but monitoring data are not sufficient to confirm this hypothesis. Using the information reviewed, the Agency for Toxic Substances and Disease Registry concludes that this site is of potential public health concern because humans may be exposed to hazardous substances at concentrations that may result in adverse health effects.

  17. Adolescent over-general memory, life events and mental health outcomes: Findings from a UK cohort study.

    PubMed

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J Mark G

    2016-01-01

    Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations. PMID:25716137

  18. Adolescent over-general memory, life events and mental health outcomes: Findings from a UK cohort study

    PubMed Central

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.

    2016-01-01

    Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations. PMID:25716137

  19. A comparative analysis of some policy options to reduce rationing in the UK's NHS: lessons from a general equilibrium model incorporating positive health effects.

    PubMed

    Rutten, Martine; Reed, Geoffrey

    2009-01-01

    This paper seeks to determine the macro-economic impacts of changes in health care provision. The resource allocation issues have been explored in theory, by applying the Rybczynski theorem, and empirically, using a computable general equilibrium (CGE) model for the UK with a detailed health component. From the theory, changes in non-health outputs are shown to depend on factor-bias and scale effects, the net effects generally being indeterminate. From the applied model, a rise in the National Health Service (NHS) budget is shown to yield overall welfare gains, which fall by two-thirds assuming health care-specific factors. A nominally equivalent migration policy yields even higher welfare gains. PMID:19062116

  20. [Suicide risk and suicide attempt in North Pas de Calais Region. Lessons from the survey Mental Health in General Population].

    PubMed

    Danel, T; Vilain, J; Roelandt, J L; Salleron, J; Vaiva, G; Amariei, A; Amarie, A; Plancke, L; Plance, L; Duhamel, A

    2010-01-01

    The Santé Mentale en Population Générale Survey (Mental Health in General Population Survey (MHGP)) is a multicentre international research and action project initiated by the World Health Organisation Collaboration Centre for research and training in mental health. Its aims are to assess the prevalence of the major mental health disorders in the general adult population and from this to record perceptions associated with "mental illness", "madness" and "depression" together with different means of assistance and specialist or lay care. In this work we present the analysis of data on risks of suicide and past history of suicide attempts in the Nord pas de Calais region. We present the qualitative features of these phenomena and correlations with socio-economic, cultural and psychopathological factors, which are discussed in terms of both protective and vulnerability factors. Risk of suicide is present in 15% of the Nord pas de Calais population and is divided into 10.44% slight risk, 2.37% moderate risk and 2.2% high risk. A comparison with data from the MHGP survey in other regions reveals the high risk of suicide in the NPDC region. A risk of suicide is present is 13% of the population in other SMPG survey regions, broken down into 9.1% low risk, 2.1% medium risk and 1.7% high risk. Compared to the 2.2% high risk figure for NPDC, the population in this category is 21% larger. In terms of risk and protective factors, a bivariate analysis of socio-economic and cultural factors confirms the classical risk factors of sex, marital, occupational and educational status and income. The odds-ratio for these socio-economic and cultural factors can be calculated from logistic regression and the protective factors ranked in decreasing order from religion (Muslim versus other religions), martial status (marked versus separated), age (over 58 years old), occupational status (working or retired versus unemployed), income (more than 1300 euros versus less than 840 euros), sex

  1. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related...

  2. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related...

  3. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related...

  4. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related...

  5. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related...

  6. Design and Evaluation of a Health-Focused Personal Informatics Application with Support for Generalized Goal Management

    ERIC Educational Resources Information Center

    Medynskiy, Yevgeniy

    2012-01-01

    The practice of health self-management offers behavioral and problem-solving strategies that can effectively promote responsibility for one's own wellbeing, improve one's health outcomes, and decrease the cost of health services. Personal informatics applications support health self-management by allowing their users to easily track…

  7. A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across the first three semesters of veterinary school.

    PubMed

    Reisbig, Allison M J; Danielson, Jared A; Wu, Tsui-Feng; Hafen, McArthur; Krienert, Ashley; Girard, Destiny; Garlock, Jessica

    2012-01-01

    This study builds on previous research on predictors of depression and anxiety in veterinary medical students and reports data on three veterinary cohorts from two universities through their first three semesters of study. Across all three semesters, 49%, 65%, and 69% of the participants reported depression levels at or above the clinical cut-off, suggesting a remarkably high percentage of students experiencing significant levels of depression symptoms. Further, this study investigated the relationship between common stressors experienced by veterinary students and mental health, general health, and academic performance. A factor analysis revealed four factors among stressors common to veterinary students: academic stress, transitional stress, family-health stress, and relationship stress. The results indicated that both academic stress and transitional stress had a robust impact on veterinary medical students' well-being during their first three semesters of study. As well, academic stress negatively impacted students in the areas of depression and anxiety symptoms, life satisfaction, general health, perception of academic performance, and grade point average (GPA). Transitional stress predicted increased depression and anxiety symptoms and decreased life satisfaction. This study helped to further illuminate the magnitude of the problem of depression and anxiety symptoms in veterinary medical students and identified factors most predictive of poor outcomes in the areas of mental health, general health, and academic performance. The discussion provides recommendations for considering structural changes to veterinary educational curricula to reduce the magnitude of academic stressors. Concurrently, recommendations are suggested for mental health interventions to help increase students' resistance to environmental stressors. PMID:23187027

  8. Evaluation of National Leprosy Eradication Program after Integration into General Health System in Rajkot District, Gujarat from 2003 to 2014

    PubMed Central

    Chudasama, Rajesh K; Lakkad, S G; Patel, Umed V; Sheth, Ankit; Thakkar, Dhara; Rangoonwala, Matib

    2016-01-01

    Background: National Leprosy Eradication Program (NLEP) was launched in 1983 with the goal of elimination of leprosy as a public health problem. Aim: To evaluate the NLEP performance after integration into general health system from April 2003 to March 2014. Material and Methods: A retrospective record based study was conducted by obtaining data from Rajkot district leprosy center. Prevalence rate (PR), new case detection rate (NCDR), proportion of female cases, child cases, multibacillary (MB) cases, Grade II disability among new cases and release from treatment (RFT) cases were evaluated from April 2003 to March 2014 and analyzed by using Chi-square for trend analysis test. Results: The PR of leprosy per 10,000 populations was significantly declined (P < 0.001) from 0.44 in 2003–2004 to 0.15 during March 2014. Reduction in NCDR trend was statistically significant (P < 0.001). The proportion of female cases among newly detected cases showed fluctuation from 36.23% in 2003–2004 to 37.10% in 2013–2014 (P > 0.05). The proportion of child cases also showed significantly declining trend from 12.08% in 2003–2004 to 6.70% in 2013–2014 (P < 0.05). Significant number of MB cases decreased from 122 (2003–2004) to 69 (2013–2014) (P < 0.001). Grade II disability proportion was 1.45% in the year 2003–2004, increased to 5.2% in 2009–2010 and then again decreased to 3.4% in 2013–2014 (P > 0.05). Proportion of patients RFT showed fluctuation from 66.66% (2003–2004) to 45.68% (2009–2010) and then 64.66% (2013–2014) (P < 0.001). Conclusion: The NLEP is having a favorable impact on the problem of leprosy by maintaining the elimination level of leprosy in Rajkot district over a decade. PMID:26955096

  9. The effect on compliance of a health education leaflet in colorectal cancer screening in general practice in central England.

    PubMed Central

    Hart, A R; Barone, T L; Gay, S P; Inglis, A; Griffin, L; Tallon, C A; Mayberry, J F

    1997-01-01

    OBJECTIVE: To raise compliance in a general practice based colorectal cancer screening programme by the use of a simple health educational leaflet. DESIGN: A randomised controlled trial of the leaflet's effect on completion of faecal occult blood tests. The leaflet explained the high frequency of colorectal cancer, the principles of screening, and addressed reasons for non-compliance. SETTING: The British town of Market Harborough where most of the population are registered with a single practice. PARTICIPANTS: These comprised 1571 residents aged 61 to 70 years registered with the practice. Residents were invited to receive a free faecal occult blood test in a colorectal cancer screening programme. Half the population were randomly assigned to receive the educational leaflet about screening. RESULTS: Compliance in test and control groups, positive rate of stool testing, and pathology detected were measured. Compliance was higher in men who received the leaflet in those aged 61 to 65 years (36% v 27%, chi2 = 4.0, p < 0.05) and in men aged 66 to 70 years (39% v 23%, chi2 = 9.7, p < 0.01). In women, use of the leaflet did not affect compliance in those aged either 61 to 65 years (38% v 36%, chi2 = 0.1, NS) or 66 to 70 years (31% v 31%, chi2 = 0.0, NS). The positive rate of stool testing in patients observing the required dietary restrictions was 1.6%. A significant lesion was detected in 1.4% of people tested (2 carcinomas and 5 patients with adenomatous polyps). CONCLUSIONS: Health education leaflets addressing reasons for non-compliance significantly increased compliance in men and should be used in screening programmes. Reasons for the lack of success of the leaflet in women should be investigated and other interventions for raising compliance should be developed. PMID:9196650

  10. Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul.

    PubMed

    Tunaligil, Verda; Dokucu, Ali Ihsan; Erdogan, Mehmet Sarper

    2016-07-01

    This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p < .05). In the private sector, commute time to and from work (p < .05), false accusations (p < .05), vocational training and education (p < .05), informed career choices (p < .05), and work-related permanent disabilities (p < .05) were found to significantly influence self-reported perceptions of well-being. EMT-Bs were asked about aspects of their working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention. PMID:27034407

  11. Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany

    PubMed Central

    2014-01-01

    Background With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients. Methods Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses. Results Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson’s disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors. Conclusion In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH. Trial registration MultiCare Cohort study registration:ISRCTN89818205. PMID:24387712

  12. Reducing health inequalities in people with learning disabilities: a multi-disciplinary team approach to care under general anaesthesia.

    PubMed

    Clough, S; Shehabi, Z; Morgan, C

    2016-05-27

    Background There remains significant inequality in health and healthcare in people with learning disabilities (LD). A lack of coordination and the episodic nature of care provision are contributory factors. Recognising the need to improve outcomes for this group, we evaluate a multi-disciplinary team (MDT) approach to care whereby additional medical procedures are carried out under the same episode of general anaesthesia (GA) as dental treatment for people with severe LD. This is the first published evaluation of its kind in the UK.Aim To evaluate the need and outcomes of an MDT approach to care among people with severe LD receiving dental treatment under GA.Method One hundred patients with severe LD and behaviour that challenges attended Barts Health Dental Hospital for dental assessment and subsequent treatment under GA. Details of failed or forthcoming medical interventions were determined. Where appropriate, care was coordinated with the relevant medical team.Findings Twenty-one percent (n = 21/100) had recent medical interventions attempted that had been abandoned, and 7.0% (n = 7/100) had future investigations or treatment planned under GA with medical specialties. An MDT approach was indicated in 28.0% (n = 28/100). For such complex cases, a successful MDT outcome was achieved in 89.3% (n = 25/28). This included ophthalmological/orthoptic, ENT and gastroenterological interventions in addition to medical imaging.Conclusion An MDT approach to care for people with LD offers improved patient-centred outcomes in addition to financial and resource efficiency. It requires a high level of cooperation between specialties, with consideration of the practicalities of a shared surgical space and equipment needs. Re-shaping of services and contractual flexibility are essential to support the future implementation of MDTs and to ensure long-term sustainability. Adoption of a holistic culture in the care of this vulnerable patient group is encouraged. PMID:27228934

  13. Determinants of Patient Waiting Time in the General Outpatient Department of a Tertiary Health Institution in North Western Nigeria

    PubMed Central

    Oche, MO; Adamu, H

    2013-01-01

    Background: The amount of time a patient waits to be seen is one factor which affects utilization of healthcare services. Patients perceive long waiting times as barrier to actually obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor. Aim: This study was aimed at assessing the determinants of patients’ waiting time in the general outpatient department (GOPD) of a tertiary health institution in northern Nigeria. Subjects and Methods: This descriptive cross-sectional study was carried out among new patients attending the GOPD of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, North Western Nigeria. A structured questionnaire was used to elicit information from 100 patients who were recruited into the study using a convenience sampling method. Data collected were entered and analyzed using Statistical Package for Social Sciences version 17; Chi-square test was used to compare differences between proportions with the level of statistical significance set at 5% (P < 0.05). Results: Sixty-one percent (59/96) of the respondents waited for 90-180 min in the clinic, whereas 36.1% (35/96) of the patients spent less than 5 min with the doctor in the consulting room. The commonest reason for the long waiting time in the GOPD was the large number of patients with few healthcare workers. Conclusion: There is an urgent need to increase the number of health workers in the GOPDs which serves as the gate way to the hospital if the aims of the Millennium Development Goals are to be realized. PMID:24380014

  14. Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network.

    PubMed

    Sun, Christina J; Mann, Lilli; Eng, Eugenia; Downs, Mario; Rhodes, Scott D

    2015-10-01

    Little is known about the sustainability of male- and men's health-focused lay health advisors. HoMBReS Por un Cambio was a community-level social network intervention designed to improve sexual health among Latino men who were members of soccer teams. During the year after the intervention implementation, lay health advisors (Navegantes) continued to promote sexual health; over 84% (16 of the 19) Navegantes conducted 9 of 10 primary health promotion activities. Describing where to get condoms was the activity that the most Navegantes reported having conducted. Navegantes had broad reach with their social networks, although the number of Navegantes that conducted each activity differed across the categories of social network members (soccer teammates, nonteammates, and women). Results suggest that HIV-related health disparities may be addressed through lay health advisor interventions because they are sustained after the intervention ends and reach large numbers of community members. PMID:26485235

  15. Integrating Oral Health with Non-Communicable Diseases as an Essential Component of General Health: WHO's Strategic Orientation for the African Region.

    PubMed

    Varenne, Benoit

    2015-05-01

    In the context of the emerging recognition of non-communicable diseases (NCDs), it has never been more timely to explore the World Health Organization (WHO) strategic orientations on oral health in the WHO African region and to raise awareness of a turning point in the search for better oral health for everyone. The global initiative against NCDs provides a unique opportunity for the oral health community to develop innovative policies for better recognition of oral health, as well as to directly contribute to the fight against NCDs and their risk factors. The WHO African region has led the way in developing the first regional oral health strategy for the prevention and control of oral diseases integrated with NCDs. The support of the international oral health community in this endeavor is urgently needed for making a success story of this initiative of integrating oral health into NCDs. PMID:25941239

  16. History of the national licensing examination for the health professions under the Japanese Government-General of Korea (1910-1945)

    PubMed Central

    Park, In-Soon

    2015-01-01

    During the reign of Japanese Government-General of Korea (Joseon) from 1910 to 1945, the main health professionals who were educated about modern medicine were categorized into physicians, dentists, pharmacists, midwives, and nurses. They were clearly distinguished from traditional health professionals. The regulations on new health professionals were enacted, and the licensing system was enforced in earnest. There were two kinds of licensing systems: the license without examination through an educational institution and the license with the national examination. The Japanese Government-General of Korea (Joseon) combined education with a national examination system to produce a large number of health professionals rapidly; however, it was insufficient to fulfill the increasing demand for health services. Therefore, the government eased the examination several times and focused on quantitative expansion of the health professions. The proportion of professionals licensed through national examination had increased. This system had produced the maximum number of available professionals at low cost. Furthermore, this system was significant in three respects: first, the establishment of the framework of the national licensing examination still used today for health professionals; second, the protection of people from the poor practices of unqualified practitioners; and third, the standardization of the quality of health. PMID:26013111

  17. The current health of the signing Deaf community in the UK compared with the general population: a cross-sectional study

    PubMed Central

    Emond, Alan; Ridd, Matthew; Sutherland, Hilary; Allsop, Lorna; Alexander, Andrew; Kyle, Jim

    2015-01-01

    Objectives To assess the current health of the Deaf community in the UK and compare with the general population. Design A quota sample of adult Deaf British Sign Language (BSL) users underwent a health assessment and interview in 2012–2013. Comparative data were obtained from the Health Survey for England (HSE) 2011 and the Quality Outcomes Framework (QOF) 2012. Setting Participants completed a structured interview and health assessment at seven Bupa centres across the UK, supported in BSL by Deaf advisers and interpreters. Participants 298 Deaf people, 20–82 years old, 47% male, with 12% from ethnic minorities. Main outcome measures Self–reported health conditions, medication usage, tobacco and alcohol consumption; measured blood pressure (BP), body mass index, fasting blood sugar and lipid profile. Results Rates of obesity in the Deaf sample were high, especially in those over 65 years, and 48% were in a high risk group for serious illness. High BP readings were obtained in 37% of Deaf people (21% in HSE): 29% were unaware of this (6% in HSE). Only 42% of Deaf people being treated for hypertension had adequate control, compared with 62% of the general population. Deaf people with self-reported cardiovascular disease (CVD) were significantly less than the general population. One-third of Deaf participants had total cholesterol >5 mmol/L but although control rates were high compared with HSE, treatment rates for self-reported CVD were half the general population rate. Eleven per cent of Deaf participants had blood sugar at prediabetic or diabetic levels, and 77% of those at prediabetic levels were unaware of it. Deaf respondents self-reported more depression (31% of women, 14% of men), but less smoking (8%) and alcohol intake (2–8 units/week). Conclusions Deaf people's health is poorer than that of the general population, with probable underdiagnosis and undertreatment of chronic conditions putting them at risk of preventable ill health. PMID:25619200

  18. Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa

    PubMed Central

    Luiz, John; Carmichael, Teresa; Peersman, Wim; Derese, Anselme

    2016-01-01

    Background The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI). South African solo general practitioners (GPs) are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI. Objectives To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs. Methods This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted. Results In all, 819 GPs responded (568 solo GPs and 251 GPs in groups). The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million) for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations) to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses) and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies. Conclusions GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa. PMID:27380785

  19. Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

    SciTech Connect

    Thong, Melissa S.Y.; Mols, Floortje; Lemmens, Valery E.P.P.; Rutten, Harm J.T.; Roukema, Jan A.; Martijn, Hendrik; Poll-Franse, Lonneke V. van de

    2011-11-01

    Purpose: To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older ({>=}75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials: Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results: A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term ({>=}5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions: For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.

  20. Memory and comprehension for health information among older adults: distinguishing the effects of domain-general and domain-specific knowledge.

    PubMed

    Chin, Jessie; Payne, Brennan; Gao, Xuefei; Conner-Garcia, Thembi; Graumlich, James F; Murray, Michael D; Morrow, Daniel G; Stine-Morrow, Elizabeth A L

    2015-01-01

    While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60-88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed. PMID:24787361

  1. Factors Influencing Early Detection of Oral Cancer by Primary Health-Care Professionals.

    PubMed

    Hassona, Y; Scully, C; Shahin, A; Maayta, W; Sawair, F

    2016-06-01

    The purposes of this study are to determine early detection practices performed by primary healthcare professionals, to compare medical and dental sub-groups, and to identify factors that influence the ability of medical and dental practitioners to recognize precancerous changes and clinical signs of oral cancer. A 28-item survey instrument was used to interview a total of 330 Jordanian primary health-care professionals (165 dental and 165 medical). An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge. An early detection practice scale (0 to 24) was generated from the reported usage and frequency of procedures in oral cancer examination. Also, a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Only 17.8 % of the participants reported that they routinely performed oral cancer screening in practices. Their oral cancer knowledge scores ranged from 3 to 31 with a mean of 15.6. The early detection practice scores ranged from 2 to 21 with a mean of 11.6. A significant positive correlation was found between knowledge scores and early detection practice scores (r = 0.22; p < 0.001). The diagnostic ability scores ranged from 11.5 to 96 with a mean of 43.6. The diagnostic ability score was significantly correlated with knowledge scores (r = 0.39; p < 0.001), but not with early detection practice scores (r = 0.01; p = 0.92). Few significant differences were found between medical and dental primary care professionals. Continuous education courses on early diagnosis of oral cancer and oral mucosal lesions are needed for primary health-care professionals. PMID:25851202

  2. Perception of health risks of electromagnetic fields by MRI radiographers and airport security officers compared to the general Dutch working population: a cross sectional analysis

    PubMed Central

    2011-01-01

    Background The amount of exposure to electromagnetic fields (EMF) at work is mainly determined by an individual's occupation and may differ from exposure at home. It is, however, unknown how different occupational groups perceive possible adverse health effects of EMF. Methods Three occupational groups, the general Dutch working population (n = 567), airport security officers who work with metal detectors (n = 106), and MRI radiographers who work with MRI (n = 193), were compared on perceived risk of and positive and negative feelings towards EMF in general and of different EMF sources, and health concerns by using analyses of variances. Data were collected via an internet survey. Results Overall, MRI radiographers had a lower perceived risk, felt less negative, and more positive towards EMF and different sources of EMF than the general working population and the security officers. For security officers, feeling more positive about EMF was not significantly related to perceived risk of EMF in general or EMF of domestic sources. Feeling positive about a source did not generalize to a lower perceived risk, while negative feelings were stronger related to perceived risk. MRI radiographers had fewer health concerns regarding EMF than the other two groups, although they considered it more likely that EMF could cause physical complaints. Conclusions These data show that although differences in occupation appear to be reflected in different perceptions of EMF, the level of occupational exposure to EMF as such does not predict the perceived health risk of EMF. PMID:22070906

  3. Subjective health complaints are more prevalent in Maasais than in Norwegians.

    PubMed

    Wilhelmsen, Ingvard; Mulindi, Sobbie; Sankok, David; Wilhelmsen, Ane B; Eriksen, Hege R; Ursin, Holger

    2007-01-01

    The aim of this observational, population-based study was to compare subjective health complaints (SHC) in Norwegians, living in a Western welfare society, and Maasai people, living in rural Kenya under primitive conditions. An interview-based version of SHC inventory was used. Data from 320 Maasais were compared to data from 1243 Norwegians. The Maasais had significantly higher score than the Norwegians on 23 of 28 items, involving musculoskeletal, "pseudo-neurological" and gastrointestinal complaints. The Maasais, living under primitive conditions, close to nature, seems to have more SHC than Norwegians, living in a modern, highly developed and industrialized country. PMID:17763124

  4. Public health assessment for US Defense General Supply Center, Richmond, Chesterfield County, Virginia, Region 3. CERCLIS No. VA3971520751. Final report

    SciTech Connect

    Not Available

    1993-04-21

    Defense General Supply Center (DGSC), south of Richmond, Virginia in Chesterfield County, is a military supply distribution center. The facility currently manages and furnishes military general supplies to the Armed Forces and several federal civilian agencies. Contaminants, primarily volatile organic chemicals, in groundwater and surface water have migrated to adjoining communities. A well survey was conducted in March 1987 by the Chesterfield County Health District, part of the Virginia Health Department. Some private wells were sampled at the time of the survey in the Rayon Park area, adjacent to the National Guard Area on DGSC, and the water contained contaminants at levels above regulatory limits. Because of those levels, 21 private wells in the community of Rayon Park were replaced with an alternate water supply in 1987. Because of infrequent exposure to low levels of VOCs in those wells, adverse health effects are not likely. Citizens have expressed concerns about contamination to installation officials and representatives of state and local health departments. They are also concerned about possible adverse health effects associated with past use of contaminated groundwater and on-going monitoring efforts being conducted by DGSC. Those concerns are evaluated in the Public Health Implications section of the public health assessment.

  5. Tobacco use, Alcohol Consumption and Self-rated Oral Health among Nigerian Prison Officials

    PubMed Central

    Azodo, Clement Chinedu; Omili, Michael

    2014-01-01

    Background: The oral health condition and lifestyle in term of tobacco use and alcohol consumption of custodian of prisons have been left unstudied. The purpose of this study was to determine the prevalence of tobacco use, alcohol consumption and self-rated oral health among Nigerian prison officials. Methods: This cross-sectional study was conducted among prison officials working in Abuja, Nassarawa and Kano prison yards between March and June 2011 using 28-item self-administered questionnaire as a tool of data collection. The questionnaire elicited information on demography, self-rated oral health, oral health behaviors, oral health conditions, tobacco use, pattern and quit attempts, alcohol consumption, type and pattern. Results: The participants were aged between 20 and 51 years, with a mean age of 32.25 ± 6.13 years. The majority of the participants were males (66.4%), Christians (76.7%), junior officials (78.1%) and of Northern origin (50.7%). A total of 50 (34.2%) of the participants indicated that they were tobacco users and 39 (78.0%) indulged in cigarette smoking only. Of the study participants, 67 (45.9%) indicated they consume alcohol, beer majorly and gin rarely with 23 (34.3%) consuming it excessively. The dominant tooth cleaning device utilized by the participants was toothbrush and toothpaste, and 65 (44.5%) had visited the dentists with the majority of the visit done >5 years ago. About one-third 57 (39.0%) reported experiencing one or more forms of oral disease. However, it was only 17 (11.6%) of them that rated their oral health poor/fair, and the determinants of self-rated oral health were age, rank, and oral health condition. Conclusions: Data from this survey revealed that the majority of the participants rated their oral health as good/excellent. The prevalence of tobacco use and alcohol consumption among prison officials was higher than reported values among the general population in Nigeria. This indicates that more surveillance and

  6. Inconsistency in the items included in tools used in general health research and physical therapy to evaluate the methodological quality of randomized controlled trials: a descriptive analysis

    PubMed Central

    2013-01-01

    Background Assessing the risk of bias of randomized controlled trials (RCTs) is crucial to understand how biases affect treatment effect estimates. A number of tools have been developed to evaluate risk of bias of RCTs; however, it is unknown how these tools compare to each other in the items included. The main objective of this study was to describe which individual items are included in RCT quality tools used in general health and physical therapy (PT) research, and how these items compare to those of the Cochrane Risk of Bias (RoB) tool. Methods We used comprehensive literature searches and a systematic approach to identify tools that evaluated the methodological quality or risk of bias of RCTs in general health and PT research. We extracted individual items from all quality tools. We calculated the frequency of quality items used across tools and compared them to those in the RoB tool. Comparisons were made between general health and PT quality tools using Chi-squared tests. Results In addition to the RoB tool, 26 quality tools were identified, with 19 being used in general health and seven in PT research. The total number of quality items included in general health research tools was 130, compared with 48 items across PT tools and seven items in the RoB tool. The most frequently included items in general health research tools (14/19, 74%) were inclusion and exclusion criteria, and appropriate statistical analysis. In contrast, the most frequent items included in PT tools (86%, 6/7) were: baseline comparability, blinding of investigator/assessor, and use of intention-to-treat analysis. Key items of the RoB tool (sequence generation and allocation concealment) were included in 71% (5/7) of PT tools, and 63% (12/19) and 37% (7/19) of general health research tools, respectively. Conclusions There is extensive item variation across tools that evaluate the risk of bias of RCTs in health research. Results call for an in-depth analysis of items that should be used to

  7. The Effects of Laughter Therapy on General Health of Elderly People Referring to Jahandidegan Community Center in Shiraz, Iran, 2014: A Randomized Controlled Trial

    PubMed Central

    Ghodsbin, Fariba; Sharif Ahmadi, Zahra; Jahanbin, Iran; Sharif, Farkhondeh

    2015-01-01

    Background: Aging and its social-biological process naturally impair the functions of different body organs and cause progressive disabilities in managing personal affairs and performing social roles. Laughter therapy is an important strategy which has been recommended by experts for increasing health promotion in older adults. Therefore, we aimed to investigate the effect of laughter therapy program on public health of senior citizens. Methods: In a randomized controlled trial, we enrolled 72 senior citizens aged 60 and over referring to Jahandidegan (Khold-e-Barin) retirement community center in Shiraz, southwest Iran during January to February 2014. The participants were assigned into experimental (N=36) and control (N=36) groups. Data were collected using General Health Questionnaire (GHQ-28) and demographic questionnaire. The participants of experimental group attended a laughter therapy program consisting of two 90-minute sessions per week lasting for 6 weeks. Results: We found a statistically significant correlation between laughter therapy program and factors such as general health (P=0.001), somatic symptoms (P=0.001), insomnia and anxiety (P=0.001). However, there was no statistically significant correlation among laughter therapy, social dysfunction (P=0.28) and depression (P=0.069). Conclusion: We concluded that laughter therapy can improve general health and its subscales in elderly people. Trial Registration Number: IRCT2014061111691N4 PMID:25553332

  8. Personality Dimensions, Religious Tendencies and Coping Strategies as Predictors of General Health in Iranian Mothers of Children with Intellectual Disability: A Comparison with Mothers of Typically Developing Children

    ERIC Educational Resources Information Center

    Mirsaleh, Y. R.; Rezai, H.; Khabaz, M.; Afkhami Ardekani, I.; Abdi, K.

    2011-01-01

    Background: Challenges related to rearing children with intellectual disability (ID) may cause mothers of these children to have mental health status problems. Method: A total of 124 mothers who had a child with ID and 124 mothers of typically developing children were selected using random sampling. Data were collected using General health…

  9. The Children of Russia Are in Danger! The Danger Comes from the Ministry of Health and the Ministry of General and Professional Education of the Russian Federation.

    ERIC Educational Resources Information Center

    Medvedeva, Irina; Shishova, Tat'iana

    1998-01-01

    Argues against the international project called "Sex Education for the Schoolchildren of Russia" that is a sex education program intended for students in the seventh through ninth grades and is carried out by the Ministry of General and Professional Education of the Russian Federation and the Ministry of Health of the Russian Federation (CMK)

  10. The British Sign Language Versions of the Patient Health Questionnaire, the Generalized Anxiety Disorder 7-Item Scale, and the Work and Social Adjustment Scale

    ERIC Educational Resources Information Center

    Rogers, Katherine D.; Young, Alys; Lovell, Karina; Campbell, Malcolm; Scott, Paul R.; Kendal, Sarah

    2013-01-01

    The present study is aimed to translate 3 widely used clinical assessment measures into British Sign Language (BSL), to pilot the BSL versions, and to establish their validity and reliability. These were the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7) scale, and the Work and Social Adjustment Scale (WSAS).…

  11. The Factor Structure and Factorial Invariance of the 12-Item General Health Questionnaire (GHQ-12) across Time: Evidence from Two Community-Based Samples

    ERIC Educational Resources Information Center

    Makikangas, Anne; Feldt, Taru; Kinnunen, Ulla; Tolvanen, Asko; Kinnunen, Marja-Liisa; Pulkkinen, Lea

    2006-01-01

    This study provides new knowledge about the factor structure of the 12-item General Health Questionnaire (GHQ-12; D. Goldberg, 1972) through the application of confirmatory factor analysis to longitudinal data, thereby enabling investigation of the factor structure, its invariance across time, and the rank-order stability of the factors. Two…

  12. Indirect Costs of Health Research--How They are Computed, What Actions are Needed. Report by the Comptroller General of the United States.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    A review by the General Accounting Office of various aspects of indirect costs associated with federal health research grants is presented. After an introduction detailing the scope of the review and defining indirect costs and federal participation, the report focuses on the causes of the rapid increase of indirect costs. Among findings was that…

  13. Inventory of Health and Physical Fitness Promotion Materials, Research and Articles from Periodicals of General Interest. Final Report. Report No. 7.

    ERIC Educational Resources Information Center

    Bozzo, Robert; And Others

    This document reports on an effort to identify, collect, and catalog: (1) various fitness- and health-related promotion materials available to the general public by federal, state, and local agencies; and (2) informational items distributed by the private sector. Printed materials are categorized as: (1) currently available brochures and pamphlets…

  14. Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility

    PubMed Central

    Shayan, Zahra; Pourmovahed, Zahra; Najafipour, Fatemeh; Abdoli, Ali Mohammad; Mohebpour, Fatemeh; Najafipour, Sedighe

    2015-01-01

    Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women. PMID:27141541

  15. Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Trial design A pragmatic cluster randomised controlled trial. Methods Participants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment. Results Numbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified. Conclusion The

  16. Asking about Sex in General Health Surveys: Comparing the Methods and Findings of the 2010 Health Survey for England with Those of the Third National Survey of Sexual Attitudes and Lifestyles

    PubMed Central

    Prah, Philip; Johnson, Anne M.; Nardone, Anthony; Clifton, Soazig; Mindell, Jennifer S.; Copas, Andrew J.; Robinson, Chloe; Craig, Rachel; Woodhall, Sarah C.; Macdowall, Wendy; Fuller, Elizabeth; Erens, Bob; Sonnenberg, Pam; Wellings, Kaye; Mercer, Catherine H.

    2015-01-01

    Objectives Including questions about sexual health in the annual Health Survey for England (HSE) provides opportunities for regular measurement of key public health indicators, augmenting Britain's decennial National Survey of Sexual Attitudes and Lifestyles (Natsal). However, contextual and methodological differences may limit comparability of the findings. We examine the extent of these differences between HSE 2010 and Natsal-3 and investigate their impact on parameter estimates. Methods Complex survey analyses of data from men and women in the 2010 HSE (n = 2,782 men and 3,588 women) and Natsal-3 undertaken 2010–2012 (n = 4,882 men and 6,869 women) aged 16-69y and resident in England, both using probability sampling, compared their characteristics, the amount of non-response to, and estimates from, sexual health questions. Both surveys used self-completion for the sexual behaviour questions but this was via computer-assisted self-interview (CASI) in Natsal-3 and a pen-and-paper questionnaire in HSE 2010. Results The surveys achieved similar response rates, both around 60%, and demographic profiles largely consistent with the census, although HSE participants tended to be less educated, and reported worse general health, than Natsal-3 participants. Item non-response to the sexual health questions was typically higher in HSE 2010 (range: 9–18%) relative to Natsal-3 (all <5%). Prevalence estimates for sexual risk behaviours and STI-related indicators were generally slightly lower in HSE 2010 than Natsal-3. Conclusions While a relatively high response to sexual health questions in HSE 2010 demonstrates the feasibility of asking such questions in a general health survey, differences with Natsal-3 do exist. These are likely due to the HSE’s context as a general health survey and methodological limitations such as its current use of pen-and-paper questionnaires. Methodological developments to the HSE should be considered so that its data can be interpreted in

  17. The General Picture of Supportive Health Environments for Persons with Intellectual Disabilities among 121 Disability Welfare Institutions in Taiwan

    ERIC Educational Resources Information Center

    Lin, J.-D.; Yen, C.-F.; Loh, C.-H.; Chwo, M.-J.; Lee, J.-T.; Wu, J.-L.; Chu, C. M.; Tang, C.-C.

    2006-01-01

    Background: Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. Methods: A cross-sectional survey was conducted to examine the perceptions…

  18. Scientific uncertainty and the role of expert advice: the case of health checks for coronary heart disease prevention by general practitioners in the UK.

    PubMed

    Florin, D

    1999-11-01

    This paper examines some of the ways in which scientific evidence influenced the development of the policy for the payment of general practitioners for coronary heart disease (CHD) prevention in the UK, in particular the introduction of 'health checks'. The specific policy events which are examined are the 1990 and 1993 contracts for health promotion by general practitioners. Data for this paper were provided by oral history interviews with key informants including general practitioners, public health doctors, civil servants and academics. The study shows the way in which complex scientific evidence interacted with other, professional and political, factors to produce a policy for which there was variable scientific evidence. The relationship between science and policy was complicated and tortuous but two aspects were particularly salient, the way in which scientific uncertainty influenced the content of the policy and the contribution of expert advice to policy making. The existence of social and technical uncertainty about the effectiveness of health checks allowed different players to hold different views depending on their professional affiliation or other agendas. The mechanisms by which scientific advice was given to policy makers were primarily by medical civil servants and through informal contacts and networks. There was no independent systematic formal system to assess and disseminate scientific advice to policy makers, for instance by an expert committee. These factors in turn allowed policy makers to ignore or misinterpret scientific evidence according to other policy imperatives. PMID:10501646

  19. Relationship Between Palpitation and Mental Health

    PubMed Central

    Alijaniha, Fatemeh; Noorbala, Ahmadali; Afsharypuor, Suleiman; Naseri, Mohsen; Fallahi, Faramarz; Mosaddegh, Mahmood; Faghih Zadeh, Soghrat; Sadrai, Sima

    2016-01-01

    Background: ‘Palpitation’ is one of the most common complaints in patients referring to cardiologists. In modern medicine era, these patients suffer from much distress and some cases are known to be difficult to treat. Although the clinician’s first duty is obviously to search for an organic basis for this symptom, the diagnostic evaluation is frequently unrevealing. However, clinical experience suggests that psychiatric causes are relatively common. Objectives: This research aimed to screen for mental disorders in patients complaining of palpitation and healthy persons in order to perform a preliminary comparison between them. Patients and Methods: This is a case-control study to screen mental disorders. The target population consisted of adult volunteers with benign palpitation and their matched healthy persons. They were referred during a 10-month-period to the cardiology outpatient’s clinic of Mostafa Khomeini hospital in Tehran, Iran. Sampling was accidental and eventually 110 participants comprised the sample size. The measuring tool was GHQ-28 (28-item general health questionnaire) and the main variable was the questionnaire score obtained from the Likert scoring method. Results: Comparing two groups showed that the number of participants with the scores more than cut-off point in palpitation group was significantly more than healthy person group (85.4% vs. 43.6% with P < 0.001). Also the total score of GHQ-28 and scores of its subscale (somatization, anxiety, and social dysfunction) in patients complaining of palpitation were significantly more than those of the healthy participants (34.2 vs. 25.7, 8.9 vs. 6.4, 9.4 vs. 6.4, and 12.3 vs. 10.8, respectively with P < 0.001, P = 0.001, P < 0.001, and P < 0.007, respectively). Conclusions: Palpitation is the most common symptom in psychiatric disorders such as anxiety and somatization disorders. According to the results of this study, psychiatric causes have an important role in Iranian patients

  20. Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries.

    PubMed

    Valentine, Nicole; Darby, Charles; Bonsel, Gouke J

    2008-05-01

    Quality of care research has reached some agreement on concepts like structure, process and outcome, and non-clinical versus clinical processes of care. These concepts are commonly explored through surveys measuring patient experiences, yet few surveys have focused on patient, or "user", priorities across different quality dimensions. Population surveys on priorities can contribute to, although not replace participation in, policy decision making. Using 105,806 survey interview records from the World Health Organization's (WHO's) general population surveys in 41 countries, this paper describes the relative importance of eight domains in the non-clinical quality of care concept WHO calls "health systems responsiveness". Responsiveness domains are divided into interpersonal domains (dignity, autonomy, communication and confidentiality) and structural domains (quality of basic amenities, choice, access to social support networks and prompt attention). This paper explores variations in domain importance by country-level variables (country of residence, human development, health system expenditure, and "geographic zones") and by subpopulations defined by sex, age, education, health status, and utilization. Most respondents selected prompt attention as the most important domain. Dignity was selected second, followed by communication. Access to social support networks was identified as the least important domain. In general, convergence in rankings was stronger across subpopulations within countries than across countries. Yet even across diverse countries, there was more convergence than divergence in views. These results provide a ranking of quality of care criteria for consideration during health reform processes further to the usual emphasis on clinical quality and supply-side efficiency. PMID:18313822

  1. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review.

    PubMed

    Gil-Montoya, José Antonio; de Mello, Ana Lucia Ferreira; Barrios, Rocío; Gonzalez-Moles, Miguel Angel; Bravo, Manuel

    2015-01-01

    Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments. PMID:25709420

  2. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review

    PubMed Central

    Gil-Montoya, José Antonio; Ferreira de Mello, Ana Lucia; Barrios, Rocío; Gonzalez-Moles, Miguel Angel; Bravo, Manuel

    2015-01-01

    Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments. PMID:25709420

  3. St John’s wort use in Australian general practice patients with depressive symptoms: their characteristics and use of other health services

    PubMed Central

    2014-01-01

    Background While depression is frequently managed by general practitioners, often patients self-manage these symptoms with alternative therapies, including St John’s wort (SJW). We tested whether use of SJW was associated with different patterns of conventional and complementary health service use, strategies used for management of depression, or user dissatisfaction with or lack of trust in their general practitioner or clinic overall. Methods Secondary analysis of data collected from an Australian population screened for a longitudinal cohort study of depression. Main outcome measures were CES-D for depressive symptoms, satisfaction with their general practitioner (GPAQ), Trust in Physician scale, self-report of health services usage and strategies used to manage depression, stress or worries. Results Response rate was 7667/17,780 (43.1%). Of these, 4.3% (320/7,432) had used SJW in the past 12 months (recent ‘SJW users’). SJW users were significantly more likely to be depressed and to have a higher CES-D score. There were no statistically significant differences between recent SJW users and non-SJW users in satisfaction with their general practice or in trust in their general practitioner (GP) when adjusted for multiple factors. SJW users were significantly more likely to use all health services, whether conventional or complementary, as well as other strategies used for mental health care. SJW users were also more likely to consider themselves the main carer for their depression. Conclusions Primary care attendees with symptoms of depression who use SJW appear not to be rejecting conventional medicine. Rather, they may be proactive care seekers who try both conventional and complementary strategies to manage their depressive symptoms. If GPs enquire and find that their depressed patients are using SJW, this may indicate that they might explore for unrelieved symptoms of depression and also consider the issue of potential for interactions between SJW and

  4. Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978-1989.

    PubMed

    Larson, D B; Sherrill, K A; Lyons, J S; Craigie, F C; Thielman, S B; Greenwold, M A; Larson, S S

    1992-04-01

    The authors assessed all measures of religious commitment (N = 139) reported in research studies published in the American Journal of Psychiatry and Archives of General Psychiatry in 1978 through 1989 (N less than 35). For nearly two-thirds of the measures, the studies either made no hypotheses or reported no results concerning the relationship of religious commitment to mental health status. For the great majority of the measures assessed, the studies reported a positive relationship between religious commitment and mental health. PMID:1532477

  5. 'In general, how do you feel today?'--self-rated health in the context of aging in India.

    PubMed

    Hirve, Siddhivinayak

    2014-01-01

    This thesis is centered on self-rated health (SRH) as an outcome measure, as a predictor, and as a marker. The thesis uses primary data from the WHO Study on global AGEing and adult health (SAGE) implemented in India in 2007. The structural equation modeling approach is employed to understand the pathways through which the social environment, disability, disease, and sociodemographic characteristics influence SRH among older adults aged 50 years and above. Cox proportional hazard model is used to explore the role of SRH as a predictor for mortality and the role of disability in modifying this effect. The hierarchical ordered probit modeling approach, which combines information from anchoring vignettes with SRH, was used to address the long overlooked methodological concern of interpersonal incomparability. Finally, multilevel model-based small area estimation techniques were used to demonstrate the use of large national surveys and census information to derive precise SRH prevalence estimates at the district and sub-district level. The thesis advocates the use of such a simple measure to identify vulnerable communities for targeted health interventions, to plan and prioritize resource allocation, and to evaluate health interventions in resource-scarce settings. The thesis provides the basis and impetus to generate and integrate similar and harmonized adult health and aging data platforms within demographic surveillance systems in different regions of India and elsewhere. PMID:24762983

  6. Effects of scanning (routine health information exposure) on cancer screening and prevention behaviors in the general population.

    PubMed

    Hornik, Robert; Parvanta, Sarah; Mello, Susan; Freres, Derek; Kelly, Bridget; Schwartz, J Sanford

    2013-01-01

    Research on health information exposure focuses primarily on deliberate information-seeking behavior and its effects on health. By contrast, this study explores the complementary and perhaps more influential role of health information acquired through exposure to routinely used sources, called scanning. The authors hypothesized that scanning from nonmedical sources, both mediated and interpersonal, affects cancer screening and prevention decisions. The authors used a nationally representative longitudinal survey of 2,489 adults 40 to 70 years of age to analyze the effects of scanning on 3 cancer screening behaviors (mammography, prostate-specific antigen [PSA], and colonoscopy) and 3 prevention behaviors (exercising, eating fruits and vegetables, and dieting to lose weight). After adjustment for baseline behaviors and covariates, scanning at baseline predicted weekly exercise days 1 year later as well as daily fruit and vegetable servings 1 year later for those whose consumption of fruits and vegetables was already higher at baseline. Also, among those reporting timely screening mammogram behavior at baseline, scanning predicted repeat mammography. Scanning was marginally predictive of PSA uptake among those not reporting a PSA at baseline. Although there were strong cross-sectional associations, scanning did not predict dieting or colonoscopy uptake in longitudinal analyses. These analyses provide substantial support for a claim that routine exposure to health content from nonmedical sources affects specific health behaviors. PMID:24083417

  7. Randomized controlled trial of a computer-tailored multiple health behaviour intervention in general practice: 12-month follow-up results

    PubMed Central

    2014-01-01

    Background Effective strategies to address risk factors of non-communicable diseases are required to curtail the expanding costs of health care. This trial tested the effectiveness over one year of a minimal intervention targeting multiple health behaviours (diet, physical activity, alcohol and smoking) in a general practice setting, through the provision of personalised, computer-tailored feedback. Methods Patients who had attended a general practice in the previous 6 months were recruited from 21 general practitioners in Brisbane, Australia. Baseline data were collected using self-reports on adherence to ten health behaviours and summarised into a health score from 0 to 10. This randomised controlled trial used a 2×2 factorial design, with one arm randomising subjects to the intervention or control group. The other arm was either feedback at baseline (single contact) or an additional assessment with feedback at 3 months (dual contact). As such, 4 study groups created were, to which participants were randomised blindly: A. Intervention with single contact; B. Intervention with dual contact; C. Control with single contact and D. Control with dual contact. All participants were assessed again at 12 months. Results Of the 4676 participants randomised, 3065 completed questionnaires at 12 months. Both single and dual contact groups improved their 10 item health scores (+0.31 and +0.49 respectively) relative to control group outcomes (+0.02; p < 0.01). Improvement in adherence to guidelines for fish intake, type of milk consumed, vegetable and fruit intake, and alcohol intake were observed in single and dual contact intervention groups (p < 0.01). Both intervention groups showed greater improvement than controls for individual health behaviours, apart from red meat intake, smoking behaviour, physical activity and body weight. Interestingly, there was an improvement in reported non-smoking rates in both intervention and control groups (3% single contact; 4

  8. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants. PMID:24654988

  9. The Health Consequences of Using Smokeless Tobacco: A Report of the Advisory Committee to the Surgeon General.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    This report on the health consequences of smokeless tobacco contains an "Introduction, Overview, and Conclusions" section and four major chapters. Chapter 1 defines the various forms of smokeless tobacco that are used in the United States and examines data pertaining to trends in prevalence and patterns of use. Methodological considerations are…

  10. Self-Injurious Behaviors, PTSD Arousal, and General Health Complaints Within a Treatment-Seeking Sample of Sexually Abused Women

    ERIC Educational Resources Information Center

    Weaver, Terri L.; Chard, Kathleen M.; Mechanic, Mindy B.; Etzel, Julie C.

    2004-01-01

    Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated…

  11. Association of Stress, General Health, and Alcohol Use with Poor Sleep Quality among U.S. College Students

    ERIC Educational Resources Information Center

    Valerio, Teresa D.; Kim, Myoung Jin; Sexton-Radek, Kathy

    2016-01-01

    Background: Poor sleep among college students is a major, growing problem associated with lower academic performance, higher rates of health and emotional problems, and development of chronic sleep disorders. Purpose: Though previous studies have focused on individual colleges, our study purpose was to reveal the association of behaviors and…

  12. Socio-Demographic Variables, General Psychological Well-Being and the Mental Health Continuum in an African Context

    ERIC Educational Resources Information Center

    Khumalo, I. P.; Temane, Q. M.; Wissing, M. P.

    2012-01-01

    Age, gender, marital status, education attainment, employment status, and environmental setting explain different amounts of variance in psychological well-being and mental health. Inconsistent findings are reported for the socio-demographic variables in psychological well-being depending amongst others on the definition and measurement of…

  13. Is poor self-rated health associated with low-grade inflammation in 43 110 late adolescent men of the general population? A cross-sectional study

    PubMed Central

    Warnoff, Carin; Lekander, Mats; Hemmingsson, Tomas; Sorjonen, Kimmo; Melin, Bo; Andreasson, Anna

    2016-01-01

    Objective Self-rated health is a powerful predictor of long-term health and mortality, hence the importance of a better understanding of its biological determinants. Previous studies have shown that low-grade inflammation is associated with poor self-rated health in clinical and healthy populations, but the evidence is sparse in men and completely lacking for men in late adolescence. The aim of this study was to investigate the association between low-grade inflammation and self-rated health among conscripts. It was hypothesised that high levels of inflammatory factors would be associated with poor self-rated health. Design Data from 49 321 men (18–21 years) conscripted for military service in 1969 and 1970 were used. Inflammation had been measured through erythrocyte sedimentation rate (ESR). Self-rated health had been assessed on a five-point scale, and was dichotomised into Good (‘Very good’/‘Good’/‘Fair’) versus Poor (‘Poor’/‘Very poor’). Data from 43 110 conscripts with normal levels of ESR, and who reported self-rated health remained after exclusion of those with ESR <1 and >11 mm/h. Associations were calculated using logistic regression analyses. Adjustments were made for body mass index, socioeconomic position, inflammatory disease, emotion regulation, smoking, risky use of alcohol and physical activity. Results High levels of ESR were associated with higher odds for poor self-rated health (OR: 1.077 for each unit mm/h increase in ESR, 95% CI 1.049 to 1.105). Conclusions The present study shows for the first time a significant association between a marker of inflammation and self-rated health in late adolescent men, adding to evidence of an association between low-grade inflammation and subjective health perception also in men, as previously demonstrated in women. Further support for inflammation as part of a general psychobiological process that underpins subjective health perception is hereby provided. PMID:27113233

  14. Comparison of Cancer-specific and General Health Literacy Assessments in an Educated Population: Correlations and Modifying Factors.

    PubMed

    Jenkins, Wiley D; Zahnd, Whitney E; Spenner, Allison; Wiley, Celeste; Roles, Rhonda; Potini, Yogitha; Jones, Linda S

    2016-06-01

    An information onslaught accompanies cancer diagnoses, but patient comprehension (health literacy; HL) is frequently low, impacting both immediate care and longer term follow-up. Knowledge and adoption of preventive measures is especially important for cancer survivors due to their increased risk of secondary malignant neoplasms. We sought to evaluate the Test of Functional Health Literacy Adult (S-TOFHLA) against the recently developed cancer-specific Cancer Message Literacy Test (CMLT-r) among an educated population of both cancer survivors and those cancer-free. Participants were recruited 2013 (May through December) from various units within a local hospital and from several local churches, and each completed the S-TOFHLA and CMLT-r and provided demographic information and cancer status. The 109 participants had a mean age of 58 years and were as follows: 65.1 % female; 92.7 % white, 50.4 % college graduates, and 41.3 % cancer survivors. S-TOFHLA scores ranged from 12-36 (mean 34.1) and non-significantly varied by gender, education, cancer status, and age. CMLT-r scores ranged from 28.6-100 % (mean 86.4 %) and significantly varied by education (p = 0.013), but not by gender, cancer status, or age. Overall, CMLT-r and S-TOFHLA significantly correlated (p < 0.001). Assessment scores were skewed towards the maximum with non-significant differences by cancer status. As cancer survivorship improves and as the population becomes more educated, more refined approaches to assess health literacy should be considered. Increased education does not imply increased health literacy, and cancer survivorship does not imply higher health or cancer literacy. Concerted efforts to improve patient understanding and implementation of preventive measures are imperative. PMID:25820603

  15. Lifestyle Risk Factors of General and Abdominal Obesity in Students of the School of Medicine and Health Science of the University of Development Studies, Tamale, Ghana

    PubMed Central

    Aleyira, Samuel

    2014-01-01

    This study evaluated the prevalence of general and abdominal obesity among students of the University for Development Studies, School of Medicine and Health Sciences (UDS-SMHS), Tamale, Ghana. Also, lifestyle risk factors for the two obesity indices were investigated. This study was conducted among a sample of 646 students. Anthropometric measures of weight, height, and waist circumference were appropriately assessed. The prevalence of general and abdominal obesity was 1.9% and 4.2%, respectively. Risk factors of general obesity were being female (crude OR = 6.9, 95% CI = 1.85–25.80, P = 0.0021), engaging in light PA (OR = 12.45, 95% CI = 2.96–52.41, P = 0.0006), being aged 28–37 years (OR = 5.37, 95% CI = 1.39–20.68, P = 0.0329), nonintake of coffee (OR = 4.1, 95% CI = 1.10–15.28, P = 0.0357), being married (OR = 5.7, 95% CI = 1.48–22.02, P = 0.0286), and being abdominally obese (OR = 02.7, 95% CI = 25.61–11.60, P < 0.0001). Risk factors for abdominal obesity were being female, being married, having general obesity, and nonintake of coffee. Abdominal obesity was more prevalent than general obesity. Risk factors included being female, married, and generally obese and nonintake of coffee. PMID:24649393

  16. Do counsellors in general practice surgeries and clinical psychologists in the National Health Service see the same patients?

    PubMed Central

    Burton, M V; Sadgrove, J; Selwyn, E

    1995-01-01

    An audit was conducted of a counsellor's work over the period 1989-1993 at two general practice surgeries in Coventry. Comparative data were available for general practitioner (GP)-referred patients seen in the district clinical psychology department in Coventry during 1988-1992. The counsellor saw significantly more patients referred with anxiety, depression, marital problems, child management and physical illness than did psychologists, whilst psychologists saw significantly more patients with relationship problems and personality disorders. To the question, 'Are these services effective?' the answer is yes, both services are effective, but they are treating different patient populations. PMID:7769604

  17. Celestial and terrestrial tele-ophthalmology: a health monitoring helmet for astronaut/cosmonaut and general public use

    NASA Astrophysics Data System (ADS)

    Ansari, Rafat R.; Rovati, Luigi; Sebag, Jerry

    2001-06-01

    A goggles-like head-mounted device equipped with several non-invasive techniques for quantitative medical evaluation of the eye, skin, and brain is envisioned for monitoring the health of astronauts and cosmonauts during long-term space travel and exploration. Real-time non-invasive evaluation of the different structures within these organs will provide indices of the health of these organs, as well as the entire body. The techniques such as dynamic light scattering (for the early detection of cataracts to evaluate effects of cosmic radiation), corneal autofluorescence (to assess extracellular matrix biology (e.g., diabetes), optical polarization (of aqueous fluid to evaluate serum chemistry), laser Doppler velocimetry (of retinal, optic nerve, and choroidal blood flow to assess ocular as well as central nervous system blood flow), reflectometry/oximetry (for oxygen metabolism), optical coherence tomography (for retinal microstructure), and possibility scanning laser technology for intraocular imaging and scanning will be integrated into this compact device.

  18. Predictors for Assessing Electronic Messaging Between Nurses and General Practitioners as a Useful Tool for Communication in Home Health Care Services: A Cross-Sectional Study

    PubMed Central

    Hofoss, Dag; Grimsmo, Anders; Hellesø, Ragnhild

    2015-01-01

    Background Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care. Objective The aim of this study was to explore home health care nurses’ assessments of the utility of the e-messaging system for communicating with GPs and identify elements that influence the assessment of e-messaging as a useful communication tool. Methods The data were collected using a self-developed questionnaire based on variables identified by focus group interviews with home health care nurses (n=425) who used e-messaging and existing research. Data were analyzed using logistic regression analyses. Results Over two-thirds (425/632, 67.2%) of the home health care nurses returned the questionnaire. A high proportion (388/399, 97.2%) of the home health care nurses who returned the questionnaire found the e-messaging system to be a useful tool for communication with GPs. The odds of reporting that e-messaging was a useful tool were over five times higher (OR 5.1, CI 2.489-10.631, P<.001) if the nurses agreed or strongly agreed that e-messaging was easy to use. The odds of finding e-messaging easy to use were nearly seven times higher (OR 6.9, CI 1.713-27.899, P=.007) if the nurses did not consider the system functionality poor. If the nurses had received training in the use of e-messaging, the odds were over six times higher (OR 6.6, CI 2.515-17.437, P<.001) that they would consider e-messaging easy to use. The odds that a home health care nurse would experience e-messaging as easy to use increased as the full-time equivalent percentage of the nurses increased (OR 1.032, CI 1.001-1.064, P=.045). Conclusions This study has shown that technical

  19. Occupational exposure limit for silver nanoparticles: considerations on the derivation of a general health-based value.

    PubMed

    Weldon, Brittany A; M Faustman, Elaine; Oberdörster, Günter; Workman, Tomomi; Griffith, William C; Kneuer, Carsten; Yu, Il Je

    2016-09-01

    With the increased production and widespread commercial use of silver nanoparticles (AgNPs), human and environmental exposures to silver nanoparticles are inevitably increasing. In particular, persons manufacturing and handling silver nanoparticles and silver nanoparticle containing products are at risk of exposure, potentially resulting in health hazards. While silver dusts, consisting of micro-sized particles and soluble compounds have established occupational exposure limits (OELs), silver nanoparticles exhibit different physicochemical properties from bulk materials. Therefore, we assessed silver nanoparticle exposure and related health hazards in order to determine whether an additional OEL may be needed. Dosimetric evaluations in our study identified the liver as the most sensitive target organ following inhalation exposure, and as such serves as the critical target organ for setting an occupational exposure standard for airborne silver nanoparticles. This study proposes an OEL of 0.19 μg/m(3) for silver nanoparticles derived from benchmark concentrations (BMCs) from subchronic rat inhalation toxicity assessments and the human equivalent concentration (HEC) with kinetic considerations and additional uncertainty factors. It is anticipated that this level will protect workers from potential health hazards, including lung, liver, and skin damage. PMID:26982810

  20. National Research Council Dialogue to Assess Progress on NASA's Human Health & Support Systems Capability Roadmap Development: General Background and Introduction

    NASA Technical Reports Server (NTRS)

    Aikins, Jan

    2005-01-01

    Contents include the following: General Background and Introduction of Capability Roadmaps. Agency Objective. Strategic Planning Transformation. Advanced Planning Organizational Roles. Public Involvement in Strategic Planning. Strategic Roadmaps and Schedule. Capability Roadmaps and Schedule. Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

  1. General practice 'going places'.

    PubMed

    Hughes, C

    1992-05-01

    This paper, which was presented at the Annual General Meeting of the Royal Australian College of General Practitioners in September 1991, outlines possible roles for the general practitioner in the public health system. Four fundamental steps need to be taken: affirmative action by health boards to include GPs in all activities; representation of the RACGP on health boards; adequate remuneration; and part time employment of GPs in all health care delivery service units. PMID:1520131

  2. Health characteristics and consultation patterns of people with intellectual disability: a cross-sectional database study in English general practice

    PubMed Central

    Carey, Iain M; Shah, Sunil M; Hosking, Fay J; DeWilde, Stephen; Harris, Tess; Beighton, Carole; Cook, Derek G

    2016-01-01

    Background People with intellectual disability (ID) are a group with high levels of healthcare needs; however, comprehensive information on these needs and service use is very limited. Aim To describe chronic disease, comorbidity, disability, and general practice use among people with ID compared with the general population. Design and setting This study is a cross-sectional analysis of a primary care database including 408 English general practices in 2012. Method A total of 14 751 adults with ID, aged 18–84 years, were compared with 86 221 age-, sex- and practice-matched controls. Depending on the outcome, prevalence (PR), risk (RR), or odds (OR) ratios comparing patients with ID with matched controls are shown. Results Patients with ID had a markedly higher prevalence of recorded epilepsy (18.5%, PR 25.33, 95% confidence interval [CI] = 23.29 to 27.57), severe mental illness (8.6%, PR 9.10, 95% CI = 8.34 to 9.92), and dementia (1.1%, PR 7.52, 95% CI = 5.95 to 9.49), as well as moderately increased rates of hypothyroidism and heart failure (PR>2.0). However, recorded prevalence of ischaemic heart disease and cancer was approximately 30% lower than the general population. The average annual number of primary care consultations was 6.29 for patients with ID, compared with 3.89 for matched controls. Patients with ID were less likely to have longer doctor consultations (OR 0.73, 95% CI = 0.69 to 0.77), and had lower continuity of care with the same doctor (OR 0.77, 95% CI = 0.73 to 0.82). Conclusion Compared with the general population, people with ID have generally higher overall levels of chronic disease and greater primary care use. Ensuring access to high-quality chronic disease management, especially for epilepsy and mental illness, will help address these greater healthcare needs. Continuity of care and longer appointment times are important potential improvements in primary care. PMID:26906630

  3. Improvement in Stress, General Self-Efficacy, and Health Related Quality of Life following Patient Education for Patients with Neuroendocrine Tumors: A Pilot Study.

    PubMed

    Haugland, Trude; Veenstra, Marijke; Vatn, Morten H; Wahl, Astrid K

    2013-01-01

    The purpose of the study was to evaluate changes in general self-efficacy, health related quality of life (HRQoL), and stress among patients with neuroendocrine tumors (NET) following a multidisciplinary educational intervention. Forty-one patients were enrolled in this exploratory pilot study. A total of 37 patients completed the full 26-week intervention based on the principles of self-efficacy. General self-efficacy was measured by the General Self-Efficacy Scale, HRQoL was measured with the SF-36, and stress was measured with the Impact of Event Scale. Mixed effect models were used to evaluate changes in general self-efficacy, mental and physical components of HRQoL, and stress adjusting for demographic and clinical variables. Results showed significant improvements in patients' general self-efficacy (β = 0.71; P < 0.05), physical component scores of HRQoL (β = 3.09; P < 0.01), and stress (β = -2.10, P = 0.008). Findings suggest that patients with NET have the capacity to improve their ability to cope with their disease, problem-solve, improve their physical status, and reduce their stress following an educational intervention based on the principles of self-efficacy. These preliminary data provide a basis for future randomized controlled trials to test interventions to improve HRQoL for patients with NET. PMID:23738063

  4. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    PubMed

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects. PMID:20825274

  5. Health-related quality of life and utility scores in people with mental disorders: a comparison with the non-mentally ill general population.

    PubMed

    Prigent, Amélie; Auraaen, Ane; Kamendje-Tchokobou, Blaise; Durand-Zaleski, Isabelle; Chevreul, Karine

    2014-03-01

    There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in outpatient and inpatient settings, and to identify the HRQoL and utility score losses attributable to mental disorders compared to the non-mentally ill general population. A cross-sectional survey was conducted to assess HRQoL (SF-12) and utility scores of patients with mental disorders and followed in four psychiatric sectors in France. Scores were described by demographic and clinical characteristics and were then adjusted on age and gender and compared with those of the non-mentally ill general population. Median HRQoL and utility scores were significantly lower in patients with mental disorders than in the non-mentally ill general population; median differences amounted to 5.4 for the HRQoL physical score, to 11.8 for the HRQoL mental score and to 0.125 for the utility score. Our findings underscore the negative impact of mental disorders on HRQoL in France and provide a baseline to assess the global impact of current and future organizational changes in the mental health care system. PMID:24608903

  6. Health-Related Quality of Life and Utility Scores in People with Mental Disorders: A Comparison with the Non-Mentally Ill General Population

    PubMed Central

    Prigent, Amélie; Auraaen, Ane; Kamendje-Tchokobou, Blaise; Durand-Zaleski, Isabelle; Chevreul, Karine

    2014-01-01

    There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in outpatient and inpatient settings, and to identify the HRQoL and utility score losses attributable to mental disorders compared to the non-mentally ill general population. A cross-sectional survey was conducted to assess HRQoL (SF-12) and utility scores of patients with mental disorders and followed in four psychiatric sectors in France. Scores were described by demographic and clinical characteristics and were then adjusted on age and gender and compared with those of the non-mentally ill general population. Median HRQoL and utility scores were significantly lower in patients with mental disorders than in the non-mentally ill general population; median differences amounted to 5.4 for the HRQoL physical score, to 11.8 for the HRQoL mental score and to 0.125 for the utility score. Our findings underscore the negative impact of mental disorders on HRQoL in France and provide a baseline to assess the global impact of current and future organizational changes in the mental health care system. PMID:24608903

  7. The Impact of Healthcare Workers Job Environment on Their Mental-emotional Health. Coping Strategies: The Case of a Local General Hospital.

    PubMed

    Koinis, Aristotelis; Giannou, Vasiliki; Drantaki, Vasiliki; Angelaina, Sophia; Stratou, Elpida; Saridi, Maria

    2015-04-13

    Workplace stress can influence healthcare professionals' physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers' mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%). Our research protocol was first approved by the hospital's review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach's α=0.862). Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals' emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life - BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001) and quitting (t=-2.564, P=0.011) are predisposing factors. For the 'mental health and spirituality' regression model, positive re-assessment (t=5.528, P=0.000) and seeking social support (t=-1.991, P=0.048) are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0.000) is a predisposing factor

  8. The Impact of Healthcare Workers Job Environment on Their Mental-emotional Health. Coping Strategies: The Case of a Local General Hospital

    PubMed Central

    Koinis, Aristotelis; Giannou, Vasiliki; Drantaki, Vasiliki; Angelaina, Sophia; Stratou, Elpida; Saridi, Maria

    2015-01-01

    Workplace stress can influence healthcare professionals’ physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers’ mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%). Our research protocol was first approved by the hospital’s review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach’s α=0.862). Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals’ emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life - BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001) and quitting (t=−2.564, P=0.011) are predisposing factors. For the ‘mental health and spirituality’ regression model, positive re-assessment (t=5.528, P=0.000) and seeking social support (t=−1.991, P=0.048) are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0.000) is a

  9. Reducing indoor air pollution by air conditioning is associated with improvements in cardiovascular health among the general population.

    PubMed

    Lin, Lian-Yu; Chuang, Hsiao-Chi; Liu, I-Jung; Chen, Hua-Wei; Chuang, Kai-Jen

    2013-10-01

    Indoor air pollution is associated with cardiovascular effects, however, little is known about the effects of improving indoor air quality on cardiovascular health. The aim of this study was to explore whether improving indoor air quality through air conditioning can improve cardiovascular health in human subjects. We recruited a panel of 300 healthy subjects from Taipei, aged 20 and over, to participate in six home visits each, to measure a variety of cardiovascular endpoints, including high sensitivity-C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), fibrinogen in plasma and heart rate variability (HRV). Indoor particles and total volatile organic compounds (VOCs) were measured simultaneously at the participant's home during each visit. Three exposure conditions were investigated in this study: participants were requested to keep their windows open during the first two visits, close their windows during the next two visits, and close the windows and turn on their air conditioners during the last two visits. We used linear mixed-effects models to associate the cardiovascular endpoints with individual indoor air pollutants. The results showed that increases in hs-CRP, 8-OHdG and fibrinogen, and decreases in HRV indices were associated with increased levels of indoor particles and total VOCs in single-pollutant and two-pollutant models. The effects of indoor particles and total VOCs on cardiovascular endpoints were greatest during visits with the windows open. During visits with the air conditioners turned on, no significant changes in cardiovascular endpoints were observed. In conclusion, indoor air pollution is associated with inflammation, oxidative stress, blood coagulation and autonomic dysfunction. Reductions in indoor air pollution and subsequent improvements in cardiovascular health can be achieved by closing windows and turning on air conditioners at home. PMID:23803502

  10. Ecological health of river basins in forested regions of eastern Washington and Oregon. Forest Service general technical report

    SciTech Connect

    Wissmar, R.C.; Smith, J.E.; McIntosh, B.A.; Li, H.W.; Reeves, G.H.

    1994-02-01

    A retrospective examination of the history of the cumulative influences of past land water uses on the ecological health of select river basins in forest regions of eastern Washington and Oregon indicates the loss of fish and riparian habitat diversity and quality since the 19th century. The study focuses on impacts of timber harvest, fire management, live stock grazing, mining and irrigation management practices on stream and riparian ecosystems. An examination of past environmental management approaches for assessing stream, riparian, and watershed conditions in forest regions shows numerous advantages and shortcomings. Rcommendations for ecosystem management with emphasis on monitoring and restoration activities are provided.

  11. Application of HACCP principles to control visitor health threats on dairy farms open to the general public.

    PubMed

    Barten, M; Noordhuizen, J P M; Lipman, L J A

    2008-10-01

    An increasing number of Dutch dairy farmers have diversified their activities, often opening their farm up to visitors (tourist accommodation, farm shop, contact with livestock, etc). It is essential to prevent these visitors from having accidents or becoming ill, which could result in financial claims and might harm the reputation of the agricultural sector. This article describes how the hazard analysis critical control points concept and principles (HACCP) can be applied to these activities and integrated with on-farm operational herd health and production management programmes. PMID:18947047

  12. Why is the General Ophthalmic Services (GOS) Contract that underpins primary eye care in the U.K. contrary to the public health interest?

    PubMed

    Shickle, D; Davey, C J; Slade, S V

    2015-07-01

    The model for delivery of primary eye care in Europe varies from country to country with differing reliance on ophthalmologists, optometrists and dispensing opticians. Comparative analysis of models has tended to focus on interprofessional working arrangements, training and regulatory issues, rather than on whether a particular model is effective for delivering public health goals for that country. National Health Service (NHS) primary eye care services in the UK are predominantly provided under a General Ophthalmic Services (GOS) Contract between the NHS and practice owners (Contractors). Over two-thirds of sight tests conducted in England, Wales and Northern Ireland and all in Scotland are performed under a GOS Contract, however many people entitled to a GOS sight test do not take up their entitlement. The fee paid for sight tests conducted under a GOS Contract in England, Wales and Northern Ireland does not cover the full cost of conducting the examination. The shortfall must be made up through profits of sale of optical appliances but this business model can be a deterrent to establishing practices within socioeconomically deprived communities, and can also be a barrier to uptake of sight tests, even though many people are entitled to a NHS optical voucher towards the cost of spectacles or contact lenses. This paper critiques the GOS Contracts within the UK. We argue that aspects of the way the GOS Contract is implemented are contrary to the public health interest and that different approaches are needed to address eye health inequalities and to reduce preventable sight loss. PMID:25273827

  13. Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

    PubMed

    Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

    2009-12-01

    Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources. PMID:19940570

  14. Effects of the accident at Three Mile Island on the mental health and behavioral responses of the general population and nuclear workers

    SciTech Connect

    Fabrikant, J.I.

    1983-02-01

    On March 28, 1979, an accident occurred at the Three Mile Island nuclear power plant Unit No. 2 near Middletown, PA. A Presidential Commission was established to investigate the incident and was given the responsibility to evaluate the actual and potential impact of the events on the health and safety of the workers and the public. A main conclusion of the investigation was that the most serious health effect was severe, short-lived mental stress. This paper describes the study and the findings for four different study groups: (1) the general population of heads of households located within 20 miles of the plant; (2) mothers of preschool children from the same area; (3) teenagers in the 7th, 9th, and 11th grades from the area; and (4) nuclear workers employed at the Three Mile Island nuclear power plant. (ACR)

  15. Feeling Refreshed by Sleep Can Predict Psychological Wellbeing Assessed Using the General Health Questionnaire in Male Workers: A 3-Year Follow-Up Study

    PubMed Central

    2012-01-01

    Prediction of psychological wellbeing based on several important predictors was conducted for ensuring maintenance of good mental health. A 3-year follow-up study to determine psychological well-being was conducted in 969 Japanese male workers. Age, body mass index, present history of medication and four lifestyle factors were used for the analysis. A logistic regression analysis revealed that the odds ratio (95% confidence interval) for obtaining a score of ≥4 in the General Health Questionnaire-12-item version, among the subjects who felt refreshed by sleep was 0.559 (0.415-0.753). None of the other factors showed any statistically significant association. Feeling refreshed by sleep was identified as a predictor of maintained psychological wellbeing in this 3-year follow-up study. PMID:23251209

  16. Feeling refreshed by sleep can predict psychological wellbeing assessed using the general health questionnaire in male workers: a 3-year follow-up study.

    PubMed

    Kawada, Tomoyuki

    2012-12-01

    Prediction of psychological wellbeing based on several important predictors was conducted for ensuring maintenance of good mental health. A 3-year follow-up study to determine psychological well-being was conducted in 969 Japanese male workers. Age, body mass index, present history of medication and four lifestyle factors were used for the analysis. A logistic regression analysis revealed that the odds ratio (95% confidence interval) for obtaining a score of ≥4 in the General Health Questionnaire-12-item version, among the subjects who felt refreshed by sleep was 0.559 (0.415-0.753). None of the other factors showed any statistically significant association. Feeling refreshed by sleep was identified as a predictor of maintained psychological wellbeing in this 3-year follow-up study. PMID:23251209

  17. Practice nurses and the effects of the new general practitioner contract in the English National Health Service: the extension of a professional project?

    PubMed

    McDonald, Ruth; Campbell, Stephen; Lester, Helen

    2009-04-01

    This paper reports the impact on nurses working in primary health care settings of changes to the general practitioner (GP) contract in England implemented in 2004. Previous changes to the GP contract in 1990, which gave financial rewards for health promotion activities, were seen as enabling nurses to take on work that GPs did not want and providing an impetus for the development of a professional project (Broadbent, J. (1998). Practice nurses and the effects of the new general practitioner contract in the British NHS: the advent of a professional project? Social Science & Medicine, 47(4), 497-506). Our study, which involved interviews with nurses from 20 practices, finds that nurses are taking on work which has previously been the exclusive preserve of medical professionals. An increasing emphasis in nurses' accounts on technical skills and knowledge may help decouple nursing from a narrative of caring, which has been seen as detracting from professional advancement. Our research suggests that practice nurse work is changing to reflect a more medical (and masculine) orientation to service delivery. At the same time, nursing work is described as routine and template driven, which may limit claims to 'professional' status. The reaction of some practice nurses to Health Care Assistants encroaching on what was previously practice nurse territory suggests a policing of boundaries, rather than an inclusive approach to colleagues within the nursing team. This resonates with Davies' (Davies, C. (1995). Gender and the professional predicament in nursing. Bucks: Open University Press) suggestion that professionalisation as a process involves compliance with a masculine notion of professionalism (autonomous, elite, individual, divisive, detached) which marginalises feminine attributes and devalues the work done by women. The study also raises questions about the role of caring in general practice settings where nurses choose to prioritise other concerns. PMID:19254819

  18. Time Trends in Prevalence of Chronic Diseases and Multimorbidity Not Only due to Aging: Data from General Practices and Health Surveys

    PubMed Central

    van Oostrom, Sandra H; Gijsen, Ronald; Stirbu, Irina; Korevaar, Joke C; Schellevis, Francois G; Picavet, H. Susan J; Hoeymans, Nancy

    2016-01-01

    Introduction Chronic diseases and multimorbidity are common and expected to rise over the coming years. The objective of this study is to examine the time trend in the prevalence of chronic diseases and multimorbidity over the period 2001 till 2011 in the Netherlands, and the extent to which this can be ascribed to the aging of the population. Methods Monitoring study, using two data sources: 1) medical records of patients listed in a nationally representative network of general practices over the period 2002–2011, and 2) national health interview surveys over the period 2001–2011. Regression models were used to study trends in the prevalence-rates over time, with and without standardization for age. Results An increase from 34.9% to 41.8% (p<0.01) in the prevalence of chronic diseases was observed in the general practice registration over the period 2004–2011 and from 41.0% to 46.6% (p<0.01) based on self-reported diseases over the period 2001–2011. Multimorbidity increased from 12.7% to 16.2% (p<0.01) and from 14.3% to 17.5% (p<0.01), respectively. Aging of the population explained part of these trends: about one-fifth based on general practice data, and one-third for chronic diseases and half of the trend for multimorbidity based on health surveys. Conclusions The prevalence of chronic diseases and multimorbidity increased over the period 2001–2011. Aging of the population only explained part of the increase, implying that other factors such as health care and society-related developments are responsible for a substantial part of this rise. PMID:27482903

  19. Adapting machine learning techniques to censored time-to-event health record data: A general-purpose approach using inverse probability of censoring weighting.

    PubMed

    Vock, David M; Wolfson, Julian; Bandyopadhyay, Sunayan; Adomavicius, Gediminas; Johnson, Paul E; Vazquez-Benitez, Gabriela; O'Connor, Patrick J

    2016-06-01

    Models for predicting the probability of experiencing various health outcomes or adverse events over a certain time frame (e.g., having a heart attack in the next 5years) based on individual patient characteristics are important tools for managing patient care. Electronic health data (EHD) are appealing sources of training data because they provide access to large amounts of rich individual-level data from present-day patient populations. However, because EHD are derived by extracting information from administrative and clinical databases, some fraction of subjects will not be under observation for the entire time frame over which one wants to make predictions; this loss to follow-up is often due to disenrollment from the health system. For subjects without complete follow-up, whether or not they experienced the adverse event is unknown, and in statistical terms the event time is said to be right-censored. Most machine learning approaches to the problem have been relatively ad hoc; for example, common approaches for handling observations in which the event status is unknown include (1) discarding those observations, (2) treating them as non-events, (3) splitting those observations into two observations: one where the event occurs and one where the event does not. In this paper, we present a general-purpose approach to account for right-censored outcomes using inverse probability of censoring weighting (IPCW). We illustrate how IPCW can easily be incorporated into a number of existing machine learning algorithms used to mine big health care data including Bayesian networks, k-nearest neighbors, decision trees, and generalized additive models. We then show that our approach leads to better calibrated predictions than the three ad hoc approaches when applied to predicting the 5-year risk of experiencing a cardiovascular adverse event, using EHD from a large U.S. Midwestern healthcare system. PMID:26992568

  20. Socioeconomic disadvantage and its implications for population health planning of obesity and overweight, using cross-sectional data from general practices from a regional catchment in Australia

    PubMed Central

    Ghosh, Abhijeet; Charlton, Karen E; Batterham, Marijka J

    2016-01-01

    Objectives To identify smaller geographic and region-specific evidence to inform population health planning for overweight and obesity. Design Cross-sectional secondary analysis of data. Setting Primary healthcare—17 general practices located in the Illawarra-Shoalhaven region of New South Wales (NSW). Participants A subset (n=36 674) of the Sentinel Practices Data Sourcing project adult persons data set (n=118 794) that included information on disease status of all adult patients who had height and weight measurements recorded in their electronic health records and had visited the included general practices within the Illawarra-Shoalhaven region of NSW between September 2011 and September 2013. Main outcome measures Age-adjusted odds ratio (aOR) of overweight and obesity was determined for high and low levels of socioeconomic disadvantage based on Socio-Economic Indexes for Areas (SEIFA)—Index of Relative Socio-Economic Disadvantage (IRSD) scores of patients' residential statistical local area. Results In men, overweight was lowest in areas of highest socioeconomic disadvantage (aOR=0.910; 95% CI 0.830 to 0.998; p<0.001); but no statistically significant association with socioeconomic score was found for women. Overall obesity was associated with high socioeconomic disadvantage (aOR=1.292; 95% CI 1.210 to 1.379; p<0.001). Conclusions This type of data analysis reveals multiple layers of evidence that should be assessed for population health approaches to curb the epidemic of obesity and overweight. It strongly highlights the need for preventive health initiatives to be specific to gender and socioeconomic attributes of the target population. PMID:27142857

  1. Do new cancer drugs offer good value for money? The perspectives of oncologists, health care policy makers, patients, and the general population

    PubMed Central

    Dilla, Tatiana; Lizan, Luís; Paz, Silvia; Garrido, Pilar; Avendaño, Cristina; Cruz-Hernández, Juan J; Espinosa, Javier; Sacristán, José A

    2016-01-01

    Background In oncology, establishing the value of new cancer treatments is challenging. A clear definition of the different perspectives regarding the drivers of innovation in oncology is required to enable new cancer treatments to be properly rewarded for the value they create. The aim of this study was to analyze the views of oncologists, health care policy makers, patients, and the general population regarding the value of new cancer treatments. Methods An exploratory and qualitative study was conducted through structured interviews to assess participants’ attitudes toward cost and outcomes of cancer drugs. First, the participants were asked to indicate the minimum survival benefit that a new treatment should have to be funded by the Spanish National Health System (NHS). Second, the participants were requested to state the highest cost that the NHS could afford for a medication that increases a patient’s quality of life (QoL) by twofold with no changes in survival. The responses were used to calculate incremental cost-effectiveness ratios (ICERs). Results The minimum improvement in patient survival means that justified inclusions into the NHS were 5.7, 8.2, 9.1, and 10.4 months, which implied different ICERs for oncologists (€106,000/quality-adjusted life year [QALY]), patients (€73,520/QALY), the general population (€66,074/QALY), and health care policy makers (€57,471/QALY), respectively. The costs stated in the QoL-enhancing scenario were €33,167, €30,200, €26,000, and €17,040, which resulted in ICERs of €82,917/QALY for patients, €75,500/QALY for the general population, €65,000/QALY for oncologists, and €42,600/QALY for health care policy makers, respectively. Conclusion All estimated ICER values were higher than the thresholds previously described in the literature. Oncologists most valued gains in survival, whereas patients assigned a higher monetary value to treatments that enhanced QoL. Health care policy makers were less

  2. Violence against children, later victimisation, and mental health: a cross-sectional study of the general Norwegian population

    PubMed Central

    Thoresen, Siri; Myhre, Mia; Wentzel-Larsen, Tore; Aakvaag, Helene Flood; Hjemdal, Ole Kristian

    2015-01-01

    Background Violence in childhood is associated with mental health problems and risk of revictimisation. Less is known about the relative importance of the various types of childhood and adult victimisation for adult mental health. Objective To estimate the associations between various types of childhood and adult violence exposure, and their combined associations to adult mental health. Method This study was a cross-sectional telephone survey of the Norwegian adult population; 2,435 women and 2,092 men aged 18–75 participated (19.3% of those we tried to call and 42.9% of those who answered the phone). The interview comprised a broad array of violence exposure in both childhood and adulthood. Anxiety/depression was measured by the Hopkins Symptom Check List (HSCL-10). Results Victimisation was commonly reported, for example, child sexual abuse (women: 10.2%, men: 3.5%), childhood–parental physical violence (women: 4.9%, men: 5.1%), and lifetime forcible rape (women: 9.4%, men: 1.1%). All categories of childhood violence were significantly associated with adult victimisation, with a 2.2–5.0 times higher occurrence in exposed children (p<0.05 for all associations). Anxiety/depression (HSCL-10) associated with adult abuse increased with the number of childhood violence categories experienced (p<0.001). All combinations of childhood violence were significantly associated with anxiety/depression (p<0.001 for all associations). Individuals reporting psychological violence/neglect had the highest levels of anxiety/depression. Conclusions Results should be interpreted in light of the low response rate. Childhood violence in all its forms was a risk factor for victimisation in adulthood. Adult anxiety/depression was associated with both the number of violence categories and the type of childhood violence experienced. A broad assessment of childhood and adult violence exposure is necessary both for research and prevention purposes. Psychological violence and neglect

  3. Understanding the relative valuation of research impact: a best–worst scaling experiment of the general public and biomedical and health researchers

    PubMed Central

    Pollitt, Alexandra; Potoglou, Dimitris; Patil, Sunil; Burge, Peter; Guthrie, Susan; King, Suzanne; Wooding, Steven; Grant, Jonathan

    2016-01-01

    Objectives (1) To test the use of best–worst scaling (BWS) experiments in valuing different types of biomedical and health research impact, and (2) to explore how different types of research impact are valued by different stakeholder groups. Design Survey-based BWS experiment and discrete choice modelling. Setting The UK. Participants Current and recent UK Medical Research Council grant holders and a representative sample of the general public recruited from an online panel. Results In relation to the study's 2 objectives: (1) we demonstrate the application of BWS methodology in the quantitative assessment and valuation of research impact. (2) The general public and researchers provided similar valuations for research impacts such as improved life expectancy, job creation and reduced health costs, but there was less agreement between the groups on other impacts, including commercial capacity development, training and dissemination. Conclusions This is the second time that a discrete choice experiment has been used to assess how the general public and researchers value different types of research impact, and the first time that BWS has been used to elicit these choices. While the 2 groups value different research impacts in different ways, we note that where they agree, this is generally about matters that are seemingly more important and associated with wider social benefit, rather than impacts occurring within the research system. These findings are a first step in exploring how the beneficiaries and producers of research value different kinds of impact, an important consideration given the growing emphasis on funding and assessing research on the basis of (potential) impact. Future research should refine and replicate both the current study and that of Miller et al in other countries and disciplines. PMID:27540096

  4. Associations between general self-efficacy and health-related quality of life among 12-13-year-old school children: a cross-sectional survey

    PubMed Central

    Kvarme, Lisbeth Gravdal; Haraldstad, Kristin; Helseth, Sølvi; Sørum, Ragnhild; Natvig, Gerd Karin

    2009-01-01

    Background While research on school children's health has mainly focused on risk factors and illness, few studies have examined aspects of health promotion. Thus, this study focuses on health promotional factors including general self-efficacy (GSE) and health-related quality of life (HRQOL). GSE refers to a global confidence in coping ability across a wide range of demanding situations, and is related to health. The purpose of this study was to examine associations between GSE and HRQOL, and associations between HRQOL and socio-demographic characteristics. Knowledge of these associations in healthy school children is currently lacking. Methods During 2006 and 2007, 279 school children in the seventh grade across eastern Norway completed a survey assessing their GSE and HRQOL. The children were from schools that had been randomly selected using cluster sampling. T-tests were computed to compare mean subscale values between HRQOL and socio-demographic variables. Single and multiple regression analyses were performed to explore associations among GSE, HRQOL and socio-demographic variables. Results Regression analyses showed a significant relationship between increasing degrees of GSE and increasing degrees of HRQOL. In analyses adjusted for socio-demographic variables, boys scored higher than girls on self-esteem. School children from single-parent families had lower scores on HRQOL than those from two-parent families, and children who had relocated within the last five years had lower scores on HRQOL than those who had not relocated. Conclusion The strong relationship between GSE and HRQOL indicates that GSE might be a resource for increasing the HRQOL for school children. PMID:19772673

  5. Ugandan Women’s View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks

    PubMed Central

    Twesigye, Rogers; Buyungo, Peter; Kaula, Henry; Buwembo, Dennis

    2016-01-01

    ABSTRACT Background: Between 2001 and 2006, IUD use in Uganda stagnated at 0.2% among women of reproductive age (WRA) ages 15–49. By 2011, IUD use had increased slightly to 0.4%. Recent studies report a significant increase in IUD use to 3.8%, but it is still low. Because the IUD is a little-used method in Uganda, we assessed the acceptability of the IUD by surveying women about their perceptions, attitudes, and beliefs. Methods: In August and September 2014, we conducted a cross-sectional survey among 1,505 WRA exiting public and private health facilities in Uganda. We collected information on women’s attitudes, knowledge, and beliefs about the IUD, as well as their perceptions about its availability. We classified women’s responses according to a behavior change framework with 3 summary constructs: opportunity (structural factors that influence behavior), ability (skills to perform the behavior), and motivation (self-interest in adopting the behavior). As these 3 types of factors are more favorable to the desired behavior (in this case, use of the IUD), individuals are more likely to perform the behavior. Cross-tabulations compared the percentage results of perceptions and knowledge by key background characteristics. Results: Most (87.8%) of the surveyed women had heard of the IUD, and nearly two-thirds had a positive attitude toward the method. But a lower percentage (38.6%) had accurate information about the IUD and more than half (51.6%) did not think the method was available in a nearby facility. More than half of the women believed incorrectly that the IUD can damage the womb (57%), that it reduces sexual pleasure (54%), and that it can cause cancer (58%). Current use of family planning or of a modern method specifically was positively associated with awareness and accurate knowledge and beliefs about the IUD. Married women had significantly higher awareness of the IUD than single women, and they had better knowledge and belief scores. The type of

  6. Assessment of general health of fishes collected at selected sites in the Great Lakes Basin In 2012

    USGS Publications Warehouse

    Mazik, Patricia M.; Braham, Ryan P.; Hahn, Cassidy M.; Blazer, Vicki

    2015-01-01

    The U. S. Fish and Wildlife Service received funding through the Great Lakes Restoration Initiative (GLRI) for an Early Warning Program to detect and identify emerging contaminants and to evaluate the effects of these contaminants on fish and wildlife. The U.S. Geological Survey (WV Cooperative Fish and Wildlife Research Unit and National Fish Health Research Laboratory, Leetown Science Center) developed and implemented a biological effects monitoring protocol to assist in this program. Fish collections and measurements of biomarkers of exposure in Fall 2010 and Spring 2011 occurred at individual sites within select Areas of Concern (AOCs). They provided an assessment of the utility of the suite of biomarkers and also identified sites for more in-depth analyses. Selected areas are characterized as areas with known emerging contaminants, sensitive or listed species, areas downstream from municipal wastewater discharges or receiving waters for industrial facilities, and/or areas susceptible to agricultural or urban contamination, or harbors or ports. The results of the 2010- 2011 studies were summarized in Blazer et al. 2014 a, b, c; Braham et al. in review and Blazer et al. in review.

  7. Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on health-related quality of life

    PubMed Central

    Miravitlles, Marc; Llor, Carles; Molina, Jesús; Naberan, Karlos; Cots, Josep M; Ros, Fernando

    2010-01-01

    Objective: To investigate the impact of exacerbations in health-related quality of life (HRQL) of patients with COPD and to compare the effect of treatment of COPD exacerbations with moxifloxacin (400 mg/day for 5 days) and amoxicillin/clavulanate (500/125 mg 3 times a day for 10 days) on HRQL. Methods: 229 outpatients with stable COPD (mean age 68.2 years; mean FEV1 % predicted 49.3%) participated in a prospective, observational study of 2 years’ duration. The St George’s Respiratory Questionnaire (SGRQ) was completed at baseline and every 6 months thereafter. Results: COPD exacerbations (mean 2.7 episodes/patient) occurred in 136 patients (124 patients received the study medications [amoxicillin/clavulanate 54, moxifloxacin 70]). Differences between baseline and the final visit were higher for moxifloxacin compared with amoxicillin/clavulanate for total SGRQ score (−2.60 [13.1] vs 4.21 [16.2], P = 0.05) and “Symptoms” subscale (−5.64 [16.7] vs 8.27 [21], P = 0.02). The same findings were observed in patients with two or more exacerbations. Conclusions: In COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate. PMID:20368907

  8. Smoking and Health-Related Quality of Life in the General Population. Independent Relationships and Large Differences According to Patterns and Quantity of Smoking and to Gender

    PubMed Central

    Coste, Joël; Quinquis, Laurent; D'Almeida, Samuel; Audureau, Etienne

    2014-01-01

    Background Relationships between smoking and health-related quality of life (HRQoL) in the general population remain unclear. Objectives To quantify the independent associations between smoking patterns and HRQoL and to identify any threshold or non-linear tendencies in these associations. Methods A national representative, cross-sectional household survey of the French general non institutionalized population included 7525 men and 8486 women, aged 25–64 year in 2003. Scores on the eight subscales of the Medical Outcomes Study 36-item Short Form were the primary outcomes. Linear regression analyses were used to evaluate the associations between HRQoL and smoking history, quantity of smoking and smoking cessation while controlling for various socio-economic variables, depression, alcohol dependence and pathological conditions. Analyses were conducted in 2013. Results Independent associations between smoking and HRQoL were found, including small positive associations for occasional or light smoking (up to 5 cigarettes per day), and larger and diffuse negative associations above this threshold. Much weaker associations and higher thresholds for negative HRQoL were found for women than for men. For ex-smokers of both genders, HRQoL was found to be better between 2 and 5 years after quitting. Conclusions Smoking was independently related to HRQoL, with large differences according to the pattern and quantity of smoking, and to gender. These results may have considerable relevance both for public health action and care of smokers. PMID:24637739

  9. Assessment of inhalation exposures and potential health risks to the general population that resulted from the collapse of the World Trade Center towers.

    PubMed

    Lorber, Matthew; Gibb, Herman; Grant, Lester; Pinto, Joseph; Pleil, Joachim; Cleverly, David

    2007-10-01

    In the days following the collapse of the World Trade Center (WTC) towers on September 11, 2001 (9/11), the U.S. Environmental Protection Agency (EPA) initiated numerous air monitoring activities to better understand the ongoing impact of emissions from that disaster. Using these data, EPA conducted an inhalation exposure and human health risk assessment to the general population. This assessment does not address exposures and potential impacts that could have occurred to rescue workers, firefighters, and other site workers, nor does it address exposures that could have occurred in the indoor environment. Contaminants evaluated include particulate matter (PM), metals, polychlorinated biphenyls, dioxins, asbestos, volatile organic compounds, particle-bound polycyclic aromatic hydrocarbons, silica, and synthetic vitreous fibers (SVFs). This evaluation yielded three principal findings. (1) Persons exposed to extremely high levels of ambient PM and its components, SVFs, and other contaminants during the collapse of the WTC towers, and for several hours afterward, were likely to be at risk for acute and potentially chronic respiratory effects. (2) Available data suggest that contaminant concentrations within and near ground zero (GZ) remained significantly elevated above background levels for a few days after 9/11. Because only limited data on these critical few days were available, exposures and potential health impacts could not be evaluated with certainty for this time period. (3) Except for inhalation exposures that may have occurred on 9/11 and a few days afterward, the ambient air concentration data suggest that persons in the general population were unlikely to suffer short-term or long-term adverse health effects caused by inhalation exposures. While this analysis by EPA evaluated the potential for health impacts based on measured air concentrations, epidemiological studies conducted by organizations other than EPA have attempted to identify actual impacts. Such

  10. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study

    PubMed Central

    Schouten, Naomi PE; Merkus, Peter JFM; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

    2015-01-01

    Background Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. Objective The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Methods Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman’s general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Results Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0

  11. The stigma of obesity in the general public and its implications for public health - a systematic review

    PubMed Central

    2011-01-01

    Background Up to this date, prevalence rates of obesity are still rising. Aside from co-morbid diseases, perceived discrimination and stigmatization leads to worsen outcomes in obese individuals. Higher stigmatizing attitudes towards obese individuals may also result in less support of preventive and interventive measures. In light of the immense burden of obesity on health care systems and also on the individuals' quality of life, accepted and subsidized preventive measures are needed. Policy support might be determined by views of the lay public on causes of obesity and resulting weight stigma. This study seeks to answer how representative samples of the lay public perceive people with obesity or overweight status (stigmatizing attitudes); what these samples attribute obesity to (causal attribution) and what types of interventions are supported by the lay public and which factors determine that support (prevention support). Methods A systematic literature search was conducted. All studies of representative samples reporting results on (a) stigmatizing attitudes towards overweight and obese individuals, (b) causal beliefs and (c) prevention support were included. Results Only 7 articles were found. One study reported prevalence rates of stigmatizing attitudes. About a quarter of the population in Germany displayed definite stigmatizing attitudes. Other studies reported causal attributions. While external influences on weight are considered as well, it seems that internal factors are rated to be of higher importance. Across the studies found, regulative prevention is supported by about half of the population, while childhood prevention has highest approval rates. Results on sociodemographic determinants differ substantially. Conclusions Further research on public attitudes toward and perception of overweight and obesity is urgently needed to depict the prevailing degree of stigmatization. Introducing a multidimensional concept of the etiology of obesity to the lay

  12. Mental health literacy: a cross-cultural approach to knowledge and beliefs about depression, schizophrenia and generalized anxiety disorder

    PubMed Central

    Altweck, Laura; Marshall, Tara C.; Ferenczi, Nelli; Lefringhausen, Katharina

    2015-01-01

    Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs. PMID:26441699

  13. Mental health literacy: a cross-cultural approach to knowledge and beliefs about depression, schizophrenia and generalized anxiety disorder.

    PubMed

    Altweck, Laura; Marshall, Tara C; Ferenczi, Nelli; Lefringhausen, Katharina

    2015-01-01

    Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)-the knowledge and positive beliefs about mental disorders-tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs. PMID:26441699

  14. Health-hazard evaluation report HETA 85-047-1632, General Telephone and Equipment Company, Carpenteria, California

    SciTech Connect

    Belanger, P.L.

    1985-11-01

    Environmental and breathing-zone samples were analyzed for methyl-chloroform, benzene, and mineral spirits at General Telephone and Equipment Company, Carpenteria, California in January, 1985. The evaluation was requested by a union local to investigate whether employees working in the switching offices were exposed to excessive concentrations of methyl-chloroform, bank cleaning fluid, or lubricant while cleaning and lubricating mechanical switches. Five workers were interviewed to determine if they experienced any symptoms of overexposure to solvents. All mineral spirits and methyl-chloroform concentrations were below their relevant standards. No benzene was detected. Two workers reported dizziness, headache, or finger numbness about 15 minutes after using methyl-chloroform to clean rotary switches. One worker reported white fingers after using methyl-chloroform. None of the workers were wearing protective equipment or clothing. The author concludes that no overexposure to organic solvents is occurring. The reported symptoms are consistent with solvent exposure, most probably dermal exposure to methyl-chloroform while cleaning rotary switches. Recommendations include providing periodic training in chemical handling and instructing workers on how to use barrier cream when handling methyl-chloroform.

  15. Disclosure of mental health problems in general practice: The gradual emergence of latent topics and resources for achieving their consideration.

    PubMed

    Tarber, Christel; Frostholm, Lisbeth

    2014-01-01

    Common mental disorders often go undetected in primary care. Sharpening general practitioners' (GPs') attention to potential signs thereof is therefore crucial. This conversation-analytic study arises from the observation that the consideration of psychological problems in new-concern visits can be achieved by way of 'gradual topic emergence'. This entails that the problem is not presented directly, but adjunct to somatic symptoms, and is hinted at by way of generic, ambiguous complaints, and furthermore by expressions of frustration and uncertainty and talk about lifeworld problems. It is argued that these materials are 'trouble-premonitory, alerting the GP to the presence of an underlying problem that can then be addressed throughfurther inquiry. The patient logic behind this approach is to assure the GP's recipiency and thus ratification of the problem's medical legitimacy. It allows the patient to introduce a potentially delicate problem 'off the record, thus guarding the patient against the loss of face that could resultfrom no uptake by the GP. The results of the study point to the importance of GPs being receptive to such interactional clues to psychological problems provided by patients. PMID:26596126

  16. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

    PubMed Central

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Objective Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. Methods In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Results Sixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. Conclusions HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future. PMID:27115139

  17. Test-retest reliability of health behavior items in the Community Health Survey in South Korea

    PubMed Central

    Han, Jin A; Kim, Young Hwa; Kim, Su Young; Lee, Hun Je; Oh, In Hwan; Lee, Jakyoung

    2015-01-01

    OBJECTIVES: Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale. METHODS: A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics. RESULTS: Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted. CONCLUSIONS: The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required. PMID:26493776

  18. Usefulness of the Population Health Metrics Research Consortium gold standard verbal autopsy data for general verbal autopsy methods

    PubMed Central

    2014-01-01

    Background Verbal Autopsy (VA) is widely viewed as the only immediate strategy for registering cause of death in much of Africa and Asia, where routine physician certification of deaths is not widely practiced. VA involves a lay interview with family or friends after a death, to record essential details of the circumstances. These data can then be processed automatically to arrive at standardized cause of death information. Methods The Population Health Metrics Research Consortium (PHMRC) undertook a study at six tertiary hospitals in low- and middle-income countries which documented over 12,000 deaths clinically and subsequently undertook VA interviews. This dataset, now in the public domain, was compared with the WHO 2012 VA standard and the InterVA-4 interpretative model. Results The PHMRC data covered 70% of the WHO 2012 VA input indicators, and categorized cause of death according to PHMRC definitions. After eliminating some problematic or incomplete records, 11,984 VAs were compared. Some of the PHMRC cause definitions, such as ‘preterm delivery’, differed substantially from the International Classification of Diseases, version 10 equivalent. There were some appreciable inconsistencies between the hospital and VA data, including 20% of the hospital maternal deaths being described as non-pregnant in the VA data. A high proportion of VA cases (66%) reported respiratory symptoms, but only 18% of assigned hospital causes were respiratory-related. Despite these issues, the concordance correlation coefficient between hospital and InterVA-4 cause of death categories was 0.61. Conclusions The PHMRC dataset is a valuable reference source for VA methods, but has to be interpreted with care. Inherently inconsistent cases should not be included when using these data to build other VA models. Conversely, models built from these data should be independently evaluated. It is important to distinguish between the internal and external validity of VA models. The effects of

  19. Association between Body Mass Index and Health-Related Quality of Life: The "Obesity Paradox" in 21,218 Adults of the Chinese General Population

    PubMed Central

    Zhu, Yanbo; Wang, Qi; Pang, Guoming; Lin, Lin; Origasa, Hideki; Wang, Yangyang; Di, Jie; Shi, Mai; Fan, Chunpok; Shi, Huimei

    2015-01-01

    Background There was no consistent recognition of the association between high or low body mass index (BMI) and health related quality of life (HRQL). The aim of this research was to study the association between BMI and HRQL in Chinese adults, and to further explore the stability of that association in the subgroup analysis stratified by status of chronic conditions. Methods A total of 21,218 adults aged 18 and older were classified as underweight, normal weight, overweight, class I obese, and class II obese based on their BMI. HRQL was measured by the SF-36 Health Survey. The independent impact of each BMI category on HRQL was examined through standard least squares regression by comparing the difference of SF-36 scores and the minimum clinically important differences (MCID), which was defined as 3 points. Results Compared to the normal weight, the class I obese was significantly associated with better HRQL scores in the mental component summary (MCS) (75.1 vs. 73.4, P<0.001). The underweight had the lowest score in both the physical components summary (PCS) (75.4 vs. 77.5, P<0.001) and mental components summary (MCS) (71.8 vs. 73.4, P<0.001). For the MCID, the HRQL score was reduced by more than 3 points in the physical functioning for the class II obese (D=-3.43) and the general health for the underweight (D=-3.71). Stratified analyses showed a similar result in the health subjects and chronic conditions, and it was significant in the chronic conditions. Conclusions The class I obese showed the best HRQL, especially in the mental domain. The worst HRQL was found in the underweight. The class II obese reduced HRQL in the physical functioning only. “Obesity paradox” was more obvious in the participants with chronic conditions. PMID:26087128

  20. The PRO-AGE study: an international randomised controlled study of health risk appraisal for older persons based in general practice

    PubMed Central

    Stuck, Andreas E; Kharicha, Kalpa; Dapp, Ulrike; Anders, Jennifer; von Renteln-Kruse, Wolfgang; Meier-Baumgartner, Hans Peter; Iliffe, Steve; Harari, Danielle; Bachmann, Martin D; Egger, Matthias; Gillmann, Gerhard; Beck, John C; Swift, Cameron G

    2007-01-01

    Background This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people – Assessment in GEneralists' practices) project. Methods/Design A group of general practitioners (GPs) in London (U.K.), Hamburg (Germany) and Solothurn (Switzerland) were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O) instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period). Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons) in the randomised controlled study was 2503 (66.0%) in London, 2580 (53.6%) in Hamburg, and 2284 (67.5%) in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible) enrolled in the concurrent comparison group was 636 (48.8%) in London, 746 (35.7%) in Hamburg, and 1171 (63.0%) in Solothurn. Discussion PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with different

  1. Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial)

    PubMed Central

    Goldberg, Sarah E; Bradshaw, Lucy E; Kearney, Fiona C; Russell, Catherine; Whittamore, Kathy H; Foster, Pippa E R; Mamza, Jil; Gladman, John R F; Jones, Rob G; Lewis, Sarah A; Porock, Davina

    2013-01-01

    Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. Setting Large acute general hospital in the United Kingdom. Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission. Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of the specialist unit included joint staffing by medical and mental health professionals; enhanced staff training in delirium, dementia, and person centred dementia care; provision of organised purposeful activity; environmental modification to meet the needs of those with cognitive impairment; delirium prevention; and a proactive and inclusive approach to family carers. Main outcome measures Primary outcome: number of days spent at home over the 90 days after randomisation. Secondary outcomes: structured non-participant observations to ascertain patients’ experiences; satisfaction of family carers with hospital care. When possible, outcome assessment was blind to allocation. Results There was no significant difference in days spent at home between the specialist unit and standard care groups (median 51 v 45 days, 95% confidence interval for difference −12 to 24; P=0.3). Median index hospital stay was 11 versus 11 days, mortality 22% versus 25% (−9% to 4%), readmission 32% versus 35% (−10% to 5%), and new admission to care home 20% versus 28% (−16% to 0) for the specialist unit and standard care groups, respectively. Patients returning home spent a median of 70.5 versus 71.0 days at home (−6.0 to 6.5). Patients on the specialist unit spent significantly more time with positive mood or

  2. Feasibility of an Electronic Survey on iPads with In-Person Data Collectors for Data Collection with Health Care Professionals and Health Care Consumers in General Emergency Departments

    PubMed Central

    Albrecht, Lauren; Given, Lisa M; Arseneau, Danielle; Klassen, Terry P

    2016-01-01

    Background Translating Emergency Knowledge for Kids was established to bridge the research-practice gap in pediatric emergency care by bringing the best evidence to Canadian general emergency departments (EDs). The first step in this process was to conduct a national needs assessment to determine the information needs and preferences of health professionals and parents in this clinical setting. Objective To describe the development and implementation of two electronic surveys, and determine the feasibility of collecting electronic survey data on iPads with in-person data collectors in a busy clinical environment. Methods Two descriptive surveys were conducted in 32 general EDs. Specific factors were addressed in four survey development and implementation stages: survey design, survey delivery, survey completion, and survey return. Feasibility of the data collection approach was determined by evaluating participation rates, completion rates, average survey time to completion, and usability of the platform. Usability was assessed with the in-person data collectors on five key variables: interactivity, portability, innovativeness, security, and proficiency. Results Health professional participation rates (1561/2575, 60.62%) and completion rates (1471/1561, 94.23%) were strong. Parental participation rates (974/1099, 88.63%) and completion rates (897/974, 92.09%) were excellent. Mean time to survey completion was 28.08 minutes for health professionals and 43.23 minutes for parents. Data collectors rated the platform “positively” to “very positively” on all five usability variables. Conclusions A number of design and implementation considerations were explored and integrated into this mixed-mode survey data collection approach. Feasibility was demonstrated by the robust survey participation and completion rates, reasonable survey completion times, and very positive usability evaluation results. PMID:27358205

  3. Effects of the accident at Three Mile Island on the mental health and behavior responses of the general population and the nuclear workers

    SciTech Connect

    Fabrikant, J.I.

    1982-02-01

    A main conclusion drawn from the investigation by the President's Commission was that the most serious health effect of the Three Mile Island nuclear accident was severe mental stress, which was short-lived. The highest levels of psychological distress were found among those living within 5 miles of Three Mile Island, in families with preschool children, and among the Three Mile Island nuclear workers. This report provides some understanding of how these conclusions were drawn, the methods used to obtain information of the experiences of mental stress and the behavioral effects and responses of the general population and the nuclear workers to the accident at Three Mile Island. In order to limit the scope of the discussion, information is taken from the Behavioral Effects Task Group Report (TMI79c) to the President's Commission, and thus from the labors of the many behavioral scientists.

  4. Understanding the burden of idiopathic generalized epilepsy in the United States, Europe, and Brazil: An analysis from the National Health and Wellness Survey.

    PubMed

    Gupta, Shaloo; Kwan, Patrick; Faught, Edward; Tsong, Wan; Forsythe, Anna; Ryvlin, Phillipe

    2016-02-01

    The aim of this study was to understand the current burden of primary generalized tonic-clonic seizures (PGTCS) associated with idiopathic generalized epilepsy (IGE) as a function of seizure frequency. We analyzed data for (IGE) as a proxy measure of PGTCS. Little is known about the quality of life (QoL), health utility, productivity, healthcare resource utilization (HRU), and cost burden of PGTCS or IGE. Patients were identified from the US (2011, 2012, & 2013), 5EU (2011 & 2013), and Brazil (2011 & 2012) National Health and Wellness Survey, a nationally representative, internet-based survey of adults (18+ years). Patients that self-reported a diagnosis of IGE were categorized into seizure frequencies of: ≥1 seizure per week, 1-3 seizures per month, 1-4 seizures per year, or <1 seizure per year. QoL was measured using the SF-36v2 Mental (MCS) and Physical Component Summary (PCS) scores, health utilities with the SF-6D, productivity with the Work Productivity and Activity Impairment (WPAI) questionnaire, and HRU as reported in the past six months. Unit costs were estimated from the literature and multiplied against HRU values to calculate direct costs and WPAI values to calculate indirect costs. Generalized linear regression was utilized to examine the relationship between seizure frequency and each measure of burden with adjustment for covariates. Out of the general population surveyed, IGE was self-reported in 782 of 176,093 (US), 172 of 30,000 (UK), 106 of 30,001 (Germany), 87 of 30,000 (France), 31 of 12,011 (Spain), 22 of 17,500 (Italy), and 34 of 24,000 (Brazil). Persistent seizures (≥1 per year) were reported in over 40% of patients with IGE (10-15% with ≥1 seizure per week, 10-15% with 1-3 seizures per month, 20-25% with 1-4 seizures per year). Over 75% were treated with antiepileptic drugs (AEDs). Compared with those having <1 seizure per year (reference group), patients in the two most frequent seizure categories reported worse MCS and PCS scores

  5. The influence of patients' immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland.

    PubMed

    Drewniak, Daniel; Krones, Tanja; Sauer, Carsten; Wild, Verina

    2016-07-01

    This study examines the influence of patients' immigration background and residence permit status on physicians' willingness to treat patients in due time. A factorial survey was conducted among 352 general practitioners with a background in internal medicine in a German-speaking region in Switzerland. Participants expressed their self-rating (SR) as well as the expected colleague-rating (CR) to provide immediate treatment to 12 fictive vignette patients. The effects of the vignette variables were analysed using random-effects models. The results show that SR as well as CR was not only influenced by the medical condition or the physicians' time pressure, but also by social factors such as the ethnicity and migration history, the residence permit status, and the economic condition of the patients. Our findings can be useful for the development of adequate, practically relevant teaching and training materials with the ultimate aim to reduce unjustified discrimination or social rationing in health care. PMID:27258017

  6. Definitions of Health Terms: General Health

    MedlinePlus

    ... Source : National Heart, Lung, and Blood Institute Body Temperature Body temperature is a measure of your body’s level of ... cycle, along with changes in your basal body temperature, may help you figure out when you are ...

  7. Estimating health-state utility values for patients with recurrent ovarian cancer using Functional Assessment of Cancer Therapy – General mapping algorithms

    PubMed Central

    Hettle, Robert; Borrill, John; Suri, Gaurav; Wulff, Jerome

    2015-01-01

    Objectives In the absence of EuroQol 5D data, mapping algorithms can be used to predict health-state utility values (HSUVs) for use in economic evaluation. In a placebo-controlled Phase II study of olaparib maintenance therapy (NCT00753545), health-related quality of life was measured using the Functional Assessment of Cancer Therapy – Ovarian (FACT-O) questionnaire. Our objective was to generate HSUVs from the FACT-O data using published mapping algorithms. Materials and methods Algorithms were identified from a review of the literature. Goodness-of-fit and patient characteristics were compared to select the best-performing algorithm, and this was used to generate base-case HSUVs for the intention-to-treat population of the olaparib study and for patients with breast cancer antigen mutations. Results Four FACT – General (the core component of FACT-O) mapping algorithms were identified and compared. Under the preferred algorithm, treatment-related adverse events had no statistically significant effect on HSU (P>0.05). Discontinuation of the study treatment and breast cancer antigen mutation status were both associated with a reduction in HSUVs (–0.06, P=0.0009; and –0.03, P=0.0511, respectively). The mean HSUV recorded at assessment visits was 0.786. Conclusion FACT – General mapping generated credible HSUVs for an economic evaluation of olaparib. As reported in other studies, different algorithms may produce significantly different estimates of HSUV. For this reason, it is important to test whether the choice of a specific algorithm changes the conclusions of an economic evaluation. PMID:26648747

  8. Association between mental demands at work and cognitive functioning in the general population – results of the health study of the Leipzig research center for civilization diseases (LIFE)

    PubMed Central

    2014-01-01

    Background The level of mental demands in the workplace is rising. The present study investigated whether and how mental demands at work are associated with cognitive functioning in the general population. Methods The analysis is based on data of the Health Study of the Leipzig Research Centre for Civilization Disease (LIFE). 2,725 participants aged 40–80 years underwent cognitive testing (Trail-Making Test, Verbal Fluency Test) and provided information on their occupational situation. Participants over the age of 65 years additionally completed the Mini-Mental State Examination. Mental demands at work were rated by a standardized classification system (O*NET). The association between mental demands and cognitive functioning was analyzed using Generalized Linear Modeling (GENLIN) adjusted for age, gender, self-regulation, working hour status, education, and health-related factors. Results Univariate as well as multivariate analyses demonstrated significant and highly consistent effects of higher mental demands on better performance in cognitive testing. The results also indicated that the effects are independent of education and intelligence. Moreover, analyses of retired individuals implied a significant association between high mental demands at work of the job they once held and a better cognitive functioning in old age. Conclusions In sum, our findings suggest a significant association between high mental demands at work and better cognitive functioning. In this sense, higher levels of mental demands – as brought about by technological changes in the working environment – may also have beneficial effects for the society as they could increase cognitive capacity levels and might even delay cognitive decline in old age. PMID:24914403

  9. General Healthcare Maintenance of IBD

    MedlinePlus

    ... health care provider about other important issues including: Vaccinations: Adults with IBD should generally follow the same vaccination schedules as the general population. The only exceptions ...

  10. Impact of dental treatment under general anesthesia on the oral health-related quality of life of adolescents and adults with special needs.

    PubMed

    Chang, Juhea; Patton, Lauren L; Kim, Hae-Young

    2014-12-01

    This study aimed to assess the perception of the family's primary caregiver on the oral health-related quality of life (OHRQoL), and the impact on family dynamics, of dental treatment under general anesthesia (GA) in adolescent and adult patients with intellectual and developmental disabilities (IDD) and neurocognitive disorders. Self-administered questionnaires were completed, before dental treatment, by 116 primary family caregivers of patients who received dental treatment under GA, and 102 (88%) of these caregivers completed the same questionnaires within 4 wk after treatment. The Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were shortened to a 14-item COHIP (COHIP-14) and a 12-item FIS (FIS-12) based on the limitations of patients' communication. The COHIP-14 and FIS-12 scores and each subscale improved after treatment. The baseline scores varied based on certain characteristics of the patients, such as age, disabilities, medications, caregivers, meal types, cooperation levels, and treatment needs. The postoperative improvement in OHRQoL was significant in the patients who were older than 30 yr of age, originally eating soft meals, displaying no or very low levels of cooperation, or receiving endodontic treatment. Based on the primary caregiver perceptions, the OHRQoL of adolescents and adults with IDD and neurocognitive disorders was improved by dental treatment under GA. PMID:25292335

  11. Primary care-led survivorship care for patients with colon cancer and the use of eHealth: a qualitative study on perspectives of general practitioners

    PubMed Central

    Duineveld, Laura A M; Wieldraaijer, Thijs; Wind, Jan; Verdonck-de Leeuw, Irma M; van Weert, Henk C P M; van Uden-Kraan, Cornelia F

    2016-01-01

    Objectives The aim of this study was to explore the perspectives of general practitioners (GPs) regarding their current and future role in survivorship care of patients with colon cancer, and to assess their perspectives on patients’ self-management capacities and the value of the eHealth application Oncokompas2.0 used by patients. Setting GPs from the central part of the Netherlands were interviewed at their location of preference. Participants 20 GPs participated (10 men, 10 women, age range 34–65 years, median age 49.5 years). The median years of experience as a GP was 14.5 years (range 3–34 years). Results GPs indicated attempting to keep in contact with patients after colon cancer treatment and mentioned being aware of symptoms of recurrent disease. Most participants would have liked to be more involved and expected to be able to provide survivorship care of colon cancer. Requirements mentioned were agreements with secondary care and a protocol. GPs considered Oncokompas2.0, which stimulates patients to structure their own survivorship care, as a useful additional tool for a specific group of patients (ie, young and highly-educated patients). Conclusions Based on the perspectives of the GPs, survivorship care of colon cancer in primary care is deemed feasible and the use of an eHealth application such as Oncokompas2.0 is expected to benefit specific groups of patients after colon cancer treatment. PMID:27126977

  12. [Ways of enhancing the effectiveness of bacterioscopic diagnosis of tuberculosis in general health care facilities in case of pilot areas of Russia].

    PubMed

    Golyshevskaia, V I; Sevast'ianova, E V; Martynova, L P; Shul'gina, M V

    2004-01-01

    The experience of researchers of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas of Russia has made it possible to perfect approaches to improving a bacteriological diagnosis of tuberculosis in general health care facilities. A decisive role in enhancing the effectiveness of detection of patients with tuberculosis by the Ziel-Nielsen test is played by the following factors: training of laboratory personnel; provision of laboratories with high-grade equipment and reagents; introduction of the methods and techniques unified and approved by the Ministry of Health of the Russian Federation; regular supervision of jurisdictional laboratories; outside control of the quality of studies. Proper organization of examination of patients, including an effectual selection of patients to be examined, the observance of the established frequency of their examination, and provision of the required quality of a taken sample greatly affect the efficiency of a microscopic diagnosis of bacillary patients. In addition, the centralization of performed microbiological tests for tuberculosis in the most trained, certified, and licensed large laboratories exercising a centralized control of the quality of microbiological studies is optimal. PMID:15478556

  13. Health effects from low-frequency noise and infrasound in the general population: Is it time to listen? A systematic review of observational studies.

    PubMed

    Baliatsas, Christos; van Kamp, Irene; van Poll, Ric; Yzermans, Joris

    2016-07-01

    A systematic review of observational studies was conducted to assess the association between everyday life low-frequency noise (LFN) components, including infrasound and health effects in the general population. Literature databases Pubmed, Embase and PsycInfo and additional bibliographic sources such as reference sections of key publications and journal databases were searched for peer-reviewed studies published from 2000 to 2015. Seven studies met the inclusion criteria. Most of them examined subjective annoyance as primary outcome. The adequacy of provided information in the included papers and methodological quality of studies was also addressed. Moreover, studies were screened for meta-analysis eligibility. Some associations were observed between exposure to LFN and annoyance, sleep-related problems, concentration difficulties and headache in the adult population living in the vicinity of a range of LFN sources. However, evidence, especially in relation to chronic medical conditions, was very limited. The estimated pooled prevalence of high subjective annoyance attributed to LFN was about 10%. Epidemiological research on LFN and health effects is scarce and suffers from methodological shortcomings. Low frequency noise in the everyday environment constitutes an issue that requires more research attention, particularly for people living in the vicinity of relevant sources. PMID:26994804

  14. Screening for Serious Mental Illness in the General Population with the K6 screening scale: Results from the WHO World Mental Health (WMH) Survey Initiative

    PubMed Central

    Kessler, Ronald C.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Bromet, Evelyn; Cuitan, Marius; Furukawa, Toshi A.; Gureje, Oye; Hinkov, Hristo; Hu, Chi-yi; Lara, Carmen; Lee, Sing; Mneimneh, Zeina; Myer, Landon; Oakley-Browne, Mark; Posada-Villa, Jose; Sagar, Rajesh; Viana, Maria Carmen; Zaslavsky, Alan M.

    2013-01-01

    Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a 6-item scale developed to provide a brief valid screen for DSM-IV SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined n = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve (AUC), was generally substantial (Median .83; Range .76-.89; Inter-quartile range .81-.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. PMID:20527002

  15. An examination of the advances in science and technology of prevention of tooth decay in young children since the Surgeon General's Report on Oral Health.

    PubMed

    Milgrom, Peter; Zero, Domenick T; Tanzer, Jason M

    2009-01-01

    This paper addresses a number of areas related to how effectively science and technology have met Healthy People 2010 goals for tooth decay prevention. In every area mentioned, it appears that science and technology are falling short of these goals. Earlier assessments identified water fluoridation as one of the greatest public health accomplishments of the last century. Yet, failure to complete needed clinical and translational research has shortchanged the caries prevention agenda at a critical juncture. Science has firmly established the transmissible nature of tooth decay. However, there is evidence that tooth decay in young children is increasing, although progress has been made in other age groups. Studies of risk assessment have not been translated into improved practice. Antiseptics, chlorhexidine varnish, and polyvinylpyrrolidone iodine (PVI-I) may have value, but definitive trials are needed. Fluorides remain the most effective agents, but are not widely disseminated to the most needy. Fluoride varnish provides a relatively effective topical preventive for very young children, yet definitive trials have not been conducted. Silver diamine fluoride also has potential but requires study in the United States. Data support effectiveness and safety of xylitol, but adoption is not widespread. Dental sealants remain a mainstay of public policy, yet after decades of research, widespread use has not occurred. We conclude that research has established the public health burden of tooth decay, but insufficient research addresses the problems identified in the report Oral Health in America: A Report of the Surgeon General. Transfer of technology from studies to implementation is needed to prevent tooth decay among children. This should involve translational research and implementation of scientific and technological advances into practice. PMID:19837019

  16. The Swedish SF-36 Health Survey--I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden.

    PubMed

    Sullivan, M; Karlsson, J; Ware, J E

    1995-11-01

    We document the applicability of the SF-36 Health Survey, which was translated into Swedish using methods later adopted by the International Quality of Life Assessment (IQOLA) Project procedures. To test its appropriateness for use in Sweden, it was administered through mail-out/mail-back questionnaires in seven general population studies with an average response rate of 68%. The 8930 respondents varied by gender (48.2% men), age (range 15-93 years, mean age 42.7), marital status, education, socio-economic status, and geographical area. Psychometric methods used in the evaluation of the SF-36 in the U.S. were replicated. Over 90% of respondents had complete items for each of the eight SF-36 scales, although more missing data were observed for subjects 75 years and over. Scale scores could be computed for the vast majority of respondents (95% and over); slightly fewer in the oldest subgroup. Item-internal consistency was consistently high across socio-demographic subgroups and the eight scales. Most reliability estimates exceeded the 0.80 level. The highest reliability was observed for the Bodily Pain Scale where all subgroups met the 0.90 level recommended for individual comparisons; coefficients at or above 0.90 were also observed in most subgroups for the Physical Functioning Scale. Tests of scaling assumptions including hypothesized item groupings, which reflect the construct validity of scales, were consistently favorable across subgroups, although lower rates were noted in the oldest age group. In conclusion, these studies have yielded empirical evidence supporting the feasibility of a non-English language reproduction of the SF-36 Health Survey. The Swedish SF-36 is ready for further evaluation. PMID:8560302

  17. A general and flexible methodology to define thresholds for heat health watch and warning systems, applied to the province of Québec (Canada).

    PubMed

    Chebana, Fateh; Martel, Barbara; Gosselin, Pierre; Giroux, Jean-Xavier; Ouarda, Taha B M J

    2013-07-01

    Several watch and warning systems have been established in the world in recent years to prevent the effects of heat waves. However, many of these approaches can be applied only in regions with perfect conditions (e.g., enough data, stationary series or homogeneous regions). Furthermore, a number of these approaches do not account for possible trend in mortality and/or temperature series, whereas others are generally not adapted to regions with low population densities or low daily mortality levels. In addition, prediction based on multiple days preceding the event can be less accurate if it attributes the same importance to each of these days, since the forecasting accuracy actually decreases with the period. The aim of the present study was to identify appropriate indicators as well as flexible and general thresholds that can be applied to a variety of regions and conditions. From a practical point of view, the province of Québec constitutes a typical case where a number of the above-mentioned constraints are present. On the other hand, until recently, the province's watch and warning system was based on a study conducted in 2005, covering only the city of Montreal and applied to the whole province. The proposed approach is applied to each one of the other health regions of the province often experiencing low daily counts of mortality and presenting trends. The first constraint led to grouping meteorologically homogeneous regions across the province in which the number of deaths is sufficient to carry out the appropriate data analyses. In each region, mortality trends are taken into account. In addition, the proposed indicators are defined by a 3-day weighted mean of maximal and minimal temperatures. The sensitivity of the results to the inclusion of traumatic deaths is also checked. The application shows that the proposed method improved the results in terms of sensitivity, specificity and number of yearly false alarms, compared to those of the existing and

  18. Gendered Disparities in Quality of Cataract Surgery in a Marginalised Population in Pakistan: The Karachi Marine Fishing Communities Eye and General Health Survey

    PubMed Central

    Ahmad, Khabir; Zwi, Anthony B.; Tarantola, Daniel J. M.; Soomro, Abdul Qadeem; Baig, Rashid; Azam, Syed Iqbal

    2015-01-01

    Background Marine fishing communities are among the most marginalised and hard-to-reach groups and have been largely neglected in health research. We examined the quality of cataract surgery and its determinants, with an emphasis on gender, in marine fishing communities in Karachi, Pakistan, using multiple indicators of performance. Methods and Findings The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional study conducted between March 2009 and April 2010 in fishing communities living on 7 islands and in coastal areas in Keamari, Karachi, located on the Arabian Sea. A population-based sample of 638 adults, aged ≥ 50 years, was studied. A total of 145 eyes (of 97 persons) had undergone cataract surgery in this sample. Cataract surgical outcomes assessed included vision (presenting and best-corrected with a reduced logMAR chart), satisfaction with surgery, astigmatism, and pupil shape. Overall, 65.5% of the operated eyes had some form of visual loss (presenting visual acuity [PVA] < 6/12). 55.2%, 29.0%, and 15.9% of these had good, borderline, and poor visual outcomes based on presenting vision; with best correction, these values were: 68.3 %, 18.6%, and 13.1%, respectively. Of 7 covariates evaluated in the multivariable generalized estimating equations (GEE) analyses, gender was the only significant independent predictor of visual outcome. Women’s eyes were nearly 4.38 times more likely to have suboptimal visual outcome (PVA<6/18) compared with men’s eyes (adjusted odds ratio 4.38, 95% CI 1.96-9.79; P<0.001) after adjusting for the effect of household financial status. A higher proportion of women’s than men’s eyes had an irregular pupil (26.5% vs. 14.8%) or severe/very severe astigmatism (27.5% vs. 18.2%). However, these differences did not reach statistical significance. Overall, more than one fourth (44/144) of cataract surgeries resulted in dissatisfaction. The only significant predictor of

  19. Initial Design of Culturally Informed Behavioral Intervention Technologies: Developing an mHealth Intervention for Young Sexual Minority Men With Generalized Anxiety Disorder and Major Depression

    PubMed Central

    Montague, Enid; Mohr, David C

    2013-01-01

    Background To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. Objective This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. Methods We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. Results General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users’ ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. Conclusions This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities. PMID:24311444

  20. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General...

  1. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General...

  2. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General...

  3. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General...

  4. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General...

  5. Iron deficiency is associated with increased levels of blood cadmium in the Korean general population: Analysis of 2008-2009 Korean National Health and Nutrition Examination Survey data

    SciTech Connect

    Lee, Byung-Kook; Kim, Yangho

    2012-01-15

    Introduction: We present data from the Korean National Health and Nutrition Examination Survey 2008-2009 on the distribution of blood cadmium levels and their association with iron deficiency in a representative sample of the adult Korean population. Methods: Serum ferritin was categorized into three levels: low (serum ferritin <15.0 {mu}g/L), low normal (15.0-30.0 {mu}g/L for women and 15.0-50.0 for men), and normal ({>=}30.0 {mu}g/L for women and {>=}50.0 for men), and its association with blood cadmium level was assessed after adjustment for various demographic and lifestyle factors. Results: Geometric means of blood cadmium in the low serum ferritin group in women, men, and all participants were significantly higher than in the normal group. Additionally, multiple regression analysis after adjusting for various covariates showed that blood cadmium was significantly higher in the low-ferritin group in women, men, and all participants compared with the normal group. We also found an association between serum ferritin and blood cadmium among never-smoking participants. Discussion: We found, similar to other recent population-based studies, an association between iron deficiency and increased blood cadmium in men and women, independent of smoking status. The results of the present study show that iron deficiency is associated with increased levels of blood cadmium in the general population.

  6. The relationship between dental occlusion/temporomandibular joint status and general body health: part 2. Fascial connection of TMJ with other parts of the body.

    PubMed

    Moon, Hyung-Joo; Lee, Yong-Keun

    2011-12-01

    In part 1 of this study, it was discussed that dental occlusion/temporomandibular joint (TMJ) status is functionally connected to general body health. The purpose of this part of the study was to attempt to formulate a conceptual account, the "fascial connection theory for TMJ and other parts of the body," to explain the functional connection between TMJ and other parts of the body. The first hypothesis that was studied is that TMJ and other parts of body are connected through the fascia as asserted by the myofascial-release schools, and the second one is that they are connected through the meridian system constituted of fascia (connective tissue). The fascial connection theory proposed here can explain the functional connection between dental occlusion/TMJ and other parts of the body based on either myofascial release or the qi and meridian system, or a combination of the two. Therefore, dental occlusion should be built up and maintained in a normal natural condition, and causes of deterioration of TMJ status should be treated in an effort to restore the natural condition. Other possible mechanisms that can account for these connections require elucidation, and additional experimental investigation should be undertaken. PMID:22082433

  7. Danger-early maladaptive schemas at work!: The role of early maladaptive schemas in career choice and the development of occupational stress in health workers.

    PubMed

    Bamber, Martin; McMahon, Rachel

    2008-01-01

    The schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006; Bamber, 2006) hypothesizes that individuals with EMS (unconsciously) gravitate toward occupations with similar dynamics and structures to the toxic early environments and relationships that created them. They subsequently re-enact these EMS and their associated maladaptive coping styles in the workplace. For most individuals, this results in 'schema healing', but for some individuals with more rigid and severe EMS, schema healing is not achieved and the structures and relationships of the workplace, together with the utilization of maladaptive coping styles, serve to perpetuate their EMS. The model hypothesizes that it is these individuals who are most vulnerable to developing occupational stress syndromesTo date, this model has been subjected to very little empirical investigation, so the main aim of this study was to address this gap in the literature by testing out some of its main assumptions and to provide empirical data, which would either support or reject the model using a population of health workers. Specifically, it was hypothesized that 'occupation-specific' EMS would be found in health workers from a range of different healthcare professions. It was also hypothesized that the presence of higher levels of EMS would be predictive of raised levels of occupational stress, psychiatric caseness and increased sickness absence in those individuals.A cross-sectional study design was employed and a total of 249 staff working within a NHS Trust, belonging to one of five occupational groups (medical doctors, nurses, clinical psychologists, IT staff and managers), participated in the study. All participants completed the Young Schema Questionnaire-Short Form (Young, 1998); the Maslach Burnout Inventory-Human Services Form (Maslach & Jackson, 1981), and the General Health Questionnaire-28-item version (Goldberg, 1978). A demographic questionnaire and sickness absence data

  8. Can the 12-item general health questionnaire be used to identify medical students who might ‘struggle’ on the medical course? A prospective study on two cohorts

    PubMed Central

    2013-01-01

    Background Students who fail to thrive on the Nottingham undergraduate medical course frequently suffer from anxiety, depression or other mental health problems. These difficulties may be the cause, or the result of, academic struggling. Early detection of vulnerable students might direct pastoral care and remedial support to where it is needed. We investigated the use of the short-form General Health Questionnaire (GHQ-12) as a possible screening tool. Methods Two consecutive cohorts (2006 and 2007) were invited to complete the GHQ-12. The questionnaire was administered online, during the second semester (after semester 1 exams) for the 2006 cohort and during the first semester for the 2007 cohort. All data were held securely and confidentially. At the end of the course, GHQ scores were examined in relation to course progress. Results 251 students entered the course in 2006 and 254 in 2007; 164 (65%) and 160 (63%), respectively, completed the GHQ-12. In both cohorts, the study and non-study groups were very similar in terms of pre-admission socio-demographic characteristics and overall course marks. In the 2006 study group, the GHQ Likert score obtained part-way through the first year was negatively correlated with exam marks during Years 1 and 2, but the average exam mark in semester 1 was the sole independent predictor of marks in semester 2 and Year 2. No correlations were found for the 2007 study group but the GHQ score was a weak positive predictor of marks in semester 2, with semester 1 average exam mark again being the strongest predictor. A post-hoc moderated-mediation analysis suggested that significant negative associations of GHQ scores with semester 1 and 2 exams applied only to those who completed the GHQ after their semester 1 exams. Students who were identified as GHQ ‘cases’ in the 2006 group were statistically less likely to complete the course on time (OR = 4.74, p 0.002). There was a non-significant trend in the same direction in the

  9. Covert checks by standardised patients of general practitioners' delivery of new periodic health examinations: clustered cross-sectional study from a consumer organisation

    PubMed Central

    Thaler, Kylie; Harris, Mark F

    2012-01-01

    Objective To assess if data collected by a consumer organisation are valid for a health service research study on physicians' performance in preventive care. To report first results of the analysis of physicians performance like consultation time and guideline adherence in history taking. Design Secondary data analysis of a clustered cross-sectional direct observation survey. Setting General practitioners (GPs) in Vienna, Austria, visited unannounced by mystery shoppers (incognito standardised patients (ISPs)). Participants 21 randomly selected GPs were visited by two different ISPs each. 40 observation protocols were realised. Main outcome measures Robustness of sampling and data collection by the consumer organisation. GPs consultation and waiting times, guideline adherence in history taking. Results The double stratified random sampling method was robust and representative for the private and contracted GPs mix of Vienna. The clinical scenarios presented by the ISPs were valid and believable, and no GP realised the ISPs were not genuine patients. The average consultation time was 46 min (95% CI 37 to 54 min). Waiting times differed more than consultation times between private and contracted GPs. No differences between private and contracted GPs in terms of adherence to the evidence-based guidelines regarding history taking including questions regarding alcohol use were found. According to the analysis, 20% of the GPs took a perfect history (95% CI 9% to 39%). Conclusions The analysis of secondary data collected by a consumer organisation was a valid method for drawing conclusions about GPs preventive practice. Initial results, like consultation times longer than anticipated, and the moderate quality of history taking encourage continuing the analysis on available clinical data. PMID:22872721

  10. The potential impact of the World Trade Organization's general agreement on trade in services on health system reform and regulation in the United States.

    PubMed

    Skala, Nicholas

    2009-01-01

    The collapse of the World Trade Organization's (WTO) Doha Round of talks without achieving new health services liberalization presents an important opportunity to evaluate the wisdom of granting further concessions to international investors in the health sector. The continuing deterioration of the U.S. health system and the primacy of reform as an issue in the 2008 presidential campaign make clear the need for a full range of policy options for addressing the national health crisis. Yet few commentators or policymakers realize that existing WTO health care commitments may already significantly constrain domestic policy options. This article illustrates these constraints through an evaluation of the potential effects of current WTO law and jurisprudence on the implementation of a single-payer national health insurance system in the United States, proposed incremental national and state health system reforms, the privatization of Medicare, and other prominent health system issues. The author concludes with some recommendations to the U.S. Trade Representative to suspend existing liberalization commitments in the health sector and to interpret current and future international trade treaties in a manner consistent with civilized notions of health care as a universal human right. PMID:19492630

  11. General Information about Melanoma

    MedlinePlus

    ... Screening Research Melanoma Treatment (PDQ®)–Patient Version General Information About Melanoma Go to Health Professional Version Key ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  12. ‘Can he have the test for bipolar, doctor? His dad's got it’: exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems – a clinical initiative

    PubMed Central

    2012-01-01

    Background General practitioners (GPs) play a key role in assessing and managing adult mental health problems, but this input is not seen in their management of child and adolescent mental health. Mental health problems in 5–19-year-olds are common, yet detection rates in primary care are low. The symptoms of most adult diagnoses of mental health problems are present by mid-adolescence, yet the typical time from onset to diagnosis is 5–15 years. The role of general practice in this area has been underexplored. Aim This pilot study explores the potential of GPs to respond to common mental health problems in children and adolescents. Design Children and young people who would have ordinarily been referred to Child and Adolescent Mental Health Services (CAMHS) were seen in a GP setting. In a UK general practice surgery serving a disadvantaged population. Method Children and young people were seen for an initial biopsychosocial assessment and formulation of the presenting concerns. GP-based interventions were offered as appropriate or referred to CAMHS. Results Data from the first 50 children (2–19 years) are presented. Twenty younger children (10 years and under) and 30 older children (11 years and above) were seen. Eighteen referrals were made to CAMHS. GP interventions included watchful waiting, brief behavioural interventions, non-directive counselling, brief cognitive– behavioural therapy (CBT) and liaison with colleagues in education, CAMHS and the voluntary sector. Conclusion This clinical pilot demonstrates that with adequate time, access to supervision and practice support, children and young people experiencing emotional and behavioural problems associated with common mental health issues can be helped in primary care. PMID:23730336

  13. 'Can he have the test for bipolar, doctor? His dad's got it': exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems - a clinical initiative.

    PubMed

    Roberts, Jane H; Bernard, Paul M

    2012-06-01

    Background General practitioners (GPs) play a key role in assessing and managing adult mental health problems, but this input is not seen in their management of child and adolescent mental health. Mental health problems in 5-19-year-olds are common, yet detection rates in primary care are low. The symptoms of most adult diagnoses of mental health problems are present by mid-adolescence, yet the typical time from onset to diagnosis is 5-15 years. The role of general practice in this area has been underexplored. Aim This pilot study explores the potential of GPs to respond to common mental health problems in children and adolescents. Design Children and young people who would have ordinarily been referred to Child and Adolescent Mental Health Services (CAMHS) were seen in a GP setting. In a UK general practice surgery serving a disadvantaged population. Method Children and young people were seen for an initial biopsychosocial assessment and formulation of the presenting concerns. GP-based interventions were offered as appropriate or referred to CAMHS. Results Data from the first 50 children (2-19 years) are presented. Twenty younger children (10 years and under) and 30 older children (11 years and above) were seen. Eighteen referrals were made to CAMHS. GP interventions included watchful waiting, brief behavioural interventions, non-directive counselling, brief cognitive- behavioural therapy (CBT) and liaison with colleagues in education, CAMHS and the voluntary sector. Conclusion This clinical pilot demonstrates that with adequate time, access to supervision and practice support, children and young people experiencing emotional and behavioural problems associated with common mental health issues can be helped in primary care. PMID:23730336

  14. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false General policy. 93.100 Section 93.100 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  15. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false General policy. 93.100 Section 93.100 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  16. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false General policy. 93.100 Section 93.100 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  17. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false General policy. 93.100 Section 93.100 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  18. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General policy. 93.100 Section 93.100 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  19. “Skill of Generalized Additive Model to Detect PM2.5 Health Signal in the Presence of Confounding Variables”

    EPA Science Inventory

    Summary. Measures of health outcomes are collinear with meteorology and air quality, making analysis of connections between human health and air quality difficult. The purpose of this analysis was to determine time scales and periods shared by the variables of interest (and...

  20. 42 CFR 21.33 - General service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General service. 21.33 Section 21.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.33 General service. Officers shall be appointed only to general service and shall be...

  1. 42 CFR 21.33 - General service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false General service. 21.33 Section 21.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.33 General service. Officers shall be appointed only to general service and shall be...

  2. General Dentist

    MedlinePlus

    ... to your desktop! more... What Is a General Dentist? Article Chapters What Is a General Dentist? General ... Reviewed: January 2012 ?xml:namespace> Related Articles: General Dentists FAGD and MAGD: What Do These Awards Mean? ...

  3. Effects of parental gender and level of education on the quality of life and general health of pediatric patients with epilepsy: An outpatient cross-sectional survey.

    PubMed

    Iqbal, Meisam; Amirsalari, Susan; Radfar, Shokofeh; Haidari, Mohsen Reza

    2016-07-01

    The quality of life (QOL) of children with epilepsy has been widely studied, and several problems related to cognition, behavior, social lives, and physical activity among these children have been reported. Family life and parental care are important aspects of the lives of these patients. The impact of parental education on the QOL of pediatric patients with epilepsy is an understudied topic, especially in developing countries. In this study, we investigated the QOL and general health (GH) of patients with epilepsy presenting at the pediatric neurology clinic at Baqiyatallah Hospital and a private clinic. The Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, which is a 92-item epilepsy-specific questionnaire covering physical activity, well-being, cognition, behavior, social activity, overall QOL, and GH, was used for interviewing parents. A total of 106 patients (m=61, 57.5% and f=45, 42.5%) aged 5-17years (mean: 10.31±2.91) participated in the study. Overall, there was no significant difference between the QOL and GH results of male and female patients. However, the maternal education level had a significant impact on the overall QOL (high school: 3.02±0.85 vs. B.Sc.: 3.67±0.61, p<0.05) and GH (high school: 2.81±0.79 vs. B.Sc.: 3.8±0.94, p<0.05) of male patients, while paternal education had no significant effect. A multiple linear regression showed that the maternal education level had an independently significant association with the physical activity of the patients (p=0.02, CI: 1.4-6.25), and the paternal education level had an independently significant association with the well-being of the patients (p=0.02, CI: 0.43-5.36). In addition, the maternal education level (high school vs. B.Sc.) had a significant effect on physical activity, well-being, cognition, and behavior for all of the patients (p<0.05), while the paternal education level (high school vs. B.Sc.) had no significant impact. However, in a comparison of high school vs. higher

  4. Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana

    PubMed Central

    Mensah, Ernest O.; Aikins, Moses K.; Gyapong, Margaret; Anto, Francis; Bockarie, Moses J.; Gyapong, John O.

    2016-01-01

    Background The global health system has a large arsenal of interventions, medical products and technologies to address current global health challenges. However, identifying the most effective and efficient strategies to deliver these resources to where they are most needed has been a challenge. Targeted and integrated interventions have been the main delivery strategies. However, the health system discourse increasingly favours integrated strategies in the context of functionally merging targeted interventions with multifunctional health care delivery systems with a focus on strengthening country health systems to deliver needed interventions. Neglected Tropical Diseases (NTD) have been identified to promote and perpetuate poverty hence there has been global effort to combat these diseases. The Neglected Tropical Diseases Programme (NTDP) in Ghana has a national programme team and office, however, it depends on the multifunctional health delivery system at the regional and district level to implement interventions. The NTDP seeks further health system integration to accelerate achievement of coverage targets. The study estimated the extent of integration of the NTDP at the national, regional and district levels to provide evidence to guide further integration. Methodology/Principal Findings The research design was a descriptive case study that interviewed key persons involved in the programme at the three levels of the health system as well as extensive document review. Integration was assessed on two planes—across health system functions–stewardship and governance, financing, planning, service delivery, monitoring and evaluation and demand generation; and across three administrative levels of the health system–national, regional and district. A composite measure of integration designated Cumulative Integration Index (CII) with a range of 0.00–1.00 was used to estimate extent of integration at the three levels of the health system. Service delivery was

  5. 42 CFR 1000.10 - General definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... benefits paid to him or her, or on his or her behalf, under Medicare or any State health care program. CFR... 42 Public Health 5 2012-10-01 2012-10-01 false General definitions. 1000.10 Section 1000.10 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  6. 42 CFR 1000.10 - General definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... benefits paid to him or her, or on his or her behalf, under Medicare or any State health care program. CFR... 42 Public Health 5 2011-10-01 2011-10-01 false General definitions. 1000.10 Section 1000.10 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  7. 42 CFR 1000.10 - General definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... benefits paid to him or her, or on his or her behalf, under Medicare or any State health care program. CFR... 42 Public Health 5 2014-10-01 2014-10-01 false General definitions. 1000.10 Section 1000.10 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  8. A case–control study of self-reported health, quality-of-life and general functioning among recent immigrants and age- and sex-matched Swedish-born controls

    PubMed Central

    Rosenblad, Andreas; Wiklund, Tony; Bennström, Halina; Leppert, Jerzy

    2014-01-01

    Aim: To examine whether new immigrants had inferior quality-of-life, well-being and general functioning compared with Swedish age- and sex-matched controls. Methods: A prospective case–control study was designed including immigrants from non-European countries, 18–65 years of age, with recent Permanent Permits to Stay (PPS) in Sweden, and age- and sex-matched Swedish-born (SB) persons from the general population in Västmanland County, Sweden. The General Health Questionnaire (GHQ-12), the brief version of the World Health Organization Quality-of-Life (WHOQOL-BREF) Scale and the General Activity Functioning Assessment Scale (GAF) from DSM-IV were posted (SB), or applied in personal interviews (PPS) with interpreters. Differences between the PPS and SB groups were measured using McNemar’s test and Wilcoxon signed-rank test conducted separately for observations at baseline, 6- and 12-month follow-up. Results: There were 93 pairs (mean age 36 years). Persons from Somalia (67%) and Iraq (27%) dominated the PPS group. The differences between the groups were statistically significant for all time points for the Psychological health and Social relationship domains of WHOQOL-BREF, and for the baseline and 6-month follow-up time points of GHQ-12 where the PPS-group had a higher degree of well-being, health and quality-of-life than the SB. This tendency applied for both sexes in the immigrant group. Conclusions: These new immigrants did not have inferior physical or psychological health, quality-of-life, well-being or social functioning compared with their age- and sex-matched Swedish born pairs during a 1-year follow-up. Thus, there is reason to advocate immigrants’ fast integration into society. PMID:25249583

  9. Roles and relationships between health professionals involved in insulin initiation for people with type 2 diabetes in the general practice setting: a qualitative study drawing on relational coordination theory

    PubMed Central

    2014-01-01

    Background The majority of care for people with type 2 diabetes occurs in general practice, however when insulin initiation is required it often does not occur in this setting or in a timely manner and this may have implications for the development of complications. Increased insulin initiation in general practice is an important goal given the increasing prevalence of type 2 diabetes and a relative shortage of specialists. Coordination between primary and secondary care, and between medical and nursing personnel, may be important in achieving this. Relational coordination theory identifies key concepts that underpin effective interprofessional work: communication which is problem solving, timely, accurate and frequent and relationships between professional roles which are characterized by shared goals, shared knowledge and mutual respect. This study explores roles and relationships between health professionals involved in insulin initiation in order to gain an understanding of factors which may impact on this task being carried out in the general practice setting. Method 21 general practitioners, practice nurses, diabetes nurse educators and physicians were purposively sampled to participate in a semi-structured interview. Transcripts of the interviews were analysed using framework analysis. Results There were four closely interlinked themes identified which impacted on how health professionals worked together to initiate people with type 2 diabetes on insulin: 1. Ambiguous roles; 2. Uncertain competency and capacity; 3. Varying relationships and communication; and 4. Developing trust and respect. Conclusions This study has shown that insulin initiation is generally recognised as acceptable in general practice. The role of the DNE and practice nurse in this space and improved communication and relationships between health professionals across organisations and levels of care are factors which need to be addressed to support this clinical work. Relational

  10. Evaluations of treatment efficacy of depression from perspective of both patients' symptoms and general sense of mental health and wellbeing: A large scale, multi-centered, longitudinal study in China.

    PubMed

    Zeng, Qingzhi; Wang, Wei Chun; Fang, Yiru; Mellor, David; Mccabe, Marita; Byrne, Linda; Zuo, Sai; Xu, Yifeng

    2016-07-30

    Relying on the absence, presence of level of symptomatology may not provide an adequate indication of the effects of treatment for depression, nor sufficient information for the development of treatment plans that meet patients' needs. Using a prospective, multi-centered, and observational design, the present study surveyed a large sample of outpatients with depression in China (n=9855). The 17-item Hamilton Rating Scale for Depression (HRSD-17) and the Remission Evaluation and Mood Inventory Tool (REMIT) were administered at baseline, two weeks later and 4 weeks, to assess patients' self-reported symptoms and general sense of mental health and wellbeing. Of 9855 outpatients, 91.3% were diagnosed as experiencing moderate to severe depression. The patients reported significant improvement over time on both depressive symptoms and general sense after 4-week treatment. The effect sizes of change in general sense were lower than those in symptoms at both two week and four week follow-up. Treatment effects on both general sense and depressive symptomatology were associated with demographic and clinical factors. The findings indicate that a focus on both general sense of mental health and wellbeing in addition to depressive symptomatology will provide clinicians, researchers and patients themselves with a broader perspective of the status of patients. PMID:27156024

  11. General Information about Cervical Cancer

    MedlinePlus

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Go to Health Professional Version ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  12. ‘In general, how do you feel today?’ – self-rated health in the context of aging in India

    PubMed Central

    Hirve, Siddhivinayak

    2014-01-01

    This thesis is centered on self-rated health (SRH) as an outcome measure, as a predictor, and as a marker. The thesis uses primary data from the WHO Study on global AGEing and adult health (SAGE) implemented in India in 2007. The structural equation modeling approach is employed to understand the pathways through which the social environment, disability, disease, and sociodemographic characteristics influence SRH among older adults aged 50 years and above. Cox proportional hazard model is used to explore the role of SRH as a predictor for mortality and the role of disability in modifying this effect. The hierarchical ordered probit modeling approach, which combines information from anchoring vignettes with SRH, was used to address the long overlooked methodological concern of interpersonal incomparability. Finally, multilevel model-based small area estimation techniques were used to demonstrate the use of large national surveys and census information to derive precise SRH prevalence estimates at the district and sub-district level. The thesis advocates the use of such a simple measure to identify vulnerable communities for targeted health interventions, to plan and prioritize resource allocation, and to evaluate health interventions in resource-scarce settings. The thesis provides the basis and impetus to generate and integrate similar and harmonized adult health and aging data platforms within demographic surveillance systems in different regions of India and elsewhere. PMID:24762983

  13. The mediating effect of affective stigma between face concern and general mental health - The case of Chinese caregivers of children with intellectual disability.

    PubMed

    Chiu, Marcus Yu Lung; Yang, Xue; Wong, Ho Ting; Li, Jin Hong

    2014-11-11

    An earlier study revealed that the mental health of caregivers of children with intellectual disability is related to the affective dimension of affiliated stigma, loss of face and anxiety level. However, how cultural values such as face concern interplay with stigma remains largely unknown. This extended study goes further to test the mediating role of affective stigma on two slightly different pathway models between the face concern and the mental health outcome of 211 caregivers in two Chinese cities, against the required standards and procedure of being a mediator. The mediating effect of affective stigma is confirmed by meeting Baron and Kenny's required standards. Two viable path models are worked out: one model with anxiety as a co-mediating variable successfully accounts for 17% more of the variance on the outcome than another model without anxiety, explaining a total of 56% of the variance. This provides empirical evidence for the first time that cultural values such as face value do not influence directly one's mental health; but works through the experience of real stigma or anticipated stigma situations, to induce anxiety and worsen mental health. Practitioners may need to employ anti-stigma and anxiety reduction strategy in promoting better mental health and to explore cultural elements that can be tapped on for better coping. PMID:25462504

  14. Health care programs: fraud and abuse; revised OIG civil money penalties resulting from public law 104-191. Office of Inspector General (OIG), HHS. Final rule.

    PubMed

    2000-04-26

    This final rule revises the OIG's civil money penalty (CMP) authorities, in conjunction with new and revised provisions set forth in the Health Insurance Portability and Accountability Act of 1996. Among other provisions, this final rulemaking codifies new CMPs for excluded individuals retaining ownership or control interest in an entity; upcoding and claims for medically unnecessary services; offering inducements to beneficiaries; and false certification of eligibility for home health services. This rule also codifies a number of technical corrections to the regulations governing OIG's sanction authorities. PMID:11010671

  15. Pesticide Applicator Training Manual, Category 8A: General Public Health Pest Control for New Jersey. A Training Program for the Certification of Commercial Pesticide Applicators, and Study Questions.

    ERIC Educational Resources Information Center

    Schulze, Terry L.; Kriner, Ray R.

    This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the public health pest control category. The text discusses invertebrate pests such as cockroaches, lice, fleas, and mites, vertebrate pests; and plant pests such as poison ivy and ragweed. A study guide…

  16. [Marked similarity between the Dutch Institute for Health Care Improvement guideline 'Aspecific low back pain complaints' and the Dutch College of General Practitioners guideline 'Low back pain'].

    PubMed

    Mazel, J A

    2004-02-14

    The Dutch Institute for Healthcare Improvement's (CBO) guideline on the diagnosis and treatment of aspecific, acute and chronic, low back complaints corresponds in general to the Dutch College of General Practitioners' guideline with regard to the following topics: time-contingent treatment, restricted use of X-ray examination, and the options for non-medical treatment. A noteworthy exception in the CBO-guideline is the suggestion of manipulation of the spine as a possible treatment although there is no mention of proof of effectiveness. PMID:15015244

  17. Forest health in the Blue Mountains: Science perspectives. A management strategy for fire-adapted ecosystems. Forest Service general technical report

    SciTech Connect

    Mutch, R.W.; Arno, S.F.; Brown, J.K.; Carlson, C.E.; Ottmar, R.D.

    1993-02-01

    The fire-adapted forests of the Blue Mountains are suffering from a forest health problem of catastrophic proportions. The composition of the forest at lower elevations has shifted from historically open-growth stands of primarily ponderosa pine and western larch to stands with dense understories of Douglas-fir and grand fir. Epidemic levels of insect infestations and large wildfires adversely affect visual quality, wildlife habitat, stream sedimentation, and timber values. A management strategy to restore forest health at lower elevations will require that the seral ponderosa pine and western larch stands be managed for much lower tree densities and a more open coniferous understory. A combination of silvicultural partial cutting and prescribed fire on a large scale will be needed to produce the desired future condition of healthy, open, and park-like forests.

  18. 42 CFR 435.401 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false General rules. 435.401 Section 435.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., AND AMERICAN SAMOA General Eligibility Requirements § 435.401 General rules. (a) A Medicaid agency...

  19. 42 CFR 435.401 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false General rules. 435.401 Section 435.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., AND AMERICAN SAMOA General Eligibility Requirements § 435.401 General rules. (a) A Medicaid agency...

  20. 42 CFR 405.405 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false General rules. 405.405 Section 405.405 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.405 General rules. (a)...

  1. 42 CFR 70.1 - General definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General definitions. 70.1 Section 70.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.1 General definitions. As used in this part, terms shall have the following meaning: CDC means the Centers for...

  2. Occurrences and sources of Differential Item Functioning (DIF) in patient-reported outcome measures: Description of DIF methods, and review of measures of depression, quality of life and general health

    PubMed Central

    Teresi, Jeanne A.; Ramirez, Mildred; Lai, Jin-Shei; Silver, Stephanie

    2009-01-01

    Examination of the equivalence of measures involves several levels, including conceptual equivalence of meaning, as well as quantitative tests of differential item functioning (DIF). The purpose of this review is to examine DIF in patient-reported outcomes. Reviewed were measures of self-reported depression, quality of life (QoL) and general health. Most measures of depression contained large amounts of DIF, and the impact of DIF at the scale level was typically sizeable. The studies of QoL and health measures identified a moderate amount of DIF; however, many of these studies examined only one type of DIF (uniform). Relative to DIF analyses of depression measures, less analysis of the impact of DIF on QoL and health measures was performed, and the authors of these analyses generally did not recommend remedial action, with one notable exception. While these studies represent good beginning efforts to examine measurement equivalence in patient-reported outcome measures, more cross-validation work is required using other (often larger) samples of different ethnic and language groups, as well as other methods that permit more extensive analyses of the type of DIF, together with magnitude and impact. PMID:20165561

  3. General inattentiveness is a long-term reliable trait independently predictive of psychological health: Danish validation studies of the Mindful Attention Awareness Scale.

    PubMed

    Jensen, Christian Gaden; Niclasen, Janni; Vangkilde, Signe Allerup; Petersen, Anders; Hasselbalch, Steen Gregers

    2016-05-01

    The Mindful Attention Awareness Scale (MAAS) measures perceived degree of inattentiveness in different contexts and is often used as a reversed indicator of mindfulness. MAAS is hypothesized to reflect a psychological trait or disposition when used outside attentional training contexts, but the long-term test-retest reliability of MAAS scores is virtually untested. It is unknown whether MAAS predicts psychological health after controlling for standardized socioeconomic status classifications. First, MAAS translated to Danish was validated psychometrically within a randomly invited healthy adult community sample (N = 490). Factor analysis confirmed that MAAS scores quantified a unifactorial construct of excellent composite reliability and consistent convergent validity. Structural equation modeling revealed that MAAS scores contributed independently to predicting psychological distress and mental health, after controlling for age, gender, income, socioeconomic occupational class, stressful life events, and social desirability (β = 0.32-.42, ps < .001). Second, MAAS scores showed satisfactory short-term test-retest reliability in 100 retested healthy university students. Finally, MAAS sample mean scores as well as individuals' scores demonstrated satisfactory test-retest reliability across a 6 months interval in the adult community (retested N = 407), intraclass correlations ≥ .74. MAAS scores displayed significantly stronger long-term test-retest reliability than scores measuring psychological distress (z = 2.78, p = .005). Test-retest reliability estimates did not differ within demographic and socioeconomic strata. Scores on the Danish MAAS were psychometrically validated in healthy adults. MAAS's inattentiveness scores reflected a unidimensional construct, long-term reliable disposition, and a factor of independent significance for predicting psychological health. (PsycINFO Database Record PMID:26751089

  4. Relationship between the elongated styloid process in panoramic radiographs and some of the general health conditions in patients over 40 years of age in the Iranian population

    PubMed Central

    Ghafari, Roshanak; Hosseini, Bahareh; Shirani, Amir Mansour; Manochehrifar, Hamed; Saghaie, Sima

    2012-01-01

    Background: The styloid process and the attached ligaments have the potential for calcification and ossification in specific conditions. The purpose of this study was to evaluate the relationship between the elongated styloid process (ESP) frequency and some of the systemic health factors of patients over 40 years of age. Materials and Methods: In this analytical-descriptive study, 296 panoramic radiographs of patients over 40 years of age (165 female and 131 male) referred to the Dental School of Khorasgan Azad University were selected. The length of the styloid process was measured by a special ruler and recorded in a questionnaire form. Other data such as sex, age, height, weight, blood pressure, heartbeat and the number of teeth present in the mouth were also recorded. The lengths equal to or more than 30 mm on the radiographs were considered as ESP. Data analysis were done by independent t-test, Pearson correlation coefficient and Chi-square test at a significance level of < 0.05. Results: ESP was observed in 135 cases (45.6%). There was a significant relationship between ESP and the body height, weight and the blood pressure, but there was no significant correlation between ESP, the heartbeat and the number of teeth present in the mouth. Conclusion: Because of the significant relationship between the length of the styloid process and the blood pressure, height and weight it is reasonable to evaluate a patient's systemic health conditions when radiographic signs of ESP are observed. PMID:23814562

  5. 21 CFR 1000.1 - General.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of...

  6. 21 CFR 1000.1 - General.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of...

  7. 21 CFR 1000.1 - General.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of the Code of Federal Regulations are to chapter...

  8. 21 CFR 1000.1 - General.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of...

  9. 21 CFR 1000.1 - General.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of...

  10. Benefit finding in response to general life stress: measurement and correlates

    PubMed Central

    Cassidy, Tony; McLaughlin, Marian; Giles, Melanie

    2014-01-01

    Benefit finding herein defined as “the process of deriving positive growth from adversity” has become a key construct in the evolution of positive psychology, and research suggests that it may provide the basis for a resource model of stress and coping. However, measures of benefit finding have tended to be domain specific. The current study focused on developing a more generic multidimensional measure of benefit finding. A measure of benefit finding was developed and tested in 855 students (574 females and 281 males) aged between 18 and 40 years. A 28-item scale with six dimensions was produced and Confirmatory Factor Analysis (CFA) confirmed the scale structure. The model proposed that psychological and social resources would mediate the relationship between experienced stressors and benefit finding. Structural equation modelling with Analysis of Moment Structures (AMOS) shows that the model is a good fit for the data and psychological and social resources partially mediated the relationship. It is argued that psychological and social resources enable benefit finding in relation to life stress and provide a focus for the development of preventive interventions to improve positive health. PMID:25750781

  11. A Field Test of Web-Based Screening for Dry Eye Disease to Enhance Awareness of Eye Problems Among General Internet Users: A Latent Strategy to Promote Health

    PubMed Central

    Uchino, Miki; Kawazoe, Takashi; Kamiyashiki, Masaaki; Sano, Kokoro; Tsubota, Kazuo

    2013-01-01

    Background A Web-based self-check system including a brief questionnaire would seem to be a suitable tool for rapid disease screening. Objective The purpose of this preliminary study was to test a Web-based self-screening questionnaire for drawing attention to dry eye disease among general Internet users and identifying those with a higher risk of developing the condition. Methods A survey website was launched and used to recruit participants from general Internet users. In the first phase, volunteers were asked to complete a Web-based self-screening questionnaire containing 12 questions on dry eye symptoms. The second phase focused on the respondents who reported five or more dry eye symptoms and expressed their intention to seek medical attention. These participants performed the Schirmer test, for evaluating tear production, and completed a paper-based lifestyle questionnaire to provide relevant background data. Results Of the 1689 visitors to the website, 980 (58.0%) volunteers completed the Web-based self-screening questionnaire. Among these, 355 (36.2%) respondents reported five or more dry eye symptoms. Then, 99 (27.9%) of the symptomatic participants performed the Schirmer test and completed the paper-based lifestyle questionnaire. Out of these, 32 (32.2%) had abnormal tear production (≤5 mm). Conclusions The proposed Web-based self-screening questionnaire seems to be a promising tool for raising awareness of dry eye disease among general Internet users and identifying those with a higher risk of developing the condition, although further research is needed to validate its effectiveness. PMID:24072379

  12. [Changes in the spectrum of the health services contract and effects on general practice, hospitals and clinics--from the viewpoint of the established surgeon].

    PubMed

    Bauch, J

    1996-01-01

    The provisions of medical care on an outpatient basis, as outlined in section 75 of the German SGB V, and on an inpatient basis, as defined in section 4 of the BPfIV 95, are differentiated quantitatively and qualitatively. Possible developments with regard to patient referral from the general practitioner to the specialist to the hospital, resulting from the introduction of the electronic chip card, are discussed. The potential consequences for the scope of patient care provided by hospitals are pointed out. PMID:9101967

  13. On the pervasiveness of event-specific alcohol use, general substance use, and mental health problems as risk factors for intimate partner violence.

    PubMed

    Reingle, Jennifer M; Jennings, Wesley G; Connell, Nadine M; Businelle, Michael S; Chartier, Karen

    2014-11-01

    The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants (N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health-related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed. PMID:24664253

  14. Factors associated with neonatal mortality in the general population: evidence from the 2007 Zambia Demographic and Health Survey (ZDHS); a cross sectional study

    PubMed Central

    Lukonga, Etambuyu; Michelo, Charles

    2015-01-01

    Introduction Neonatal mortality accounts for almost 40 percent of under-five child mortality globally and this could be associated with a complex chain of factors including but not limited to socio-economic, biological and healthcare-related factors. We examined factors that may be associated with neonatal mortality in Zambia. Methods Using across-sectional design, data were extracted from the 2007 Zambia Demographic and Health Survey for women using a “Women's Questionnaire” for respondents aged 15-49 years in the selected households. Records of women who reported having given birth to live infants within the five years preceding the survey defined the study population. However only records on those infants who could have lived through the first month (28 days) were assessed (de facto population). Results Overall (n=6 435), there were 3204(49.8%) males and 3231(50.2%)females. There were 219 (3.4%) neonatal deaths recorded. Low birth weight and overweight were reported as the prominent factors. The odds of dying were significantly higher for infants with low birth weight compared to infants born with normal weight, (aOR=2.58, 95%CI 1.02-6.49). The pattern was the same in both rural though insignificant. Over weight born babies showed increased odds of dying (aOR 3.21, 95%CI 1.36-7.59). Compared to infants born from Mothers with no education, infants born from mothers with higher education were associated with increased odds of dying (aOR 3.55, CI 95%, 1.26-9.94). Conclusion Neonatal survival is still a challenge in this population and determinants show varying socio-demographic contrasts. This may suggest limitations in past efforts to improve neonatal health. Future strategies need to continue but should account for varying setting specific epidemiological contrasts. PMID:26090022

  15. The role of common mental and physical disorders in days out of role in the Iraqi general population: Results from the WHO World Mental Health Surveys

    PubMed Central

    Al-Hamzawi, Ali Obaid; Rosellini, Anthony J.; Lindberg, Marrena; Petukhova, Maria; Kessler, Ronald C; Bruffaerts, Ronny

    2014-01-01

    In an effort to support mental health policy planning efforts in conjunction with the reconstruction of Iraq, a nationally representative face-to-face household survey was carried out that assessed the prevalence and correlates of common mental disorders in the Iraqi population. A total of 4,332 adult (ages 18+) respondents were interviewed (95.2% response rate). The current report presents data on the role impairments (number of days out-of-role in the past 30 days) associated with the nine mental disorders assessed in the survey in comparison to the impairments associated with ten chronic physical disorders also assessed in the survey. These disorders were all assessed with the WHO Composite International Diagnostic Interview. Days out-of-role was assessed with the WHO Disability Assessment Schedule. Both individual-level and societal-level effects of the disorders were estimated. Strongest individual-level predictors were bipolar and drug abuse disorders (176-95 days per year), with mental disorders making up five of the seven strongest predictors. The strongest population-level predictors were headache/migraine and arthritis (22-12% population proportions). Overall population proportions were 57% of days out-of-role due to the chronic physical disorders considered here and 18% for the mental disorders. Despite commonly-occurring mental disorders accounting for more individual-level days out-of-role than the physical disorders, mental disorders are much less likely to receive treatment in Iraq (e.g., due to stigma). These results highlight the need for culturally tailored mental health prevention and treatment programs in Iraq. PMID:24581572

  16. Government public housing health needs assessment: focus on race, ethnicity, and the older adult: background, methods, and demographics.

    PubMed

    Lascher, Steven; Tasir-Rodriguez, Wesley; Moon, Grace; Irizzary, Maria; Baney, Matthew; Kellogg, F Russell

    2013-01-01

    St. Vincent's Catholic Medical Centers of New York initiated a study in 2009 to assess the health needs of residents of New York City (NYC) municipal housing at the Robert Fulton public housing complex in Manhattan. The aim of this project was to provide valid data on perceived health services needs of the residents of a NYC housing project. These data may also be used to support hospital and community collaborative strategic decisions for developing resident-appropriate health and social services and would be valuable for use in formulating policies and programs by other interested nonprofit health and social services organizations and government. We designed a 28-item instrument and pilot tested it with our research team and members of the population under study. The English and Spanish surveys were designed as an in-person surveyor-administered instruments addressing four domains: demographics, access and barriers to health care services, risk behaviors, and perceived health needs. The sampling was an apartment-level stratified random sampling. A 20%, 188 apartment sample was drawn from the population of 944 housing units. Our response rate was 92% (173/188 apartments). Background methods, and demographic results are reported in this article. A second article will report on the needs assessment results. PMID:23930518

  17. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa.

    PubMed

    Kalichman, Seth C; Simbayi, Leickness C; Cain, Demetria; Jooste, Sean; Skinner, Donald; Cherry, Charsey

    2006-04-01

    We tested the Information-Motivation-Behavioural Skills (IMB) model of AIDS preventive behaviour in South Africa. Prospective path analyses were performed on measures collected from 131 men and 60 women with sexually transmitted infections (STI) in Cape Town. Results showed that IMB constructs collected at baseline predicted risk reduction behaviour 3 months later. Risk reduction intentions were positively associated with risk reduction self-efficacy and self-efficacy was in turn positively associated with protective behaviour 3 months later. In a second model, AIDS-related stigmas correlated inversely with AIDS knowledge and there was a trend toward AIDS stigmas correlating inversely with behavioural intentions. Accounting for AIDS-related stigmas did not improve model fit. These findings parallel similar tests of the IMB model in US samples and suggest that the IMB model may generalize to South Africa and may therefore be useful in guiding HIV risk reduction interventions. PMID:16546776

  18. Elevated C-Reactive Protein Is Associated with Cognitive Decline in Outpatients of a General Hospital: The Project in Sado for Total Health (PROST)

    PubMed Central

    Watanabe, Yumi; Kitamura, Kaori; Nakamura, Kazutoshi; Sanpei, Kazuhiro; Wakasugi, Minako; Yokoseki, Akio; Onodera, Osamu; Ikeuchi, Takeshi; Kuwano, Ryozo; Momotsu, Takeshi; Narita, Ichiei; Endo, Naoto

    2016-01-01

    Background/Aims We aimed to determine whether the concentration of serum C-reactive protein (CRP) is associated with cognitive function in an adult Japanese population. Methods Participants of this cross-sectional study were from a subgroup of the Project in Sado for Total Health (PROST; n = 454; mean age, 70.5 years). The cognitive state was evaluated using the Mini-Mental State Examination (MMSE), and those with an MMSE score <24 were considered ‘cognitively declined’. Concentrations of serum high-sensitivity CRP were measured. Multiple logistic regression analysis was used to calculate odds ratios (ORs) for cognitive decline, adjusting for the covariates of age, sex, BMI, disease history, and APOE allele. Results Of the 454 participants, 94 (20.7%) were cognitively declined. Relative to the lowest (first) quartile of CRP concentration, adjusted ORs were 1.29 (95% CI 0.61-2.75) for the second, 1.78 (95% CI 0.82-3.86) for the third, and 3.05 (95% CI 1.45-6.42) for the highest (fourth) quartiles (p for trend = 0.018). When data were stratified by sex, the association between CRP concentration and cognitive decline was observed only in women. Conclusion Our findings suggest an association between higher CRP concentration and lower cognitive function. Chronic inflammation may affect cognitive function in adults, in particular women. PMID:26933436

  19. The Association Between Blood Mercury Levels and Risk for Overweight in a General Adult Population: Results from the Korean National Health and Nutrition Examination Survey.

    PubMed

    Lee, Seunghyun; Yoon, Jin-Ha; Won, Jong-Uk; Lee, Wanhyung; Lee, June-Hee; Seok, Hongdeok; Kim, Yeong-Kwang; Kim, Chi-Nyon; Roh, Jaehoon

    2016-06-01

    The primary objective of this study was to estimate the association between blood mercury levels and overweight in Korean adults. We analyzed cross-sectional data from 9228 participants (4283 men and 4945 women) who completed the Korean National Health and Nutrition Examination Survey (KNHANES), 2007-2013. The population was divided into two groups according to the body mass index (BMI) and waist circumference (WC). Blood mercury levels were analyzed using a gold amalgam method with a DMA-80 instrument, categorized into quartiles, and stratified by sex. After adjusting for all covariates, blood mercury was significantly associated with overweight in all subjects. According to the BMI criteria, the adjusted odds ratio of being in the highest blood mercury quartile was 1.75 (95 % confidence interval [CI], 1.53-2.01) overall, 2.09 (95 % CI, 1.71-2.55) in men, and 1.58 (95 % CI, 1.32-1.89) in women. According to the WC criteria, the adjusted odds ratio of being in the highest blood mercury quartile was 1.85 (95 % CI, 1.49-2.30) in men and 1.96 (95 % CI, 1.62-2.36) in women compared to the lowest quartile. Additionally, a trend in overweight across increasing blood mercury levels was observed by the p for trend test in the multiple diagnostic criteria. PMID:26458904

  20. Validation of an instrument to evaluate health promotion at schools

    PubMed Central

    Pinto, Raquel Oliveira; Pattussi, Marcos Pascoal; Fontoura, Larissa do Prado; Poletto, Simone; Grapiglia, Valenca Lemes; Balbinot, Alexandre Didó; Teixeira, Vanessa Andina; Horta, Rogério Lessa

    2016-01-01

    ABSTRACT OBJECTIVE To validate an instrument designed to assess health promotion in the school environment. METHODS A questionnaire, based on guidelines from the World Health Organization and in line with the Brazilian school health context, was developed to validate the research instrument. There were 60 items in the instrument that included 40 questions for the school manager and 20 items with direct observations made by the interviewer. The items’ content validation was performed using the Delphi technique, with the instrument being applied in 53 schools from two medium-sized cities in the South region of Brazil. Reliability (Cronbach’s alpha and split-half) and validity (principal component analysis) analyses were performed. RESULTS The final instrument remained composed of 28 items, distributed into three dimensions: pedagogical, structural and relational. The resulting components showed good factorial loads (> 0.4) and acceptable reliability (> 0.6) for most items. The pedagogical dimension identifies educational activities regarding drugs and sexuality, violence and prejudice, auto care and peace and quality of life. The structural dimension is comprised of access, sanitary structure, and conservation and equipment. The relational dimension includes relationships within the school and with the community. CONCLUSIONS The proposed instrument presents satisfactory validity and reliability values, which include aspects relevant to promote health in schools. Its use allows the description of the health promotion conditions to which students from each educational institution are exposed. Because this instrument includes items directly observed by the investigator, it should only be used during periods when there are full and regular activities at the school in question. PMID:26982958

  1. 76 FR 30373 - National Institute of General Medical Sciences; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... HUMAN SERVICES National Institutes of Health National Institute of General Medical Sciences; Meeting... personal privacy. Name of Committee: National Institute of General Medical Sciences Initial Review Group... Review, National Institute of General Medical Sciences, National Institutes of Health, 45 Center...

  2. Consultations between Immigrant Patients, Their Interpreters, and Their General Practitioners: Are They Real Meetings or Just Encounters? A Qualitative Study in Primary Health Care

    PubMed Central

    Sundquist, Jan; Saleh-Stattin, Nouha

    2013-01-01

    Objective. In Sweden, about 19% of residents have a foreign background. Previous studies reported immigrant patients experience communication difficulties despite the presence of interpreters during consultations. The objective of this study was to gain insights into the participants' perceptions and reflections of the triangular meeting by means of in-depth interviews with immigrant patients, interpreters, and general practitioners (GPs). Method. A total of 29 participants—10 patients, 9 interpreters, and 10 GPs—participated in face-to-face interviews. Content analysis was used to process the interview material. Results. Six themes were generated and arranged under two subject areas: the interpretation process (the means of interpreting and means of informing) and the meeting itself (individual tailored approaches, consultation time, the patient's feelings, and the role of family members). Conclusion. This paper highlights feelings including frustration and insecurity when interpretation and relationships are suboptimal. Strategies for immigrant patients, interpreters, and GPs for getting a successful consultation may be needed. To transform the triangular meeting from an encounter to a real meeting, our results indicate a need for professional interpreters, for GPs to use a patient-tailored approach, and sufficient consultation time. Practice Implications. Use of professional interpreters is recommended, as is developing cultural competence. PMID:23476769

  3. Genome-Wide Study of Percent Emphysema on Computed Tomography in the General Population. The Multi-Ethnic Study of Atherosclerosis Lung/SNP Health Association Resource Study

    PubMed Central

    Manichaikul, Ani; Hoffman, Eric A.; Smolonska, Joanna; Gao, Wei; Cho, Michael H.; Baumhauer, Heather; Budoff, Matthew; Austin, John H. M.; Washko, George R.; Carr, J. Jeffrey; Kaufman, Joel D.; Pottinger, Tess; Powell, Charles A.; Wijmenga, Cisca; Zanen, Pieter; Groen, Harry J. M.; Postma, Dirkje S.; Wanner, Adam; Rouhani, Farshid N.; Brantly, Mark L.; Powell, Rhea; Smith, Benjamin M.; Rabinowitz, Dan; Raffel, Leslie J.; Hinckley Stukovsky, Karen D.; Crapo, James D.; Beaty, Terri H.; Hokanson, John E.; Silverman, Edwin K.; Dupuis, Josée; O’Connor, George T.; Boezen, H. Marike; Rich, Stephen S.

    2014-01-01

    Rationale: Pulmonary emphysema overlaps partially with spirometrically defined chronic obstructive pulmonary disease and is heritable, with moderately high familial clustering. Objectives: To complete a genome-wide association study (GWAS) for the percentage of emphysema-like lung on computed tomography in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung/SNP Health Association Resource (SHARe) Study, a large, population-based cohort in the United States. Methods: We determined percent emphysema and upper-lower lobe ratio in emphysema defined by lung regions less than −950 HU on cardiac scans. Genetic analyses were reported combined across four race/ethnic groups: non-Hispanic white (n = 2,587), African American (n = 2,510), Hispanic (n = 2,113), and Chinese (n = 704) and stratified by race and ethnicity. Measurements and Main Results: Among 7,914 participants, we identified regions at genome-wide significance for percent emphysema in or near SNRPF (rs7957346; P = 2.2 × 10−8) and PPT2 (rs10947233; P = 3.2 × 10−8), both of which replicated in an additional 6,023 individuals of European ancestry. Both single-nucleotide polymorphisms were previously implicated as genes influencing lung function, and analyses including lung function revealed independent associations for percent emphysema. Among Hispanics, we identified a genetic locus for upper-lower lobe ratio near the α-mannosidase–related gene MAN2B1 (rs10411619; P = 1.1 × 10−9; minor allele frequency [MAF], 4.4%). Among Chinese, we identified single-nucleotide polymorphisms associated with upper-lower lobe ratio near DHX15 (rs7698250; P = 1.8 × 10−10; MAF, 2.7%) and MGAT5B (rs7221059; P = 2.7 × 10−8; MAF, 2.6%), which acts on α-linked mannose. Among African Americans, a locus near a third α-mannosidase–related gene, MAN1C1 (rs12130495; P = 9.9 × 10−6; MAF, 13.3%) was associated with percent emphysema. Conclusions: Our results suggest that some genes previously identified as

  4. Perceived organizational support and job involvement in the Iranian health care system: A case study of emergency room nurses in general hospitals

    PubMed Central

    Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh

    2014-01-01

    Background and Objectives: Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. Materials and Methods: This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Results: Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). Discussion: The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always

  5. Adalimumab improves health-related quality of life in patients with moderate to severe plaque psoriasis compared with the United States general population norms: Results from a randomized, controlled Phase III study

    PubMed Central

    Revicki, Dennis A; Menter, Alan; Feldman, Steven; Kimel, Miriam; Harnam, Neesha; Willian, Mary K

    2008-01-01

    Objective To evaluate the impact of adalimumab on health-related quality of life (HRQOL) for patients with moderate to severe plaque psoriasis. Background Psoriasis is a chronic, inflammatory, immune-mediated disease that has a significant impact on patients' HRQOL. Adalimumab is a fully human monoclonal antibody that blocks tumor necrosis factor, a pro-inflammatory cytokine, and is effective and well-tolerated for patients with moderate to severe psoriasis. Methods Data were obtained for a secondary analysis of patients in a randomized, controlled Phase III trial evaluating the effect of adalimumab in patients with psoriasis (N = 1,205). Patients with moderate to severe psoriasis were randomized in a 2:1 ratio to adalimumab 80 mg (two 40 mg injections administered subcutaneously at baseline followed by one 40 mg injection every other week from Week 1 to Week 15) or placebo. Short Form-36 (SF-36) Health Survey scores of psoriasis patients were used to assess HRQOL and were compared with United States (US) population norms at baseline and Week 16. Results Baseline Physical Component Summary (PCS) scores for the placebo and adalimumab groups were similar to the general US population. Baseline mean Mental Component Summary (MCS) scores were significantly lower for the adalimumab and placebo groups compared with the general population (47.4, 47.7, and 50.8 points, respectively; p < 0.0001). PCS scores at Week 16 for patients receiving adalimumab had improved and were significantly greater than scores for the general US population (52.7 vs 48.9; p < 0.001). Compared with the general US population, MCS scores at Week 16 were similar for patients receiving adalimumab (51.2 vs 50.8; p = 1.000) and lower for patients receiving placebo (50.8 vs 48.7; p < 0.0001). Conclusion Psoriasis has a broad impact on patient functioning and well-being. Improvement in skin lesions and joint symptoms associated with adalimumab treatment was accompanied by improvements in HRQOL to levels

  6. 42 CFR 416.163 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false General rules. 416.163 Section 416.163 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... System for ASC Services Furnished on or After January 1, 2008 § 416.163 General rules. (a) Payment...

  7. 42 CFR 416.60 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false General rules. 416.60 Section 416.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE....60 General rules. (a) The services payable under this part are facility services furnished...

  8. 42 CFR 436.401 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false General rules. 436.401 Section 436.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Requirements § 436.401 General rules. (a) The agency may not impose any eligibility requirement that...

  9. 42 CFR 435.1102 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false General rules. 435.1102 Section 435.1102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....1102 General rules. (a) The agency may provide services to children under age 19 during one or...

  10. 42 CFR 436.1102 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false General rules. 436.1102 Section 436.1102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of Special Groups Presumptive Eligibility for Children § 436.1102 General rules. (a) The agency...

  11. 42 CFR 436.401 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false General rules. 436.401 Section 436.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Requirements § 436.401 General rules. (a) The agency may not impose any eligibility requirement that...

  12. 42 CFR 88.2 - General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND RELATED ACTIVITIES WORLD TRADE CENTER HEALTH PROGRAM § 88.2 General provisions. (a) Designated... 42 Public Health 1 2011-10-01 2011-10-01 false General provisions. 88.2 Section 88.2 Public Health... appointment must be in writing. (2) There may be only one representative at any time. After one...

  13. 42 CFR 424.11 - General procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false General procedures. 424.11 Section 424.11 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Certification and Plan Requirements § 424.11 General procedures. (a) Responsibility of the...

  14. 42 CFR 493.1804 - General considerations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false General considerations. 493.1804 Section 493.1804 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1804 General considerations. (a) Purpose. The...

  15. Surgeon General

    MedlinePlus

    ... the Conversation → Step it Up! Help Make Our Communities Walkable YouTube embedded video: https://www.youtube-nocookie. ... Surgeon General Vivek H. Murthy to make our communities more walkable. Watch the video . See All Videos → ...

  16. General anesthesia

    MedlinePlus

    General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel ... doctor called an anesthesiologist will give you the anesthesia. Sometimes, a certified and registered nurse anesthetist will ...

  17. Consumer Health: Products and Services.

    ERIC Educational Resources Information Center

    Haag, Jessie Helen

    This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…

  18. Caregiver Health and Wellness

    MedlinePlus

    ... content was developed with general underwriting support from Nature Made®. ... Caregiver stress fact sheet by U.S. Department of Health and Human Services, Office on Women’s Health ( April 10, 2012, ...

  19. General Information about Pancreatic Cancer

    MedlinePlus

    ... Research Pancreatic Cancer Treatment (PDQ®)–Patient Version General Information About Pancreatic Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  20. General Information about Vaginal Cancer

    MedlinePlus

    ... Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...