Science.gov

Sample records for adult health evidence

  1. Health Consequences of Uninsurance among Adults in the United States: Recent Evidence and Implications

    PubMed Central

    McWilliams, J Michael

    2009-01-01

    Context: Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform. However, evidence of the adverse health effects of uninsurance has been largely based on observational studies with designs that do not support causal conclusions. Although recent research using more rigorous methods may offer a better understanding of this important subject, it has not been comprehensively reviewed. Methods: The clinical and economic literature since 2002 was systematically searched. New research contributions were reviewed and evaluated based on their methodological strength. Because the effectiveness of medical care varies considerably by clinical risk and across conditions, the consistency of study findings with clinical expectations was considered in their interpretation. Updated conclusions were formulated from the current body of research. Findings: The quality of research has improved significantly, as investigators have employed quasi-experimental designs with increasing frequency to address limitations of earlier research. Recent studies have found consistently positive and often significant effects of health insurance coverage on health across a range of outcomes. In particular, significant benefits of coverage have now been robustly demonstrated for adults with acute or chronic conditions for which there are effective treatments. Conclusions: Based on the evidence to date, the health consequences of uninsurance are real, vary in magnitude in a clinically consistent manner, strengthen the argument for universal coverage in the United States, and underscore the importance of evidence-based determinations in providing health care to a diverse population of adults. PMID:19523125

  2. Gardening Activities and Physical Health Among Older Adults: A Review of the Evidence.

    PubMed

    Nicklett, Emily J; Anderson, Lynda A; Yen, Irene H

    2016-06-01

    Few studies have examined the health-related consequences of gardening among older adults. This scoping review summarizes and characterizes current research that examines the relationship between physical health and participation in planned gardening activities, including establishing, maintaining, or caring for plants. Six databases were searched. Eligible studies were published between 2000 and 2013, were published in English, and assessed different aspects of physical health (e.g., functional ability, energy expenditure, injury) for older adults who had participated in a planned gardening activity. Of the eight eligible studies identified with these criteria, four assessed energy expenditures and four assessed physical functioning. Studies assessing energy expenditures documented that the majority of gardening tasks were classified into low-to-moderate intensity physical activity. The current literature does not provide sufficient evidence of the physical functioning consequences of gardening. Future studies should consider how specific gardening interventions help older adults meet physical activity guidelines.

  3. Health literacy for older adults: using evidence to build a model educational program.

    PubMed

    Aspinall, Erinn E; Beschnett, Anne; Ellwood, Alisha F

    2012-01-01

    HeLP MN Seniors was a pilot program aimed at developing an evidence-based educational program to improve health literacy/health information literacy skills in older adults. A two-part workshop series was created and a pilot test was conducted with residents of a senior living community. After attending the pilot workshops, older adults reported that they used several workshop tools and tips, were more empowered to ask questions, and were more successful in finding online health information. Based upon evidence gathered through formal program evaluation, the pilot curriculum was further customized and developed into a model educational program that has been made available for use by others. PMID:22853303

  4. Evidence of impact: health, psychological and social effects of adult HIV on children.

    PubMed

    Sherr, L; Cluver, L D; Betancourt, T S; Kellerman, S E; Richter, L M; Desmond, C

    2014-07-01

    There is a growing evidence base on the immediate and short-term effects of adult HIV on children. We provide an overview of this literature, highlighting the multiple risks and resultant negative consequences stemming from adult HIV infection on the children they care for on an individual and family basis. We trace these consequences from their origin in the health and wellbeing of adults on whom children depend, through multiple pathways to negative impacts for children. As effective treatment reduces vertical transmission, the needs of affected children will predominate. Pathways include exposure to HIV in utero, poor caregiver mental or physical health, the impact of illness, stigma and increased poverty. We summarize the evidence of negative consequences, including those affecting health, cognitive development, education, child mental health, exposure to abuse and adolescent risk behaviour, including sexual risk behaviour, which has obvious implications for HIV-prevention efforts. We also highlight the evidence of positive outcomes, despite adversity, considering the importance of recognizing and supporting the development of resilience. This study is the first in a series of three commissioned by President's Emergency Plan for AIDS Relief (PEPFAR)/United States Agency for International Development (USAID), the summary provided here was used to inform a second study which seeks to identify insights from the broader child development field which will help us predict what long-term negative consequences children affected by HIV and AIDS are likely to experience. The third study discusses the design of a model to estimate these consequences. Although comprehensive, the review is often hampered by poor-quality research, inadequate design, small sample sizes and single studies in some areas.

  5. Evidence of impact: health, psychological and social effects of adult HIV on children.

    PubMed

    Sherr, L; Cluver, L D; Betancourt, T S; Kellerman, S E; Richter, L M; Desmond, C

    2014-07-01

    There is a growing evidence base on the immediate and short-term effects of adult HIV on children. We provide an overview of this literature, highlighting the multiple risks and resultant negative consequences stemming from adult HIV infection on the children they care for on an individual and family basis. We trace these consequences from their origin in the health and wellbeing of adults on whom children depend, through multiple pathways to negative impacts for children. As effective treatment reduces vertical transmission, the needs of affected children will predominate. Pathways include exposure to HIV in utero, poor caregiver mental or physical health, the impact of illness, stigma and increased poverty. We summarize the evidence of negative consequences, including those affecting health, cognitive development, education, child mental health, exposure to abuse and adolescent risk behaviour, including sexual risk behaviour, which has obvious implications for HIV-prevention efforts. We also highlight the evidence of positive outcomes, despite adversity, considering the importance of recognizing and supporting the development of resilience. This study is the first in a series of three commissioned by President's Emergency Plan for AIDS Relief (PEPFAR)/United States Agency for International Development (USAID), the summary provided here was used to inform a second study which seeks to identify insights from the broader child development field which will help us predict what long-term negative consequences children affected by HIV and AIDS are likely to experience. The third study discusses the design of a model to estimate these consequences. Although comprehensive, the review is often hampered by poor-quality research, inadequate design, small sample sizes and single studies in some areas. PMID:24991898

  6. Cross-sectional schooling-health associations misrepresented causal schooling effects on adult health and health-related behaviors: evidence from the Chinese Adults Twins Survey.

    PubMed

    Behrman, Jere R; Xiong, Yanyan; Zhang, Junsen

    2015-02-01

    Adult health outcomes and health behaviors are often associated with schooling. However, such associations do not necessarily imply that schooling has causal effects on health with the signs or magnitudes found in the cross-sectional associations. Schooling may be proxying for unobserved factors related to genetics and family background that directly affect both health and schooling. Recently several studies have used within-monozygotic (MZ) twins methods to control for unobserved factors shared by identical twins. Within-MZ estimates for developed countries are generally smaller than suggested by cross-sectional associations, consistent with positive correlations between unobserved factors that determine schooling and those that determine health. This study contributes new estimates of cross-sectional associations and within-MZ causal effects using the Chinese Adults Twins Survey, the first study of its type for developing countries. The cross-sectional estimates suggest that schooling is significantly associated with adult health-related behaviors (smoking, drinking, exercising) but not with own or spouse health outcomes (general health, mental health, overweight, chronic diseases). However, within-MZ-twins estimators change the estimates for approximately half of these health indicators, in one case declining in absolute magnitudes and becoming insignificant and in the other cases increasing in absolute magnitudes. Within-MZ estimates indicate significant pro-health effects for at least one of the indicators for own health (better mental health), own health-related behaviors (less smoking) and spouse health (less overweight). PMID:25464872

  7. Cross-sectional schooling-health associations misrepresented causal schooling effects on adult health and health-related behaviors: Evidence from the Chinese Adults Twins Survey

    PubMed Central

    Behrman, Jere R.; Xiong, Yanyan; Zhang, Junsen

    2015-01-01

    Adult health outcomes and health behaviors are often associated with schooling. However, such associations do not necessarily imply that schooling has causal effects on health with the signs or magnitudes found in the cross-sectional associations. Schooling may be proxying for unobserved factors related to genetics and family background that directly affect both health and schooling. Recently several studies have used within-monozygotic (MZ) twins methods to control for unobserved factors shared by identical twins. Within-MZ estimates for developed countries are generally smaller than suggested by cross-sectional associations, consistent with positive correlations between unobserved factors that determine schooling and those that determine health. This study contributes new estimates of cross-sectional associations and within-MZ causal effects using the Chinese Adults Twins Survey, the first study of its type for developing countries. The cross-sectional estimates suggest that schooling is significantly associated with adult health-related behaviors (smoking, drinking, exercising) but not with own or spouse health outcomes (general health, mental health, overweight, chronic diseases). However, within-MZ-twins estimators change the estimates for approximately half of these health indicators, in one case declining in absolute magnitudes and becoming insignificant and in the other cases increasing in absolute magnitudes. Within-MZ estimates indicate significant pro-health effects for at least one of the indicators for own health (better mental health), own health-related behaviors (less smoking) and spouse health (less overweight). PMID:25464872

  8. Evidence-based health practice: knowing and using what works for older adults.

    PubMed

    Altpeter, Mary; Bryant, Lucinda; Schneider, Ellen; Whitelaw, Nancy

    2006-01-01

    Community-based health care agencies are facing demands for improved outcomes, cost-effective programming, and higher customer satisfaction. Implementing evidence-based health interventions and programs can help to address these challenges. This article provides an overview of evidence-based health practice, including the definition and advantages of this approach, other key terms and concepts inherent to evidence-based practice, and the tasks and steps necessary to its implementation. The article concludes with a list of resources to help health care providers learn about, plan, and implement evidence-based health interventions and programs.

  9. Are literacy skills associated with young adults' health in Africa? Evidence from Malawi.

    PubMed

    Smith-Greenaway, Emily

    2015-02-01

    This study investigates whether literacy skills are a distinct dimension of education that influences young adults' health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults' health - net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy's prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy's prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited.

  10. A systematic review of sexual health interventions for adults: narrative evidence.

    PubMed

    Hogben, Matthew; Ford, Jessie; Becasen, Jeffrey S; Brown, Kathryn F

    2015-01-01

    Recent work has explored the intersection between sexual health (as construed by the World Health Organization and others) and public health domains of action in the United States of America. This article reports the narrative results of a systematic review of sexual health intervention effects on public health-relevant outcomes. To qualify, interventions had to be based on the principles (1) that sexual health is intrinsic to individuals and their overall health and (2) that relationships reflecting sexual health must be positive for all parties concerned. Outcomes were classed in domains: knowledge, attitudes, communication, health care use, sexual behavior, and adverse events. We summarized data from 58 studies (English language, adult populations, 1996-2011) by population (adults, parents, sexual minorities, vulnerable populations) across domains. Interventions were predominantly individual and small-group designs that addressed sexual behaviors (72%) and attitudes/norms (55%). They yielded positive effects in that 98% reported a positive finding in at least one domain; 50% also reported null effects. The most consistently positive effects on behaviors and adverse events were found for sexual minorities, vulnerable populations, and parental communication. Whether via direct action or through partnerships, incorporating principles from existing sexual health definitions in public health efforts may help improve sexual health. PMID:25406027

  11. A Systematic Review of Sexual Health Interventions for Adults: Narrative Evidence

    PubMed Central

    Hogben, Matthew; Ford, Jessie; Becasen, Jeffrey S; Brown, Kathryn F

    2015-01-01

    Recent work has explored the intersection between sexual health (as construed by the World Health Organization and others) and public health domains of action in the United States of America. This paper reports the narrative results of a systematic review of sexual health intervention effects on public health-relevant outcomes. To qualify, interventions had to be based on the principles: (1) that sexual health is intrinsic to individuals and their overall health and (2) that relationships reflecting sexual health must be positive for all parties concerned. Outcomes were classed in domains: knowledge, attitudes, communication, healthcare use, sexual behavior and adverse events. We summarized data from 58 studies (English language, adult populations, 1996–2011) by population (adults, parents, sexual minorities, vulnerable populations) across domains. Interventions were predominantly individual and small-group designs that addressed sexual behaviors (72%) and attitudes/norms (55%). They yielded positive effects in that 98% reported a positive finding in at least one domain: 50% also reported null effects. The most consistently positive effects on behaviors and adverse events were found for sexual minorities, vulnerable populations, and parental communication. Whether via direct action or through partnerships, incorporating principles from existing sexual health definitions in public health efforts may help improve sexual health. PMID:25406027

  12. Cigarette Taxes and Older Adult Smoking: Evidence from the Health and Retirement Study.

    PubMed

    MacLean, Johanna Catherine; Kessler, Asia Sikora; Kenkel, Donald S

    2016-04-01

    In this study, we use the Health and Retirement Study to test whether older adult smokers, defined as those 50 years and older, respond to cigarette tax increases. Our preferred specifications show that older adult smokers respond modestly to tax increases: a $1.00 (131.6%) tax increase leads to a 3.8-5.2% reduction in cigarettes smoked per day (implied tax elasticity = -0.03 to -0.04). We identify heterogeneity in tax elasticity across demographic groups as defined by sex, race/ethnicity, education, and marital status and by smoking intensity and level of addictive stock. These findings have implications for public health policy implementation in an aging population.

  13. The Effect of Private Insurance on the Health of Older, Working Age Adults: Evidence from the Health and Retirement Study

    PubMed Central

    Dor, Avi; Sudano, Joseph; Baker, David W

    2006-01-01

    Objective Primarily, to determine if the presence of private insurance leads to improved health status, as measured by a survey-based health score. Secondarily, to explore sensitivity of estimates to adjustments for endogeneity. The study focuses on adults in late middle age who are nearing entry into Medicare. Data Sources The analysis file is drawn from the Health and Retirement Study, a national survey of relatively older adults in the labor force. The dependent variable, an index of 5 health outcome items, was obtained from the 1996 survey. Independent variables were obtained from the 1992 survey. State-level instrumental variables were obtained from the Area Resources File and the TAXSIM file. The final sample consists of 9,034 individuals of which 1,540 were uninsured. Study Design Estimation addresses endogeneity of the insurance participation decision in health score regressions. In addition to ordinary least squares (OLS), two models are tested: an instrumental variables (IV) model, and a model with endogenous treatment effects due to Heckman (1978). Insurance participation and health behaviors enter with a lag to allow their effects to dissipate over time. Separate regressions were run for groupings of chronic conditions. Principal Findings The OLS model results in statistically significant albeit small effects of insurance on the computed health score, but the results may be downward biased. Adjusting for endogeneity using state-level instrumental variables yields up to a six-fold increase in the insurance effect. Results are consistent across IV and treatment effects models, and for major groupings of medical conditions. The insurance effect appears to be in the range of about 2–11 percent. There appear to be no significant differences in the insurance effect for subgroups with and without major chronic conditions. Conclusions Extending insurance coverage to working age adults may result in improved health. By conjecture, policies aimed at expanding

  14. Adult Mortality and Natural Resource Use in Rural South Africa: Evidence From the Agincourt Health and Demographic Surveillance Site

    PubMed Central

    HUNTER, LORI M.; TWINE, WAYNE; JOHNSON, AARON

    2009-01-01

    There is little empirical evidence on the association between household experience with HIV/AIDS and shifts in the use of natural resources in developing countries, where residents of rural regions remain highly dependent on often-declining local supplies of natural resources. This study examines household strategies with regard to fuelwood and water among impoverished rural South African households having experienced a recent adult mortality and those without such mortality experience. Quantitative survey data reveal higher levels of natural resource dependence among mortality-affected households, as well as differences in collection strategies. Qualitative interview data provide insight into subtle and complex adjustments at the household level, revealing that impacts vary by the role of the deceased within the household economy. Resource management and public health implications are explored. PMID:21866207

  15. The Health Benefits of Network Growth: New Evidence from a National Survey of Older Adults*

    PubMed Central

    Cornwell, Benjamin; Laumann, Edward O.

    2013-01-01

    Scholars who study how social networks affect older adults’ health are often concerned with the prospect of declining social connectedness in late life. This paper shifts the focus to older adults’ tendencies to cultivate new social ties. This process of network growth can improve access to social resources, boost self-esteem, reduce loneliness, and increase physical activity. We therefore examine the link between tie cultivation and health using new longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), which recorded changes in older adults’ confidant network rosters over a period of about five years. Most respondents (81.8%) added at least one new network member during the study period, and most (59.4%) cultivated multiple new confidant relationships. Longitudinal analyses suggest that the addition of new confidants is associated with improvements in functional, self-rated, and psychological health, net of baseline connectedness as well as any network losses that occurred during the same period. Network losses were associated with physical but not psychological well-being. These findings underscore the importance of distinguishing between concurrent processes that underlie social network change in later life, and highlight the need for additional research on the mechanisms by which network change may improve health. PMID:24128674

  16. An Implementation Study of Two Evidence-Based Exercise and Health Education Programmes for Older Adults with Osteoarthritis of the Knee and Hip

    ERIC Educational Resources Information Center

    de Jong, O. R. W.; Hopman-Rock, M.; Tak, E. C. M. P.; Klazinga, N. S.

    2004-01-01

    Implementation studies are recommended to assess the feasibility and effectiveness in real-life of programmes which have been tested in randomized controlled trials (RCTs). We report on an implementation study of two evidence-based exercise and health education programmes for older adults with osteoarthritis (OA) of the knee or hip. Three types of…

  17. Health Human Capital in Sub-Saharan Africa: Conflicting Evidence from Infant Mortality Rates and Adult Heights

    PubMed Central

    Akachi, Yoko; Canning, David

    2011-01-01

    We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. PMID:20634153

  18. Depression, anxiety and telomere length in young adults: evidence from the National Health and Nutrition Examination Survey.

    PubMed

    Needham, B L; Mezuk, B; Bareis, N; Lin, J; Blackburn, E H; Epel, E S

    2015-04-01

    Telomere length has been hypothesized to be a marker of cumulative exposure to stress, and stress is an established cause of depression and anxiety disorders. The aim of this study was to examine the relationship between depression, anxiety and telomere length, and to assess whether this relationship is moderated by race/ethnicity, gender and/or antidepressant use. Data were from the 1999-2002 National Health and Nutrition Examination Survey. Telomere length was assessed using the quantitative PCR method of telomere length relative to standard reference DNA. Past-year major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD), as well as depressed affect and anxious affect, were assessed using the Composite International Diagnostic Inventory (N=1290). Multiple linear regression was used to assess the relationship between depression and anxiety disorders and telomere length. Among women, those with GAD or PD had shorter telomeres than those with no anxious affect (β: -0.07, P<0.01), but there was no relationship among men (β: 0.08, P>0.05). Among respondents currently taking an antidepressant, those with MD had shorter telomeres than those without (β: -0.26, P<0.05), but there was no association between MD and telomere length among those not using antidepressants (β: -0.00, P>0.05). Neither depressive nor anxiety disorders were directly associated with telomere length in young adults. There was suggestive evidence that pharmacologically treated MD is associated with shorter telomere length, likely reflecting the more severe nature of MD that has come to clinical attention.

  19. Examining Associations between Self-Rated Health and Proficiency in Literacy and Numeracy among Immigrants and U.S.-Born Adults: Evidence from the Program for the International Assessment of Adult Competencies (PIAAC).

    PubMed

    Prins, Esther; Monnat, Shannon

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between self-reported health (SRH) and literacy and numeracy proficiency for immigrants compared to U.S.-born respondents and for Hispanic versus Asian immigrants. The research questions were: (1) Are literacy and numeracy scores associated with adults' SRH? (2) Are associations between SRH and literacy and numeracy proficiency moderated by immigrant status? (3) Among immigrants, are literacy and numeracy scores more strongly associated with SRH for Hispanics versus Asians? Immigrants had significantly lower literacy and numeracy scores, yet reported better health than U.S.-born respondents. Ordinal logistic regression analyses showed that literacy and numeracy were both positively related to SRH for immigrants and U.S.-born adults, and should therefore be viewed as part of the growing evidence that literacy is an independent and significant social determinant of health. Second, U.S.-born and immigrant adults accrued similarly positive health benefits from stronger literacy and numeracy skills. Third, although Hispanic immigrants were more disadvantaged than Asian immigrants on almost all socioeconomic characteristics and had significantly lower literacy and numeracy scores and worse SRH than Asian immigrants, both Hispanic and Asian immigrants experienced similar positive health returns from literacy and numeracy proficiency. These findings underscore the potential health benefits of providing adult basic education instruction, particularly for immigrants with the least formal schooling and fewest socioeconomic resources.

  20. Examining Associations between Self-Rated Health and Proficiency in Literacy and Numeracy among Immigrants and U.S.-Born Adults: Evidence from the Program for the International Assessment of Adult Competencies (PIAAC)

    PubMed Central

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between self-reported health (SRH) and literacy and numeracy proficiency for immigrants compared to U.S.-born respondents and for Hispanic versus Asian immigrants. The research questions were: (1) Are literacy and numeracy scores associated with adults’ SRH? (2) Are associations between SRH and literacy and numeracy proficiency moderated by immigrant status? (3) Among immigrants, are literacy and numeracy scores more strongly associated with SRH for Hispanics versus Asians? Immigrants had significantly lower literacy and numeracy scores, yet reported better health than U.S.-born respondents. Ordinal logistic regression analyses showed that literacy and numeracy were both positively related to SRH for immigrants and U.S.-born adults, and should therefore be viewed as part of the growing evidence that literacy is an independent and significant social determinant of health. Second, U.S.-born and immigrant adults accrued similarly positive health benefits from stronger literacy and numeracy skills. Third, although Hispanic immigrants were more disadvantaged than Asian immigrants on almost all socioeconomic characteristics and had significantly lower literacy and numeracy scores and worse SRH than Asian immigrants, both Hispanic and Asian immigrants experienced similar positive health returns from literacy and numeracy proficiency. These findings underscore the potential health benefits of providing adult basic education instruction, particularly for immigrants with the least formal schooling and fewest socioeconomic resources. PMID:26132212

  1. Evidence in mental health.

    PubMed

    Weeks, Susan Mace

    2014-12-01

    Health practitioners wishing to positively improve health outcomes for their clients have access to a unique set of collated tools to guide their practice. Systematic reviews provide guidance in the form of synthesized evidence that can form the basis of decision making as they provide care for their clients. This article describes systematic reviews as a basis for informed decision making by mental health practitioners. The process of systematic review is discussed, examples of existing systematic review topics relevant to mental health are presented, a sample systematic review is described, and gaps and emerging topics for mental health systematic reviews are addressed.

  2. How does social capital matter to the health status of older adults? Evidence from the China Health and Retirement Longitudinal Survey.

    PubMed

    Liu, Gordon G; Xue, Xindong; Yu, Chenxi; Wang, Yafeng

    2016-09-01

    This paper uses longitudinal data from China to examine the causal relationship between structural social capital and health among Chinese older adults. We employ various econometric strategies to control for the potential endogeneity of social capital and account for the possible contextual confounding effects by including community-level social capital. We use three indicators to measure individuals' general, physical, and mental health. Results indicate that social capital has a significant and positive effect on general and physical health. Based on our primary IV findings, a one standard-deviation increase in social capital leads to a 4.9 standard-deviation decrease in the probability of having bad health and a 2.2 standard-deviation decrease in physical activity limitations. Our results are robust to a series of sensitivity checks. Further analysis suggests heterogeneous effects by age but not by gender or area of residence. PMID:27235837

  3. How does social capital matter to the health status of older adults? Evidence from the China Health and Retirement Longitudinal Survey.

    PubMed

    Liu, Gordon G; Xue, Xindong; Yu, Chenxi; Wang, Yafeng

    2016-09-01

    This paper uses longitudinal data from China to examine the causal relationship between structural social capital and health among Chinese older adults. We employ various econometric strategies to control for the potential endogeneity of social capital and account for the possible contextual confounding effects by including community-level social capital. We use three indicators to measure individuals' general, physical, and mental health. Results indicate that social capital has a significant and positive effect on general and physical health. Based on our primary IV findings, a one standard-deviation increase in social capital leads to a 4.9 standard-deviation decrease in the probability of having bad health and a 2.2 standard-deviation decrease in physical activity limitations. Our results are robust to a series of sensitivity checks. Further analysis suggests heterogeneous effects by age but not by gender or area of residence.

  4. College Selectivity and Young Adult Health Behaviors

    ERIC Educational Resources Information Center

    Fletcher, Jason M.; Frisvold, David E.

    2011-01-01

    Large literatures have shown important links between the quantity of completed education and health outcomes on one hand and the quality or selectivity of schooling on a host of adult outcomes, such as wages, on the other hand. However, little research attempts to produce evidence of the link between school quality and health. The paper presents…

  5. Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010

    PubMed Central

    Phillips-Howard, Penelope A.; Laserson, Kayla F.; Amek, Nyaguara; Beynon, Caryl M.; Angell, Sonia Y.; Khagayi, Sammy; Byass, Peter; Hamel, Mary J.; van Eijk, Anne M.; Zielinski-Gutierrez, Emily; Slutsker, Laurence; De Cock, Kevin M.; Vulule, John; Odhiambo, Frank O.

    2014-01-01

    Background Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. Methods and Findings Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female) of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35%) and cardio-vascular diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y. Conclusions NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs. PMID:25426945

  6. Disseminating Evidence-Based Practices for Adults with PTSD and Severe Mental Illness in Public-Sector Mental Health Agencies

    ERIC Educational Resources Information Center

    Frueh, B. Christopher; Grubaugh, Anouk L.; Cusack, Karen J.; Elhai, Jon D.

    2009-01-01

    Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental…

  7. Adolescent health and adult labor market outcomes.

    PubMed

    Lundborg, Petter; Nilsson, Anton; Rooth, Dan-Olof

    2014-09-01

    Whereas a large literature has shown the importance of early life health for adult socioeconomic outcomes, there is little evidence on the importance of adolescent health. We contribute to the literature by studying the impact of adolescent health status on adult labor market outcomes using a unique and large-scale dataset covering almost the entire population of Swedish males. We show that most types of major conditions have long-run effects on future outcomes, and that the strongest effects result from mental conditions. Including sibling fixed effects or twin pair fixed effects reduces the magnitudes of the estimates, but they remain substantial.

  8. Evidence for Association between SH2B1 Gene Variants and Glycated Hemoglobin in Nondiabetic European American Young Adults: The Add Health Study.

    PubMed

    Lange, Leslie A; Graff, Mariaelisa; Lange, Ethan M; Young, Kristin L; Richardson, Andrea S; Mohlke, Karen L; North, Kari E; Harris, Kathleen M; Gordon-Larsen, Penny

    2016-09-01

    Glycated hemoglobin (HbA1c) is used to classify glycaemia and type 2 diabetes (T2D). Body mass index (BMI) is a predictor of HbA1c levels and T2D. We tested 43 established BMI and obesity loci for association with HbA1c in a nationally representative multiethnic sample of young adults from the National Longitudinal Study of Adolescent to Adult Health [Add Health: age 24-34 years; n = 5641 European Americans (EA); 1740 African Americans (AA); 1444 Hispanic Americans (HA)] without T2D, using two levels of covariate adjustment (Model 1: age, sex, smoking, and geographic region; Model 2: Model 1 covariates plus BMI). Bonferroni adjustment was made for 43 SNPs and we considered P < 0.0011 statistically significant. Means (SD) for HbA1c were 5.4% (0.3) in EA, 5.7% (0.4) in AA, and 5.5% (0.3) in HA. We observed significant evidence for association with HbA1c for two variants near SH2B1 in EA (rs4788102, P = 2.2 × 10(-4) ; rs7359397, P = 9.8 × 10(-4) ) for Model 1. Both results were attenuated after adjustment for BMI (rs4788102, P = 1.7 × 10(-3) ; rs7359397, P = 4.6 × 10(-3) ). No variant reached Bonferroni-corrected significance in AA or HA. These results suggest that SH2B1 polymorphisms are associated with HbA1c, largely independent of BMI, in EA young adults. PMID:27530450

  9. Evidence for Association between SH2B1 Gene Variants and Glycated Hemoglobin in Nondiabetic European American Young Adults: The Add Health Study.

    PubMed

    Lange, Leslie A; Graff, Mariaelisa; Lange, Ethan M; Young, Kristin L; Richardson, Andrea S; Mohlke, Karen L; North, Kari E; Harris, Kathleen M; Gordon-Larsen, Penny

    2016-09-01

    Glycated hemoglobin (HbA1c) is used to classify glycaemia and type 2 diabetes (T2D). Body mass index (BMI) is a predictor of HbA1c levels and T2D. We tested 43 established BMI and obesity loci for association with HbA1c in a nationally representative multiethnic sample of young adults from the National Longitudinal Study of Adolescent to Adult Health [Add Health: age 24-34 years; n = 5641 European Americans (EA); 1740 African Americans (AA); 1444 Hispanic Americans (HA)] without T2D, using two levels of covariate adjustment (Model 1: age, sex, smoking, and geographic region; Model 2: Model 1 covariates plus BMI). Bonferroni adjustment was made for 43 SNPs and we considered P < 0.0011 statistically significant. Means (SD) for HbA1c were 5.4% (0.3) in EA, 5.7% (0.4) in AA, and 5.5% (0.3) in HA. We observed significant evidence for association with HbA1c for two variants near SH2B1 in EA (rs4788102, P = 2.2 × 10(-4) ; rs7359397, P = 9.8 × 10(-4) ) for Model 1. Both results were attenuated after adjustment for BMI (rs4788102, P = 1.7 × 10(-3) ; rs7359397, P = 4.6 × 10(-3) ). No variant reached Bonferroni-corrected significance in AA or HA. These results suggest that SH2B1 polymorphisms are associated with HbA1c, largely independent of BMI, in EA young adults.

  10. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey.

    PubMed

    Fisher, Koren L; Harrison, Elizabeth L; Reeder, Bruce A; Sari, Nazmi; Chad, Karen E

    2015-01-01

    Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50-65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73;  P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92;  P < 0.01) than their inactive peers. Active persons aged 65-79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82,  P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services. PMID:26347491

  11. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey

    PubMed Central

    Fisher, Koren L.; Harrison, Elizabeth L.; Reeder, Bruce A.; Sari, Nazmi; Chad, Karen E.

    2015-01-01

    Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50–65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73;  P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92;  P < 0.01) than their inactive peers. Active persons aged 65–79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82,  P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services. PMID:26347491

  12. Adult height, nutrition, and population health.

    PubMed

    Perkins, Jessica M; Subramanian, S V; Davey Smith, George; Özaltin, Emre

    2016-03-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence.

  13. The Quality of Life Implications of Health Practices among Older Adults: Evidence from the 1991 Canadian General Social Survey.

    ERIC Educational Resources Information Center

    Gillis, Kelly J.; Hirdes, John P.

    1996-01-01

    A survey of permanent residents of Canada over 50 years of age (n=5,102) regarding the effect of smoking, alcohol consumption, obesity, and physical activity found the following: (1) smoking is associated with negative outcomes; (2) there is little evidence of adverse effects for alcohol consumption; (3) physical activity is positive; and (4) body…

  14. Health Tips for Adults

    MedlinePlus

    ... Griffin Rodgers, Director of the NIDDK Clinical Trials Current research studies and how you can volunteer Community Outreach and Health Fairs Science-based information and tips for planning an outreach effort or community event For Health Care Professionals Patient and provider resources ...

  15. Social Determinants of Health and Tobacco Use in Thirteen Low and Middle Income Countries: Evidence from Global Adult Tobacco Survey

    PubMed Central

    Palipudi, Krishna M.; Gupta, Prakash C.; Sinha, Dhirendra N.; Andes, Linda J.; Asma, Samira; McAfee, Tim

    2012-01-01

    Background Tobacco use has been identified as the single biggest cause of inequality in morbidity. The objective of this study is to examine the role of social determinants on current tobacco use in thirteen low-and-middle income countries. Methodology/Principal Findings We used nationally representative data from the Global Adult Tobacco Survey (GATS) conducted during 2008–2010 in 13 low-and-middle income countries: Bangladesh, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam. These surveys provided information on 209,027 respondent's aged 15 years and above and the country datasets were analyzed individually for estimating current tobacco use across various socio-demographic factors (gender, age, place of residence, education, wealth index, and knowledge on harmful effects of smoking). Multiple logistic regression analysis was used to predict the impact of these determinants on current tobacco use status. Current tobacco use was defined as current smoking or use of smokeless tobacco, either daily or occasionally. Former smokers were excluded from the analysis. Adjusted odds ratios for current tobacco use after controlling other cofactors, was significantly higher for males across all countries and for urban areas in eight of the 13 countries. For educational level, the trend was significant in Bangladesh, Egypt, India, Philippines and Thailand demonstrating decreasing prevalence of tobacco use with increasing levels of education. For wealth index, the trend of decreasing prevalence of tobacco use with increasing wealth was significant for Bangladesh, India, Philippines, Thailand, Turkey, Ukraine, Uruguay and Viet Nam. The trend of decreasing prevalence with increasing levels of knowledge on harmful effects of smoking was significant in China, India, Philippines, Poland, Russian Federation, Thailand, Ukraine and Viet Nam. Conclusions/Significance These findings demonstrate a significant but

  16. How Is Health Related to Literacy, Numeracy, and Technological Problem-Solving Skills among U.S. Adults? Evidence from the Program for the International Assessment of Adult Competencies (PIAAC)

    ERIC Educational Resources Information Center

    Prins, Esther; Monnat, Shannon; Clymer, Carol; Toso, Blaire Wilson

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between U.S. adults' self-reported health and proficiencies in literacy, numeracy, and technological problem solving. Ordinal logistic regression analyses showed that scores on all three scales were positively and…

  17. Associations among Selected Motor Skills and Health-Related Fitness: Indirect Evidence for Seefeldt's Proficiency Barrier in Young Adults?

    ERIC Educational Resources Information Center

    Stodden, David F.; True, Larissa K.; Langendorfer, Stephen J.; Gao, Zan

    2013-01-01

    Purpose: This exploratory study examined the notion of Seefeldt's (1980) hypothesized motor skill "proficiency barrier" related to composite levels of health-related physical fitness (HRF) in young adults. Method: A motor skill competence (MSC) index composed of maximum throwing and kicking speed and jumping distance in 187 young…

  18. Health Literacy Education within Adult Literacy Instruction

    ERIC Educational Resources Information Center

    Diehl, Sandra J.

    2011-01-01

    Building health literacy skills among adult learners has the potential to contribute to efforts to eliminate health disparities and improve health outcomes. Adults with limited literacy skills are more likely to be underserved by health services and at risk for poorer health. Recognition of the need for stronger health literacy skills and a desire…

  19. Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.

    PubMed

    Mberu, Blessing; Wamukoya, Marylene; Oti, Samuel; Kyobutungi, Catherine

    2015-06-01

    also find a fifteen percentage point increase in the incidences of male deaths due to injuries between 2003 and 2012. For women, the corresponding deaths due to injuries remain fairly stable throughout the period. We find cardiovascular diseases as a significant cause of death over the period, with overall mortality increasing steadily from 1.6% in 2003 to 8.1% in 2012, and peaking at 13.7% in 2005 and at 12.0% in 2009. These deaths were consistently higher among women. We identified substantial variations in causes of death by age, with TB, HIV/AIDS, and CVD deaths lowest among younger residents and increasing with age, while injury-related deaths are highest among the youngest adults 15-19 and steadily declined with age. Also, deaths related to neoplasms and respiratory tract infections (RTIs) were prominent among older adults 50 years and above, especially since 2005. Emerging at this stage is evidence that HIV/AIDS, TB, injuries, and cardiovascular disease are linked to approximately 73% of all adult deaths among the urban poor in Nairobi slums of Korogocho and Viwandani in the last 10 years. While mortality related to HIV/AIDS is generally declining, we see an increasing proportion of deaths due to TB, injuries, and cardiovascular diseases. In sum, substantial epidemiological transition is ongoing in this local context, with deaths linked to communicable diseases declining from 66% in 2003 to 53% in 2012, while deaths due to noncommunicable causes experienced a four-fold increase from 5% in 2003 to 21.3% in 2012, together with another two-fold increase in deaths due to external causes (injuries) from 11% in 2003 to 22% in 2012. It is important to also underscore the gender dimensions of the epidemiological transition clearly visible in the mix. Finally, the elevated levels of disadvantage of slum dwellers in our analysis relative to other population subgroups in Kenya continue to demonstrate appreciable deterioration of key urban health and social indicators

  20. Negative Health Comparisons Decrease Affective and Cognitive Well-Being in Older Adults. Evidence from a Population-Based Longitudinal Study in Germany

    PubMed Central

    Hajek, André; König, Hans-Helmut

    2016-01-01

    Purpose: To examine the effect of health comparisons on affective (AWB) and cognitive well-being (CWB) in older adults longitudinally. Methods: Data were derived from the third and fourth wave of the German Ageing Survey (DEAS) which is a population-based prospective cohort study of community-dwelling subjects in Germany aged 40 and above (with 8,277 observations in fixed effects regressions). Health comparisons were assessed by the question “How would you rate your health compared with other people your age” (Much better; somewhat better; the same; somewhat worse, much worse). While AWB was quantified by using the Positive and Negative Affect Schedule (PANAS), CWB was assessed by using the Satisfaction with Life Scale (SWLS). Fixed effects regressions were used to analyze the effect of health comparisons on AWB and CWB. Results: While positive health comparisons only slightly increased CWB (total sample), negative health comparisons markedly decreased CWB (total sample and women), and negative affects (women). Neither positive nor negative health comparisons affected positive affects. Conclusions: Our findings stress the importance of negative health comparisons for CWB and negative affects in women. Comparison effects are asymmetric and in most cases upwards. Consequently, designing interventions to avoid upwards health comparisons might be a fruitful approach in order to maintain AWB and CWB. PMID:27445953

  1. Interactive Influences on Health and Adult Education

    ERIC Educational Resources Information Center

    Hill, Lilian H.

    2016-01-01

    This chapter examines multiple convergent forces affecting health, relates these to social determinants of health and critical adult health learning, and closes with discussion of opportunities for adult educators to contribute to human health at the individual, community, health provider, policy/regulatory agency, and international levels.

  2. Genetic and Environmental Influences on Adult Mental Health: Evidence for Gene-Environment Interplay as a Function of Maternal and Paternal Discipline and Affection.

    PubMed

    South, Susan C; Jarnecke, Amber M

    2015-07-01

    Researchers have long theorized that genetic influence on mental health may differ as a function of environmental risk factors. One likely moderator of genetic and environmental influences on psychopathological symptoms is parenting behavior, as phenotypic research shows that negative aspects of parent-child relationships are associated with greater likelihood of mental illness in adulthood. The current study examined whether levels of reported parental discipline and affection experienced in childhood act as a trigger, or buffer, for adult mental health problems. Results from a nationwide twin sample suggest level of father's discipline and affection, as reported by now-adult twins, moderated genetic and environmental influences on internalizing symptoms in adulthood, such that heritability was greatest at the highest levels of discipline and affection. Father's affection also moderated the etiological influences on alcohol use problems, with greater heritability at the lowest levels of affection. No moderating effect was found for mothers. Findings suggest relationships with fathers in childhood can have long-lasting effects on the etiological influences on adult mental health outcomes.

  3. Genetic and Environmental Influences on Adult Mental Health: Evidence for Gene-Environment Interplay as a Function of Maternal and Paternal Discipline and Affection.

    PubMed

    South, Susan C; Jarnecke, Amber M

    2015-07-01

    Researchers have long theorized that genetic influence on mental health may differ as a function of environmental risk factors. One likely moderator of genetic and environmental influences on psychopathological symptoms is parenting behavior, as phenotypic research shows that negative aspects of parent-child relationships are associated with greater likelihood of mental illness in adulthood. The current study examined whether levels of reported parental discipline and affection experienced in childhood act as a trigger, or buffer, for adult mental health problems. Results from a nationwide twin sample suggest level of father's discipline and affection, as reported by now-adult twins, moderated genetic and environmental influences on internalizing symptoms in adulthood, such that heritability was greatest at the highest levels of discipline and affection. Father's affection also moderated the etiological influences on alcohol use problems, with greater heritability at the lowest levels of affection. No moderating effect was found for mothers. Findings suggest relationships with fathers in childhood can have long-lasting effects on the etiological influences on adult mental health outcomes. PMID:25842345

  4. The impact of an unconditional tax credit for families on self-rated health in adults: further evidence from the cohort study of 6900 New Zealanders.

    PubMed

    Pega, Frank; Carter, Kristie; Kawachi, Ichiro; Davis, Peter; Blakely, Tony

    2014-05-01

    It is hypothesized that unconditional (given without obligation) publicly funded financial credits more effectively improve health than conditional financial credits in high-income countries. We previously reported no discernible short-term impact of an employment-conditional tax credit for families on self-rated health (SRH) in adults in New Zealand. This study estimates the effect of an unconditional tax credit for families, called Family Tax Credit (FTC), on SRH in the same study population and setting. A balanced panel of 6900 adults in families was extracted from seven waves (2002-2009) of the Survey of Family, Income and Employment. The exposures, eligibility for and amount of FTC, were derived by applying government eligibility and entitlement criteria. The outcome, SRH, was collected annually. Fixed effects regression analyses eliminated all time-invariant confounding and adjusted for measured time-varying confounders. Becoming eligible for FTC was associated with a small and statistically insignificant change in SRH over the past year [effect estimate: 0.013; 95% confidence interval (CI) -0.011 to 0.037], as was an increase in the estimated amount of FTC by $1000 (effect estimate: -0.001; 95% CI -0.006 to 0.004). The unconditional tax credit for families had no discernible short-term impact on SRH in adults in New Zealand. It did not more effectively improve health status than an employment-conditional tax credit for families.

  5. How Possibly Do Leisure and Social Activities Impact Mental Health of Middle-Aged Adults in Japan?: An Evidence from a National Longitudinal Survey

    PubMed Central

    Takeda, Fumi; Noguchi, Haruko; Monma, Takafumi; Tamiya, Nanako

    2015-01-01

    Objectives This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period. Methods This study focused on 16,642 middle-aged adults, age 50–59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities (‘hobbies or cultural activities’ and ‘exercise or sports’) and four social activities (‘community events’, ‘support for children’, ‘support for elderly individuals’ and ‘other social activities’) at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities (‘by oneself’, ‘with others’, or ‘both’ (both ‘by oneself’ and ‘with others’)) at baseline and mental health status at follow-up. Results Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women. Furthermore, in men, both ‘hobbies or cultural activities’ and ‘exercise or sports’ were significantly related to mental health status only when conducted ‘with others’. In women, the effects of ‘hobbies or cultural activities’ on mental health status were no differences regardless of the ways of participating, while the result of ‘exercise or sports’ was same as that in men. Conclusions Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if

  6. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

    Golbeck, Amanda L.; Ahlers-Schmidt, Carolyn R.; Paschal, Angelia M.

    2005-01-01

    Adult basic education (ABE) is an ideal venue for developing health literacy skills. Literacy and numeracy assessments used in ABE were identified and the most common were examined for health components. Only the Comprehensive Adult Student Assessment System (CASAS) included health. The two most common health literacy assessments used in general…

  7. Health Contract with Sedentary Older Adults

    ERIC Educational Resources Information Center

    Haber, David; Rhodes, Darson

    2004-01-01

    Purpose: Health educators used health contracts with sedentary older adults for the purpose of increasing exercise or physical activity. Design and Methods: Two health educators helped 25 sedentary older adults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully…

  8. Racial discrimination & health: pathways & evidence.

    PubMed

    Ahmed, Ameena T; Mohammed, Selina A; Williams, David R

    2007-10-01

    This review provides an overview of the existing empirical research of the multiple ways by which discrimination can affect health. Institutional mechanisms of discrimination such as restricting marginalized groups to live in undesirable residential areas can have deleterious health consequences by limiting socio-economic status (SES) and creating health-damaging conditions in residential environments. Discrimination can also adversely affect health through restricting access to desirable services such as medical care and creating elevated exposure to traditional stressors such as unemployment and financial strain. Central to racism is an ideology of inferiority that can adversely affect non-dominant groups because some members of marginalized populations will accept as true the dominant society's ideology of their group's inferiority. Limited empirical research indicates that internalized racism is inversely related to health. In addition, the existence of these negative stereotypes can lead dominant group members to consciously and unconsciously discriminate against the stigmatized. An overview of the growing body of research examining the ways in which psychosocial stress generated by subjective experiences of discrimination can affect health is also provided. We review the evidence from the United States and other societies that suggest that the subjective experience of discrimination can adversely affect health and health enhancing behaviours. Advancing our understanding of the relationship between discrimination and health requires improved assessment of the phenomenon of discrimination and increased attention to identifying the psychosocial and biological pathways that may link exposure to discrimination to health status.

  9. Senior Health: Older Adults and Newer Technology

    MedlinePlus

    ... Medical Director Senior Health: Older Adults and Newer Technology Volume 15 · Issue 6 · November/December 2005 Text ... adults who struggle to stand and walk. New technology includes knee units, shock-absorbing pylons, and other ...

  10. Health Literacy, Social Support, and Health Status among Older Adults

    ERIC Educational Resources Information Center

    Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

    2009-01-01

    The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

  11. Training Older Adults to Access Health Information

    ERIC Educational Resources Information Center

    Bertera, Elizabeth M.; Bertera, Robert L.; Morgan, Russell; Wuertz, Ellen; Attey, Alfred M. O.

    2007-01-01

    Many older adults do not use health information available on the Internet. Older adults residing in affordable housing were taught to use the NIHSeniorHealth.gov Web site. Participants were predominantly African American women with limited education and income (N = 42). Outcomes included changes in computer and health Web site navigation skills.…

  12. Early childhood investments substantially boost adult health.

    PubMed

    Campbell, Frances; Conti, Gabriella; Heckman, James J; Moon, Seong Hyeok; Pinto, Rodrigo; Pungello, Elizabeth; Pan, Yi

    2014-03-28

    High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health. PMID:24675955

  13. Childhood adversity and adult health: Evaluating intervening mechanisms.

    PubMed

    Turner, R Jay; Thomas, Courtney S; Brown, Tyson H

    2016-05-01

    Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience - implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences - a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure. PMID:27030896

  14. Exploring Older Adults' Health Information Seeking Behaviors

    ERIC Educational Resources Information Center

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  15. Evidence-based practices in community mental health: outcome evaluation.

    PubMed

    Painter, Kirstin

    2012-10-01

    In 2003, questions were being raised relating to the lack of evidence-based treatments available in public mental health and whether the use of treatments found effective in research settings would be equally effective in real world situations. In response, one state passed a bill mandating a disease management model of service delivery and the use of evidence-based practices designed to obtain better clinical and functional outcomes, and to maximize the possibility for recovery for adults experiencing a serious mental illness. The purpose of this article is to provide an overview of the re-engineered public mental health system and report on findings of a longitudinal time-series study of the redesigned community mental health system. Findings of the study suggest using evidence-based practices and following a disease management model of mental health service delivery can be effective in real world settings for adults experiencing serious mental health symptoms and functional impairment.

  16. Hydrate for health: listening to older adults' need for information.

    PubMed

    Palmer, Mary H; Marquez, Celine S; Kline, Katherine V; Morris, Erin; Linares, Brenda; Carlson, Barbara W

    2014-10-01

    An interdisciplinary team of faculty and students developed the Hydrate for Health project to provide relevant and evidence-based information to community-dwelling older adults. Evidence-based factsheets on bladder health, nighttime urination, medication safety, and physical activity/exercise, as well as a fluid intake self-monitoring tool, were developed. Four focus groups were conducted and included older adults (N = 21) who participated in activities at two local senior centers to obtain their feedback about the relevance of the factsheets. Extensive revisions were required based on the feedback received. Older adults expressed a desire for pragmatic information (i.e., how to determine fluid sources from food, how to measure water, how to determine their own fluid needs). They also wanted information that could be easily incorporated into daily life. Nurses play a central role in listening to and incorporating older adults' voices into consumer education materials.

  17. Influence of Point-of-Sale Tobacco Displays and Graphic Health Warning Signs on Adults: Evidence From a Virtual Store Experimental Study

    PubMed Central

    Kim, Annice E.; Nonnemaker, James M.; Loomis, Brett R.; Shafer, Paul R.; Shaikh, Asma; Hill, Edward; Holloway, John W.; Farrelly, Matthew C.

    2014-01-01

    Objectives. We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS). Methods. We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts. Results. The enclosed display significantly lowered current smokers’ (B = −7.05; 95% confidence interval [CI] = −13.20, −0.91; P < .05) and recent quitters’ (Β = −6.00, 95% CI = −11.00, −1.00; P < .01) urge to smoke and current smokers’ purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display. Conclusions. These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases. PMID:24625149

  18. Health literacy among adults in Yazd, Iran

    PubMed Central

    Haerian, Ahmad; Moghaddam, Mohammad Hossein Baghiayni; Ehrampoush, Mohammad Hassan; Bazm, Soheila; Bahsoun, Maryam Hassan

    2015-01-01

    The purpose of this survey was to assess the health literacy levels and determine the relationship between health literacy with demographic variables and the socioeconomic status Three hundred and eighty adults, 18 years and older, were randomly selected and assessed by the Test of Functional Health Literacy in Adults (TOFHLA) instrument in two sections of reading comprehension and numeracy. The second instrument used to detect the relationship between the demographic variables and socio-economic status and the level of health literacy of the subjects of adults in Yazd district. Three hundred and eighty adults, 18 years and older, were randomly selected and assessed by the Test of Functional Health Literacy in Adults (TOFHLA) instrument in two sections of reading comprehension and numeracy. The second instrument used to detect the relationship between the demographic variables and socio-economic status and the level of health literacy of the subjects. The mean score of a participant's health literacy was 73.33 ± 1.29. Fifty-four percent of the individuals had adequate health literacy and the rest of them had limited health literacy. The mean score of functional health literacy was significantly different by socio-economic status (p0.05) and the years of schooling (P = 0.00). On the basis of linear regression, in this research, the years of schooling (B0.28, p0.01) and marital status (B = 3.08, p0.05) were two predictors of health literacy. PMID:27462633

  19. Older adults experiences of rehabilitation in acute health care.

    PubMed

    Atwal, Anita; Tattersall, Kirsty; Murphy, Susana; Davenport, Neil; Craik, Christine; Caldwell, Kay; McIntyre, Anne

    2007-09-01

    Rehabilitation is a key component of nursing and allied healthcare professionals' roles in most health and social care settings. This paper reports on stage 2 of an action research project to ascertain older adult's experience of rehabilitation. Twenty postdischarge interviews were conducted and the interview transcripts were analysed using thematic content analysis. All older adults discharged from an acute older acute rehabilitation ward to their own homes in the community were eligible to participate. The only exclusion criterion was older adults who were thought to be unable to give consent to participate by the nurse in charge and the researcher. Whilst 92 older adults were eligible to participate in this research study, only 20 were interviewed. The findings from this study suggest that older adults valued communication with health professionals but were aware of their time constraints that hindered communication. This study suggests that both nurses and allied health professionals are not actively providing rehabilitative services to promote health and well-being, which contradicts the focus of active ageing. Furthermore, there was evidence of unmet needs on discharge, and older adults unable to recall the professions that were involved in their interventions and the rationale for therapy input. It is suggested that further research is needed to explore the effectiveness of allied health rehabilitation in the acute setting. This study highlights the need for further research into older adults' perceptions of the rehabilitation process in the acute setting.

  20. Improving the Evidence Base for Treating Older Adults With Cancer: American Society of Clinical Oncology Statement.

    PubMed

    Hurria, Arti; Levit, Laura A; Dale, William; Mohile, Supriya G; Muss, Hyman B; Fehrenbacher, Louis; Magnuson, Allison; Lichtman, Stuart M; Bruinooge, Suanna S; Soto-Perez-de-Celis, Enrique; Tew, William P; Postow, Michael A; Cohen, Harvey J

    2015-11-10

    The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response to a critical need identified by the Institute of Medicine. Older adults experience the majority of cancer diagnoses and deaths and make up the majority of cancer survivors. Older adults are also the fastest growing segment of the US population. However, the evidence base for treating this population is sparse, because older adults are underrepresented in clinical trials, and trials designed specifically for older adults are rare. The result is that clinicians have less evidence on how to treat older adults, who represent the majority of patients with cancer. Clinicians and patients are forced to extrapolate from trials conducted in younger, healthier populations when developing treatment plans. This has created a dearth of knowledge regarding the risk of toxicity in the average older patient and about key end points of importance to older adults. ASCO makes five recommendations to improve evidence generation in this population: (1) Use clinical trials to improve the evidence base for treating older adults with cancer, (2) leverage research designs and infrastructure for generating evidence on older adults with cancer, (3) increase US Food and Drug Administration authority to incentivize and require research involving older adults with cancer, (4) increase clinicians' recruitment of older adults with cancer to clinical trials, and (5) use journal policies to improve researchers' reporting on the age distribution and health risk profiles of research participants.

  1. Converging roads: evidence for an adult hemangioblast.

    PubMed

    Bailey, Alexis S; Fleming, William H

    2003-11-01

    Classical studies of the developing embryo first suggested the existence of the hemangioblast, a precursor cell with the potential to differentiate into both blood and blood vessels. Several lines of investigation demonstrated that many of the genes activated during early hematopoietic development are also expressed in the vascular endothelium. Gene-targeting studies using embryonic stem cells have identified Flk-1, SCL, and Runx-1 as important regulatory molecules that specify both hematopoietic and vascular outcomes. Although it was anticipated that the hemangioblast would be present only during the earliest stages of vascular development in the yolk sac, accumulating evidence now indicates that hematopoietic cells with hemangioblast activity persist into adulthood. In the adult, bone marrow-derived, circulating endothelial progenitors contribute to postnatal neovascularization and enhance vascular repair following ischemic injury. Highly purified populations of hematopoietic stem cells from humans and mice can differentiate into both blood cells and vascular tissue at the single cell level. These recent findings suggest that bone marrow-derived hematopoietic stem cells or their progeny may contribute to the maintenance and repair of both the hematopoietic and the vascular systems during adult life.

  2. Marriage and mental health among young adults.

    PubMed

    Uecker, Jeremy E

    2012-03-01

    Marriage is widely thought to confer mental health benefits, but little is known about how this apparent benefit may vary across the life course. Early marriage, which is nonnormative, could have no, or even negative, mental health consequences for young adults. Using survey data from waves 1 and 3 of the National Longitudinal Study of Adolescent Health (n = 11,695), I find that married young adults exhibit levels of psychological distress that are similar to those of young adults in any kind of romantic relationship. Married and engaged young adults also report lower frequency of drunkenness than those who are not in a romantic relationship. Married young adults, especially those who first married at ages 22 to 26, report higher life satisfaction than those in other type of romantic relationships,those in no romantic relationship, and those who married prior to age 22. Explanations for these findings are examined, and their implications are discussed.

  3. Health and Social Functioning of Adults with Intellectual Disability and Autism

    ERIC Educational Resources Information Center

    Underwood, Lisa; McCarthy, Jane; Tsakanikos, Elias; Howlin, Patricia; Bouras, Nick; Craig, Tom K. J.

    2012-01-01

    There is little information on the mental health needs of adults with intellectual disability (ID) and autism spectrum disorders (ASDs). Such evidence is much needed for the development of more effective mental health services for this group. The aim of this study is to compare adults with ID and ASD receiving specialist mental health services…

  4. Older Adults and Mental Health

    MedlinePlus

    ... is a widely underrecognized and undertreated medical illness. Depression often co-occurs with other serious illnesses, such as heart disease, stroke, diabetes, cancer, and Parkinson's disease. Because many older adults face these illnesses as well as various social and ...

  5. Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults

    PubMed Central

    Liu, Longjian; Simon, Barbara; Shi, Jinggaofu; Mallhi, Arshpreet Kaur; Eisen, Howard J

    2016-01-01

    AIM To examine the epidemic of diabetes mellitus (DM) and its impact on mortality from all-cause and cardiovascular disease (CVD), and to test the effect of antidiabetic therapy on the mortality in United States adults. METHODS The analysis included a randomized population sample of 272149 subjects ages ≥ 18 years who participated in the National Health Interview Surveys (NHIS) in 2000-2009. Chronic conditions (hypertension, DM and CVD) were classified by participants’ self-reports of physician diagnosis. NHIS-Mortality Linked Files, and NHIS-Medical Expenditure Panel Survey Linkage Files on prescribed medicines for patients with DM were used to test the research questions. χ2, Poisson and Cox’s regression models were applied in data analysis. RESULTS Of all participants, 22305 (8.2%) had DM. The prevalence of DM significantly increased from 2000 to 2009 in all age groups (P < 0.001). Within an average 7.39 (SD = 3) years of follow-up, male DM patients had 1.56 times higher risk of death from all-cause (HR = 1.56, 95%CI: 1.49-1.64), 1.72 times higher from heart disease [1.72 (1.53-1.93)], 1.48 times higher from cerebrovascular disease [1.48 (1.18-1.85)], and 1.67 times higher from CVD [1.67 (1.51-1.86)] than subjects without DM, respectively. Similar results were observed in females. In males, 10% of DM patients did not use any antidiabetic medications, 38.1% used antidiabetic monotherapy, and 51.9% used ≥ 2 antidiabetic medications. These corresponding values were 10.3%, 40.4% and 49.4% in females. A significant protective effect of metformin monotherapy or combination therapy (except for insulin) on all-cause mortality and a protective but non-significant effect on CVD mortality were observed. CONCLUSION This is the first study using data from multiple linkage files to confirm a significant increased prevalence of DM in the last decade in the United States. Patients with DM have significantly higher risk of death from all-cause and CVD than those without

  6. Self-reported utilization of mental health services in the adult German population--evidence for unmet needs? Results of the DEGS1-Mental Health Module (DEGS1-MH).

    PubMed

    Mack, Simon; Jacobi, Frank; Gerschler, Anja; Strehle, Jens; Höfler, Michael; Busch, Markus A; Maske, Ulrike E; Hapke, Ulfert; Seiffert, Ingeburg; Gaebel, Wolfgang; Zielasek, Jürgen; Maier, Wolfgang; Wittchen, Hans-Ulrich

    2014-09-01

    This paper provides up-to-date data on service use for mental health problems and disorders among adults aged 18-79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH; N=4483). Data are based exclusively on self-report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA-X/M-CIDI to assess diagnoses according to the criteria of DSM-IV-TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12-month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio-demographic characteristics. Lowest 12-month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self-reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS-MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type

  7. Quick Guide to Health Literacy and Older Adults

    MedlinePlus

    ... Disease Prevention and Health Promotion Quick Guide to Health Literacy and Older Adults skip to content ODPHP Health Communication Healthy People 2010 Health Communication Focus Area Health Literacy Improvement Consumer and Patient e-Health Resources Health ...

  8. Effects of Negative and Positive Evidence on Adult Word Learning

    ERIC Educational Resources Information Center

    Strapp, Chehalis M.; Helmick, Augusta L.; Tonkovich, Hayley M.; Bleakney, Dana M.

    2011-01-01

    This study compared negative and positive evidence in adult word learning, predicting that adults would learn more forms following negative evidence. Ninety-two native English speakers (32 men and 60 women [M[subscript age] = 20.38 years, SD = 2.80]), learned nonsense nouns and verbs provided within English frames. Later, participants produced…

  9. Health Issues for Adults with Developmental Disability.

    ERIC Educational Resources Information Center

    Sutherland, Georgina; Couch, Murray A.; Iacono, Teresa

    2002-01-01

    This paper reviews recent literature on health issues for adults with developmental disabilities, reflecting on how it informs service provision, future research, and social and health policy. Results suggest future research should focus on interactions among biology, pathology, and behavioral and environmental determinants. More use of…

  10. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

    The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

  11. Adult Dental Health Survey 2009: implications of findings for clinical practice and oral health policy.

    PubMed

    Watt, R G; Steele, J G; Treasure, E T; White, D A; Pitts, N B; Murray, J J

    2013-01-01

    This is the final paper in a series reporting on the results of the 2009 Adult Dental Health Survey. Since 1968 national adult surveys have been repeated every decade with broadly similar methods providing a unique overview of trends in oral health over a 40-year period. This paper aims to explore the implications for dentists and oral health policy of the key results from the Adult Dental Health Survey 2009. Although repeat, cross-sectional, epidemiological surveys provide very valuable data on trends in disease patterns, they do not provide answers to test causal relationships and therefore cannot identify the causes for the significant improvements in oral health over the last 40 years. Evidence would indicate, however, that broad societal shifts in population norms and behaviours, combined with changes in clinical diagnostic criteria, treatment planning and clinical procedures are the main reasons for the changes that have taken place. Key implications of the survey results include the need to monitor, support and maintain the good state of oral health of the increasing proportion of younger adults with relatively simple treatment needs. A smaller number of young and middle aged adults but a significant proportion of older adults will have far more complex treatment needs requiring advanced restorative and periodontal care. Future oral health policy will need to address oral health inequalities, encourage skill mix and promote and facilitate the dental profession to deliver appropriate and high quality care relevant to the needs of their local population.

  12. Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007-2010.

    PubMed

    Aggarwal, Anju; Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

    2016-09-01

    Concerns with taste, nutrition, cost, and convenience are said to be key influences on food choices. This study examined the importance of food-related attitudes in relation to diet quality using US national level data. Interactions by socioeconomic status (SES), gender and race/ethnicity were tested. Analyses of 8957 adults from National Health and Nutrition Examination Survey (NHANES 2007-2010) were conducted in 2014-15. Perceived importance of taste, nutrition, cost, and convenience in dietary choices were assessed using 4-point Likert scales. Education and family income-to-poverty ratio (FIPR) were SES indicators. Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was the diet quality measure. Survey-weighted regressions examined associations between attitudes and HEI, and tested for interactions. Taste was rated as "very important" by 77.0% of the US adults, followed by nutrition (59.9%), cost (39.9%), and convenience (29.8%). However, it was the perceived importance of nutrition that most strongly predicted HEI (β: +8.0 HEI scores among "very important" vs. "not at all important"). By contrast, greater importance for taste and convenience had a weak inverse relation with HEI (β: -5.1 and -1.5 respectively), adjusting for SES. Significant interactions were observed by race/ethnicity, but not SES and gender. Those who prioritized nutrition during food shopping had higher-quality diets regardless of gender, education and income in the US. Certain racial/ethnic groups managed to eat healthy despite attaching importance to cost and convenience. This is the first evidence of nutrition resilience among US adults using national data, which has huge implications for nutrition interventions. PMID:27374943

  13. Perceived Utility of the RE-AIM Framework for Health Promotion/Disease Prevention Initiatives for Older Adults: A Case Study from the U.S. Evidence-Based Disease Prevention Initiative

    PubMed Central

    Ory, Marcia G.; Altpeter, Mary; Belza, Basia; Helduser, Janet; Zhang, Chen; Smith, Matthew Lee

    2015-01-01

    Dissemination and implementation (D&I) frameworks are increasingly being promoted in public health research. However, less is known about their uptake in the field, especially for diverse sets of programs. Limited questionnaires exist to assess the ways that frameworks can be utilized in program planning and evaluation. We present a case study from the United States that describes the implementation of the RE-AIM framework by state aging services providers and public health partners and a questionnaire that can be used to assess the utility of such frameworks in practice. An online questionnaire was developed to capture community perspectives about the utility of the RE-AIM framework. Distributed to project leads in 27 funded states in an evidence-based disease prevention initiative for older adults, 40 key stakeholders responded representing a 100% state-participation rate among the 27 funded states. Findings suggest that there is perceived utility in using the RE-AIM framework when evaluating grand-scale initiatives for older adults. The RE-AIM framework was seen as useful for planning, implementation, and evaluation with relevance for evaluators, providers, community leaders, and policy makers. Yet, the uptake was not universal, and some respondents reported difficulties in use, especially adopting the framework as a whole. This questionnaire can serve as the basis to assess ways the RE-AIM framework can be utilized by practitioners in state-wide D&I efforts. Maximal benefit can be derived from examining the assessment of RE-AIM-related knowledge and confidence as part of a continual quality assurance process. We recommend such an assessment be performed before the implementation of new funding initiatives and throughout their course to assess RE-AIM uptake and to identify areas for technical assistance. PMID:25964897

  14. The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self-Assessed Health.

    PubMed

    Darden, Michael; Gilleskie, Donna

    2016-08-01

    An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd.

  15. Medicare, health care reform, and older adults.

    PubMed

    McCracken, Ann L

    2010-12-01

    Nurses will play a key role in health care reform, educating and engaging consumers, providing input into and monitoring implementation, and assisting organizations with transition to new policies. As the largest group of professional health care providers, nurses must be key players in the actualization of health care reform. This article addresses how The Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 will affect the solvency of Medicare, what older adults will gain, effects on quality and effectiveness of care, cost reduction, changes in taxes, and the key provisions of special interest to nurses.

  16. Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

    PubMed Central

    O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

    2014-01-01

    Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these

  17. Dental health practices in Norwegian adults.

    PubMed

    Helöe, L A; Aarö, L E; Sögaard, A J

    1982-12-01

    A nationwide sample of 1511 Norwegian adults were interviewed in 1979-80 concerning health habits, including dental habits. While daily toothbrushing and regular treatment attendance appeared to have become the rule among young and middle aged individuals, use of dental floss and especially of fluoride tablets or rinses, still are the exception. Dental health habits were clustered around the variable treatment attendance with slightly different patterns for men and for women. Measures of sugar consumptions were only slightly correlated with background variables and dental health behavior. While the latter was socially dependent, consumption of sugar probably was attached to personal characteristics or situational factors. The correlations between dental health behavior and other health behavior practices were generally weak, and somewhat different for men and women. Two separate types of motives for preventive behavior were distinguished between: health motives and cosmetic motives.

  18. Health literacy, smoking, and health indicators in African American adults

    PubMed Central

    Stewart, Diana W.; Vidrine, Jennifer I.; Shete, Sanjay; Spears, Claire A.; Cano, Miguel A.; Correa-Fernández, Virmarie; Wetter, David W.; McNeill, Lorna H.

    2015-01-01

    We examined cross-sectional associations of health literacy (HL) with smoking and other established health indicators among 1,467 African American adults. Data emanated from a longitudinal cohort study designed to investigate cancer risk factors among church-going African American adults. We conducted linear and logistic regression analyses to assess associations between HL and health indicators. HL was assessed using an established single-item screening question. Outcomes included indicators of poor physical (cigarette smoking, self-rated general and physical health) and mental health (self-rated mental health, depressive symptoms, perceived stress). Nearly 19% of participants had low HL. Low HL was significantly associated with current smoking, poorer self-rated general and physical health, and higher perceived stress (ps < .05) even after controlling for demographic variables (i.e., age, gender, relationship status) and indicators of socioeconomic status (i.e., education, income, insurance status). Low HL appears to be an independent risk factor for smoking and other indicators of poor physical and mental health in a large sample of African American adults. Future directions and clinical implications are discussed. PMID:26513028

  19. Towards Evidence Based Usability in Health Informatics?

    PubMed

    Marcilly, Romaric; Peute, Linda W; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W

    2015-01-01

    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still lacking. This paper underlines the need for evidence based HIT design and provides a definition of evidence based usability practice as the conscientious, explicit and judicious use of current best evidence in making decisions in design of interactive systems in health by applying usability engineering and usability design principles that have proven their value in practice. Current issues that hamper evidence based usability practice are highlighted and steps needed to achieve evidence are presented.

  20. Meditation for older adults: a new look at an ancient intervention for mental health.

    PubMed

    Sorrell, Jeanne M

    2015-05-01

    New research is providing health care professionals with evidence for the effectiveness of mindfulness meditation as an intervention for older adults. Recent studies have provided evidence that meditation results in observable changes in brain structure related to memory, sense of self, empathy, and stress. Health care professionals should consider mindfulness training as a helpful intervention for older adults with problems such as depression, anxiety, chronic pain, loneliness, and caregiver burden.

  1. New evidence in health economics.

    PubMed

    Moscone, Francesco; Vittadini, Giorgio

    2011-02-01

    The 2nd Health Econometrics Workshop took place at the Catholic University of Rome in Italy on 15-17 July 2010. The purpose of this meeting was to provide a forum where policy makers, economists and econometricians could discuss the use of statistical and econometric methods to address issues in the field of health economics. There were seven keynote speakers - leading scholars in the subject - invited to give their contributions: Alberto Holly, Stephen Hall, Badi Baltagi, William Greene, Andrew Jones, John Mullahy and Edward Norton. The meeting was attended by 50 participants from around the world, and 17 scientific papers were presented. Some of these works will be published in the forthcoming special issue of Empirical Economics.

  2. New evidence in health economics.

    PubMed

    Moscone, Francesco; Vittadini, Giorgio

    2011-02-01

    The 2nd Health Econometrics Workshop took place at the Catholic University of Rome in Italy on 15-17 July 2010. The purpose of this meeting was to provide a forum where policy makers, economists and econometricians could discuss the use of statistical and econometric methods to address issues in the field of health economics. There were seven keynote speakers - leading scholars in the subject - invited to give their contributions: Alberto Holly, Stephen Hall, Badi Baltagi, William Greene, Andrew Jones, John Mullahy and Edward Norton. The meeting was attended by 50 participants from around the world, and 17 scientific papers were presented. Some of these works will be published in the forthcoming special issue of Empirical Economics. PMID:21351856

  3. Characteristics of graduate adult health nursing programs.

    PubMed

    Stokes, E; Whitis, G; Moore-Thrasher, L

    1997-02-01

    This descriptive study explored the current characteristics and emphases of graduate programs which offer adult health nursing curricula. All NLN-accredited master's programs offering the adult health focus were requested to send selected demographic information and materials/bulletins normally sent to prospective students. The Conrad and Pratt model for curriculum decision-making was used to organize results related to environmental input and curriculum design variables. Descriptive statistics were employed to analyze admission requirements, types of study permitted, length of program, type of courses (core, electives/cognates, specialty) and completion requirements. Results indicated that adult health graduate programs have multi-tracks. Students were generally attending part-time. Full-time study completion time was four to six semesters. Evening and one day per week offerings were frequently found, as were numerous innovative strategies. Prevalent admission requirements were: graduation from an NLN-accredited BSN program, current licensure, specified GPA, GRE scores, health assessment and statistics courses, professional references and possible personal interview. Most programs required core courses in theory/conceptual frameworks, issues, roles, statistics and research. Electives/cognate courses and thesis/non-thesis options were present in most programs. PMID:9029416

  4. Evidence-Based Practice in Mental Health Care to Ethnic Minority Communities: Has Its Practice Fallen Short of Its Evidence?

    ERIC Educational Resources Information Center

    Aisenberg, Eugene

    2008-01-01

    Evidence-based practice (EBP) has contributed substantially to the advancement of knowledge in the treatment and prevention of adult mental health disorders. A fundamental assumption, based on documented evidence of effectiveness with certain populations, is that EBP is equally effective and applicable to all populations. However, small sample…

  5. Living with Multiple Health Problems: What Older Adults Should Know

    MedlinePlus

    ... PDF Living With Multiple Health Problems: What Older Adults Should Know Download Join our e-newsletter! Resources Living With Multiple Health Problems: What Older Adults Should Know Tools and Tips Printer-friendly PDF ...

  6. The Mental Health of Older LGBT Adults.

    PubMed

    Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

    2016-06-01

    There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

  7. The Mental Health of Older LGBT Adults.

    PubMed

    Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

    2016-06-01

    There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults. PMID:27142205

  8. Health Inequalities Among Sexual Minority Adults

    PubMed Central

    Blosnich, John R.; Farmer, Grant W.; Lee, Joseph G. L.; Silenzio, Vincent M. B.; Bowen, Deborah J.

    2014-01-01

    Background Improving the health of lesbian, gay, and bisexual (LGB) individuals is a Healthy People 2020 goal; however, the IOM highlighted the paucity of information currently available about LGB populations. Purpose To compare health indicators by gender and sexual orientation statuses. Methods Data are from Behavioral Risk Factor Surveillance System surveys conducted January–December of 2010 with population-based samples of non-institutionalized U.S. adults aged over 18 years (N=93,414) in ten states that asked about respondents’ sexual orientation (response rates=41.1%–65.6%). Analyses were stratified by gender and sexual orientation to compare indicators of mental health, physical health, risk behaviors, preventive health behaviors, screening tests, health care utilization, and medical diagnoses. Analyses were conducted in March 2013. Results Overall, 2.4% (95% CI=2.2, 2.7) of the sample identified as LGB. All sexual minority groups were more likely to be current smokers than their heterosexual peers. Compared with heterosexual women, lesbian women had over 30% decreased odds of having an annual routine physical exam, and bisexual women had over 2.5 times the odds of not seeking medical care owing to cost. Compared with heterosexual men, gay men were less likely to be overweight or obese, and bisexual men were twice as likely to report a lifetime asthma diagnosis. Conclusions This study represents one of the largest samples of LGB adults and finds important health inequalities, including that bisexual women bear particularly high burdens of health disparities. Further work is needed to identify causes of and intervention for these disparities. PMID:24650836

  9. Perspectives of Young Emerging Adults with Serious Mental Health Conditions on Vocational Peer Mentors

    ERIC Educational Resources Information Center

    Klodnick, Vanessa V.; Sabella, Kathryn; Brenner, Christopher J.; Krzos, Izabela M.; Ellison, Marsha L.; Kaiser, Susan M.; Davis, Maryann; Fagan, Marc A.

    2015-01-01

    For early emerging adults with serious mental health conditions, vocational services with peer mentors are a promising adaptation of adult system evidence-based practices. Peer mentors were added to the Individual Placement and Support model of supported employment for 17- to 20-year-olds receiving residential and psychiatric care. To explore the…

  10. Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

    PubMed

    Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

    2014-01-01

    Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare.

  11. Using social media to engage adolescents and young adults with their health

    PubMed Central

    Wong, Charlene A.; Merchant, Raina M.; Moreno, Megan A.

    2015-01-01

    We focus on the potential of social media related to the health of adolescent and young adults, who are nearly ubiquitous social media users but difficult to engage with their health and relatively low healthcare utilizers. Opportunities to better engage adolescents and young adults through social media exist in healthcare delivery, health education and health policy. However, challenges remain for harnessing social media, including making a clear value proposition and developing evidence-based frameworks for measuring the impact of social media on health. PMID:25984444

  12. Legislating for health: locating the evidence.

    PubMed

    Pawson, Ray; Owen, Lesley; Wong, Geoff

    2010-07-01

    This article examines the timorous courtship between public health law and evidence-based policy. Legislation, in the form of direct prescriptions or proscriptions on behaviour, is perhaps the most powerful tool available to the public health policymaker. Increasingly, the same policymakers have striven to ensure that interventions are based soundly on a secure evidence base. The modern mantra is that the policies to follow are the ones that have been demonstrated to work. Legislative interventions, involving trade-offs between public benefit and private interests, present formidable challenges for the evaluator. Systematic reviews of their overall efficacy, the main tool of evidence-based policy, are in their infancy. The article presents a design for such reviews using the example of a forthcoming synthesis on the effectiveness of banning smoking in cars carrying children.

  13. Consumer attitudes towards evidence based mental health services among American mental health consumers.

    PubMed

    Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

    2016-10-01

    The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes.

  14. Consumer attitudes towards evidence based mental health services among American mental health consumers.

    PubMed

    Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

    2016-10-01

    The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. PMID:27291072

  15. A framework for disseminating evidence-based health promotion practices.

    PubMed

    Harris, Jeffrey R; Cheadle, Allen; Hannon, Peggy A; Forehand, Mark; Lichiello, Patricia; Mahoney, Eustacia; Snyder, Susan; Yarrow, Judith

    2012-01-01

    Wider adoption of evidence-based, health promotion practices depends on developing and testing effective dissemination approaches. To assist in developing these approaches, we created a practical framework drawn from the literature on dissemination and our experiences disseminating evidence-based practices. The main elements of our framework are 1) a close partnership between researchers and a disseminating organization that takes ownership of the dissemination process and 2) use of social marketing principles to work closely with potential user organizations. We present 2 examples illustrating the framework: EnhanceFitness, for physical activity among older adults, and American Cancer Society Workplace Solutions, for chronic disease prevention among workers. We also discuss 7 practical roles that researchers play in dissemination and related research: sorting through the evidence, conducting formative research, assessing readiness of user organizations, balancing fidelity and reinvention, monitoring and evaluating, influencing the outer context, and testing dissemination approaches. PMID:22172189

  16. Investing in the health and well-being of young adults.

    PubMed

    Stroud, Clare; Walker, Leslie R; Davis, Maryann; Irwin, Charles E

    2015-02-01

    Contrary to popular perception, young adults-ages approximately 18-26 years-are surprisingly unhealthy. They are less healthy than adolescents, and they also show a worse health profile than those in their late 20s and 30s. The Affordable Care Act provisions to extend coverage for young adults are well known, and some states had already been pursuing similar efforts before the Affordable Care Act was enacted. These initiatives have resulted in important gains in young adults' heath care coverage. However, too little attention has been paid to the care that young adults receive once they are in the system. Given young adults' health problems, this is a critical omission. The Institute of Medicine and National Research Council recently released a report titled Investing in the Health and Well-Being of Young Adults. The report concludes that young adulthood is a critical developmental period and recommends that young adults ages 18-26 years be treated as a distinct subpopulation in policy, planning, programming, and research. The report also recommends action in three priority areas to improve health care for young adults: improving the transition from pediatric to adult medical and behavioral health care, enhancing preventive care for young adults, and developing evidence-based practices.

  17. Health systems integration: state of the evidence

    PubMed Central

    Armitage, Gail D.; Suter, Esther; Oelke, Nelly D.; Adair, Carol E.

    2009-01-01

    Introduction Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration. PMID:19590762

  18. Obesity and health expenditures: evidence from Australia.

    PubMed

    Buchmueller, Thomas C; Johar, Meliyanni

    2015-04-01

    Rising rates of obesity are a public health concern in every industrialized country. This study investigates the relationship between obesity and health care expenditure in Australia, where the rate of obesity has tripled in the last three decades. Now one in four Australians is considered obese, defined as having a body mass index (BMI, kg/m(2)) of 30 or over. The analysis is based on a random sample survey of over 240,000 adults aged 45 and over that is linked at the individual-level to comprehensive administrative health care claims for the period 2006-2009. This sub-population group has an obesity rate that is nearly 30% and is a major consumer of health services. Relative to the average annual health expenditures of those with normal weight, we find that the health expenditures of those with a BMI between 30 and 35 (obese type I) are 19% higher and expenditures of those with BMI greater than 35 (obese type II/III) are 51% higher. We find large and significant differences in all types of care: inpatient, emergency department, outpatient and prescription drugs. The obesity-related health expenditures are higher for obese type I women than men, but in the obese type II/III state, obesity-related expenditures are higher for men. When we stratify further by age groups, we find that obesity has the largest impact among men over age 75 and women aged 60-74 years old. In addition, we find that obesity impacts health expenditures not only through its link to chronic diseases, but also because it increases the cost of recovery from acute health shocks.

  19. Cultural Diversity Among Older Adults: Addressing Health Education

    ERIC Educational Resources Information Center

    Haber, David

    2005-01-01

    The diversity of the older adult population is increasing, and health professionals need to learn new knowledge and skills to improve the adherence of older ethnic clients to their health recommendations. Much of the existing research literature on diversity in gerontology concludes that ethnic older adults are at a health disadvantage. Few if any…

  20. Health Literacy Programs for Older Adults: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Older adults make up the fastest growing age group in North America. This has demanded increased attention in supporting the health and well-being of this population and, in particular, the role of health information in promoting the health and well-being of older adults. Increased availability and accessibility of information as well as a greater…

  1. Gender Differences in Adult Health: An International Comparison.

    ERIC Educational Resources Information Center

    Rahman, Omar; And Others

    1994-01-01

    Used data from United States, Jamaica, Malaysia, and Bangladesh to explore gender differences in adult health. Found that women fared worse than men across variety of self-reported health measures in all four countries. Data from Jamaica indicated that gender disparities in adult health arose early and persisted throughout the life cycle, with…

  2. An examination of electronic health information privacy in older adults.

    PubMed

    Le, Thai; Thompson, Hilaire; Demiris, George

    2013-01-01

    Older adults are the quickest growing demographic group and are key consumers of health services. As the United States health system transitions to electronic health records, it is important to understand older adult perceptions of privacy and security. We performed a secondary analysis of the Health Information National Trends Survey (2012, Cycle 1), to examine differences in perceptions of electronic health information privacy between older adults and the general population. We found differences in the level of importance placed on access to electronic health information (older adults placed greater emphasis on provider as opposed to personal access) and tendency to withhold information out of concerns for privacy and security (older adults were less likely to withhold information). We provide recommendations to alleviate some of these privacy concerns. This may facilitate greater use of electronic health communication between patient and provider, while promoting shared decision making.

  3. The Digital Health Divide: Evaluating Online Health Information Access and Use among Older Adults

    ERIC Educational Resources Information Center

    Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

    2015-01-01

    Objective: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide…

  4. Subjective health literacy and older adults' assessment of direct-to-consumer prescription drug ads.

    PubMed

    An, Soontae; Muturi, Nancy

    2011-01-01

    Older adults are increasingly the intended target of direct-to-consumer (DTC) prescription drug ads, but limited evidence exists as to how they assess the educational value of DTC ads and, more importantly, whether their assessment depends on their level of health literacy. In-person interviews of 170 older adults revealed that those with low subjective health literacy evaluated the educational value of DTC ads significantly lower than did those with high subjective health literacy. The results prompt us to pay more scholarly attention to determining how effectively DTC ads convey useful medical information, particularly to those with limited health literacy.

  5. Autism spectrum disorder in adults: diagnosis, management, and health services development

    PubMed Central

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

  6. Autism spectrum disorder in adults: diagnosis, management, and health services development.

    PubMed

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

  7. Autism spectrum disorder in adults: diagnosis, management, and health services development.

    PubMed

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD.

  8. Parental education and child health: intracountry evidence.

    PubMed

    Cochrane, S H; Leslie, J; O'Hara, D J

    1982-03-01

    This paper examines a wide range of evidence on the relationship between parental education and child health. Ideally, measures of child nutritional status, morbidity and mortality would have been included, but very few studies on morbidity were found which included education. The data reviewed here indicate that maternal education is closely related to child health measured either by nutritional status or by infant and child mortality. The effect of father's education on infant and child mortality appears to be about one half that of mother's education. The exact mechanisms through which education acts to affect child health are unclear. Better nutrition among the children of the more educated has been well-documented here, but it is unclear to what extent these effects result from improved knowledge and to what extent from higher income. The analysis does suggest that income differences cannot explain all the effect or perhaps even as much as half.

  9. Diarrhea - what to ask your health care provider - adult

    MedlinePlus

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health ... medicines, vitamins, herbs, or supplements I take cause diarrhea? Should I stop taking any of them? What ...

  10. Comprehension of Health-Related Written Materials by Older Adults

    ERIC Educational Resources Information Center

    Liu, Chiung-Ju; Kemper, Susan; Bovaird, James A.

    2009-01-01

    This study examined how Flesch Reading Ease and text cohesion affect older adults' comprehension of common health texts. All older adults benefited when high Flesh Reading Ease was combined with high cohesion. Older adults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, older adults…

  11. Adult Learning in Health and Safety: Some Issues and Approaches.

    ERIC Educational Resources Information Center

    O Fathaigh, Mairtin

    This document, which was developed for presentation at a seminar on adult learning and safety, examines approaches to occupational safety and health (OSH) learning/training in the workplace. Section 1 examines selected factors affecting adults' learning in workplace OSH programs. The principal dimensions along which individual adult learners will…

  12. Volunteerism, Health, and Civic Engagement among Older Adults

    ERIC Educational Resources Information Center

    Gottlieb, Benjamin H.; Gillespie, Alayna A.

    2008-01-01

    In North America, 40-50 per cent of older adults are actively involved as formal volunteers in providing diverse health and human services. We review empirical studies concerning older adults' motivations for volunteering, as well as the health and morale benefits they derive from this expression of altruism. Knowledge of the exact nature and…

  13. Treatments for somnambulism in adults: assessing the evidence.

    PubMed

    Harris, Melanie; Grunstein, Ronald R

    2009-08-01

    Somnambulism, or sleepwalking, is a parasomnia of non-rapid eye movement (NREM) sleep where movement behaviours usually confined to wakefulness are displayed during sleep. Generally, if sleepwalking is causing distress or danger in spite of safety measures, medical or psychological treatment is indicated. Clinicians will need to assess the evidence for treatment options. MEDLINE, EMBASE, PsycINFO and the Ovid Evidence-Based Medicine Reviews (EBM) multifile databases were searched. No properly powered rigorous controlled trials were found for treatment of sleepwalking in adults. Seven reports described small trials with some kind of control arm, or retrospective case series which included 30 or more patients. With no high quality evidence to underpin recommendations for treatments of somnambulism, full discussion with patients is advised. Adequately powered, well-designed clinical trials are now needed, and multi-centre collaborations may be required to obtain the sample sizes required.

  14. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  15. Virtual Visits in Home Health Care for Older Adults

    PubMed Central

    Husebø, Anne Marie Lunde

    2014-01-01

    Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home. PMID:25506616

  16. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  17. Transitioning adolescents and young adults with a chronic health condition to adult healthcare - an exemplar program.

    PubMed

    Kaufmann Rauen, Karen; Sawin, Kathleen J; Bartelt, Tera; Waring, William P; Orr, Merle; Corey O'Connor, R

    2013-01-01

    Pediatric specialists have successfully improved the longevity and quality of life of many children with chronic health conditions. As these children reach adolescence and young adulthood, the scope of their concomitant medical problems often include those typically seen in older patients. As a result, these individuals need continuing quality health care in focused adult healthcare facilities. This article describes the effective partnership between pediatric and adult healthcare providers to create and implement an exemplar Spina Bifida Transition Program. The processes, strategies and tools discussed are likely to be useful to other healthcare professionals interested in developing pediatric to adult transition programs for adolescents and young adults with chronic health conditions.

  18. Health benefits of cycle ergometer training for older adults over 70: a review.

    PubMed

    Bouaziz, Walid; Schmitt, Elise; Kaltenbach, Georges; Geny, Bernard; Vogel, Thomas

    2015-01-01

    As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original observational and intervention studies on the relationship between cycle ergometer training and health among older patients over 70. Twenty-five studies examined interventions aimed specifically at promoting cycling for older adults over 70. These studies reported a positive effect on the prevention of cardiovascular disease, and a significant improvement in metabolic responses. Improving functional status, muscle strength and cognitive performance are also well established. Overall, this review demonstrates a positive effect of cycle ergometer training with functional benefits and positive health outcomes for older adults over 70. Based on this evidence, clinicians can now encourage older adults to profit from the health benefits of cycle ergometer training to be able to pursue their daily activities independently.

  19. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  20. One-year routine opportunistic screening for hypertension in formal medical settings and potential improvements in hypertension awareness among older persons in developing countries: evidence from the Study on Global Ageing and Adult Health (SAGE).

    PubMed

    Maurer, Jürgen; Ramos, Alejandra

    2015-02-01

    Hypertension is a leading risk factor in the global disease burden. Limited hypertension awareness is a major determinant of widespread gaps in hypertension treatment and control, especially in developing countries. We analyzed data on persons aged 50 years or older from 6 low- and middle-income countries participating in the first wave (2007-2010) of the World Health Organization's Survey of Global Ageing and Adult Health (SAGE). Our estimates suggest that just 1 year of routine opportunistic hypertension screening during formal visits to medical-care providers could yield significant increases in hypertension awareness among seniors in the developing world. We also show that eliminating missed opportunities for hypertension screening in medical settings would not necessarily exacerbate existing socioeconomic differences in hypertension awareness, despite requiring at least occasional contact with a formal health-care provider for obtaining a hypertension diagnosis. Thus, routine opportunistic screening for hypertension in formal medical settings may provide a simple but reliable way to increase hypertension awareness. Moreover, the proposed approach has the added advantage of leveraging existing resources and infrastructures, as well as facilitating a direct transition from the point of diagnosis to subsequent expert counseling and clinical care for newly identified hypertension patients.

  1. Who needs evidence-based health care?

    PubMed Central

    Tsafrir, J; Grinberg, M

    1998-01-01

    The vast amount of published material in clinical and biomedical sciences, and conflicting results on diagnostic and therapeutic procedures may introduce doubts in decision-making for patient care. Information retrieving skills and the critical appraisal of published literature, together with elaboration of practice guidelines based on epidemiological methodology, form the basis of the trend towards evidence-based health care, which aims to overcome these problems. A survey conducted by questionnaire at the Chaim Sheba Medical Center analyzed which types of information sources are considered most relevant and useful for patient care by a cross-section of physicians with varying degrees of experience. They considered review articles and meta-analyses extremely reliable for information purposes, while for practical patient-care purposes they tended to rely more on the opinions of peers and experts. As the requirements of evidence-based health care may influence the attitudes of clinicians to the published literature and its evaluation, they have implications for medical libraries and information centers. Specifically, information specialists will be called upon more and more to impart information-retrieval and critical appraisal skills to clinicians. The involvement of information specialists in information gathering and selection will provide added value to the expertise and knowledge of in-house experts for decision-making. PMID:9549011

  2. Nutrition: Eating for Better Health. Teacher's Guide. Health Promotion for Adult Literacy Students: An Empowering Approach.

    ERIC Educational Resources Information Center

    Hudson River Center for Program Development, Glenmont, NY.

    This teaching guide is part of a series of materials developed, with input from adult learners, to aid adult literacy teachers in incorporating health education into the curriculum. This guide aims to help teachers to provide adult students with information about good nutritional habits and positive health behaviors that will substantially reduce…

  3. Adolescent exposure to violence and adult physical and mental health problems.

    PubMed

    Franzese, Robert J; Covey, Herbert C; Tucker, Abigail S; McCoy, Leah; Menard, Scott

    2014-12-01

    Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems.

  4. Development of evidence-informed physical activity guidelines for adults with multiple sclerosis.

    PubMed

    Latimer-Cheung, Amy E; Martin Ginis, Kathleen A; Hicks, Audrey L; Motl, Robert W; Pilutti, Lara A; Duggan, Mary; Wheeler, Garry; Persad, Ravin; Smith, Karen M

    2013-09-01

    Most adults with multiple sclerosis (MS) are physically inactive. Physical activity guidelines are an important tool for exercise prescription, promotion, and monitoring. This article describes the application of international standards for guideline development in the creation of evidence-based physical activity guidelines for people with MS. The development process was informed by the Appraisal of Guidelines Research and Evaluation II instrument. The evidence base for the guidelines consisted of a systematic review of research examining the effects of exercise on fitness, fatigue, mobility, and health-related quality of life among people with MS. A multidisciplinary consensus panel deliberated the evidence and generated the guidelines and a preamble. Expert and stakeholder reviews of the materials led to refinement of the wording of both components of the guidelines. The resulting guidelines state that to achieve important fitness benefits, adults with MS who have mild to moderate disability need at least 30 minutes of moderate intensity aerobic activity 2 times per week and strength training exercises for major muscle groups 2 times per week. Meeting these guidelines may also reduce fatigue, improve mobility, and enhance elements of health-related quality of life. People with MS and health professionals are encouraged to adopt these rigorously developed guidelines.

  5. The health status of young adults in the United States.

    PubMed

    Park, M Jane; Paul Mulye, Tina; Adams, Sally H; Brindis, Claire D; Irwin, Charles E

    2006-09-01

    The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

  6. Can universal pre-kindergarten programs improve population health and longevity? Mechanisms, evidence, and policy implications.

    PubMed

    Muennig, Peter

    2015-02-01

    Recent research has found that children who attended pre-kindergarten programs in childhood were more likely to be healthy as adults. One intuitive way of improving population health and longevity may therefore be to invest in pre-kindergarten programs. However, much of the research linking pre-kindergarten programs to health is very recent and has not been synthesized. In this paper, I review the mechanisms linking pre-kindergarten programs in childhood to adult longevity, and the experimental evidence backing up these linkages. I conclude with a critical exploration of whether investments in pre-kindergarten programs could also serve as investments in public health.

  7. Health and Social Care Interventions Which Promote Social Participation for Adults with Learning Disabilities: A Review

    ERIC Educational Resources Information Center

    Howarth, Sharon; Morris, David; Newlin, Meredith; Webber, Martin

    2016-01-01

    People with learning disabilities are among the most socially excluded in society. There is a significant gap in research evidence showing how health and social care workers can intervene to improve the social participation of adults with learning disabilities. A systematic review and modified narrative synthesis was used to appraise the quality…

  8. Mental Health and Substance Use Disorders among Latino and Asian American Lesbian, Gay, and Bisexual Adults

    ERIC Educational Resources Information Center

    Cochran, Susan D.; Mays, Vickie M.; Alegria, Margarita; Ortega, Alexander N.; Takeuchi, David

    2007-01-01

    Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report…

  9. Health effects of protein intake in healthy adults: A systematic literature review

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy adults. The literature search covered the years 2000-2011. Prospective cohort, case-control, and intervention studies were i...

  10. Health Literacy among Adults: A Study from Turkey

    ERIC Educational Resources Information Center

    Ozdemir, H.; Alper, Z.; Uncu, Y.; Bilgel, N.

    2010-01-01

    Patients' health literacy is increasingly recognized as a critical factor affecting health communication and outcomes. We performed this study to assess the levels of health literacy by using Rapid Estimate of Adult Literacy in Medicine (REALM) and Newest Vital Sign (NVS) instruments. Patients (n = 456) at a family medicine clinic completed…

  11. Transitioning Adolescents and Young Adults With Sickle Cell Disease From Pediatric to Adult Health Care: Provider Perspectives.

    PubMed

    Stollon, Natalie B; Paine, Christine W; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Bonafide, Christopher P; Schwartz, Lisa A

    2015-11-01

    The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method. Our results showed that transition success was measured by health care utilization, quality of life, and continuation on a stable disease trajectory. We also found that barriers to transition include negative experiences in the emergency department, sociodemographic factors, and adolescent skills. Facilitators include a positive relationship with the provider, family support, and developmental maturity. Success in SCD transition is primarily determined by the patients' quality of relationships with their parents and providers and their developmental maturity and skills. Understanding these concepts will aid in the development of future evidence-based transition care models.

  12. Transitioning Adolescents and Young Adults With Sickle Cell Disease From Pediatric to Adult Health Care: Provider Perspectives.

    PubMed

    Stollon, Natalie B; Paine, Christine W; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Bonafide, Christopher P; Schwartz, Lisa A

    2015-11-01

    The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method. Our results showed that transition success was measured by health care utilization, quality of life, and continuation on a stable disease trajectory. We also found that barriers to transition include negative experiences in the emergency department, sociodemographic factors, and adolescent skills. Facilitators include a positive relationship with the provider, family support, and developmental maturity. Success in SCD transition is primarily determined by the patients' quality of relationships with their parents and providers and their developmental maturity and skills. Understanding these concepts will aid in the development of future evidence-based transition care models. PMID:26492583

  13. Neighbourhood renewal and health: evidence from a local case study.

    PubMed

    Blackman, T; Harvey, J; Lawrence, M; Simon, A

    2001-06-01

    This article presents findings from a before-and-after study of the effects of neighbourhood renewal on residents' health. Survey data were analysed using multivariate logistic regression. Before the renewal programme, damp and draughts had significant independent effects on respiratory health problems. Draughts and perceived community safety were associated with mental health problems. Children's mental health was associated with parental mental health. Following the renewal work, improvements occurred in both adults' and children's mental health, and smoking declined sharply. Respiratory health did not improve and there was no change in use of health services. Neighbourhood renewal in deprived areas can have an important role in improving community health. PMID:11470223

  14. Evidence for Health I: Producing evidence for improving health and reducing inequities.

    PubMed

    Andermann, Anne; Pang, Tikki; Newton, John N; Davis, Adrian; Panisset, Ulysses

    2016-01-01

    In an ideal world, researchers and decision-makers would be involved from the outset in co-producing evidence, with local health needs assessments informing the research agenda and research evidence informing the actions taken to improve health. The first step in improving the health of individuals and populations is therefore gaining a better understanding of what the main health problems are, and of these, which are the most urgent priorities by using both quantitative data to develop a health portrait and qualitative data to better understand why the local population thinks that addressing certain health challenges should be prioritized in their context. Understanding the causes of these health problems often involves analytical research, such as case-control and cohort studies, or qualitative studies to better understand how more complex exposures lead to specific health problems (e.g. by interviewing local teenagers discovering that watching teachers smoke in the school yard, peer pressure, and media influence smoking initiation among youth). Such research helps to develop a logic model to better map out the proximal and distal causes of poor health and to determine potential pathways for intervening and impacting health outcomes. Rarely is there a single 'cure' or stand-alone intervention, but rather, a continuum of strategies are needed from diagnosis and treatment of patients already affected, to disease prevention, health promotion and addressing the upstream social determinants of health. Research for developing and testing more upstream interventions must often go beyond randomized controlled trials, which are expensive, less amenable to more complex interventions, and can be associated with certain ethical challenges. Indeed, a much neglected area of the research cycle is implementation and evaluation research, which often involves quasi-experimental research study designs as well as qualitative research, to better understand how to derive the greatest

  15. Familism and Health Care Provision to Hispanic Older Adults.

    PubMed

    Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

    2016-01-01

    The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described.

  16. Health-Related Variables and Functional Fitness among Older Adults

    ERIC Educational Resources Information Center

    Wilkin, Linda D.; Haddock, Bryan L.

    2010-01-01

    This study assesses the functional fitness of a convenient sample of older adults (greater than 70 years), to examine correlations between functional fitness and several other health-related variables and to compare with criterion performance data as established by Rikli and Jones (2001). One hundred and seven community-dwelling older adults with…

  17. Mental Health Problems in Adults with Williams Syndrome

    ERIC Educational Resources Information Center

    Stinton, Chris; Elison, Sarah; Howlin, Patricia

    2010-01-01

    Although many researchers have investigated emotional and behavioral difficulties in individuals with Williams syndrome, few have used standardized diagnostic assessments. We examined mental health problems in 92 adults with Williams syndrome using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities--PAS-ADD (Moss,…

  18. Development and pilot-testing of the perceived health Web Site usability questionnaire (PHWSUQ) for older adults.

    PubMed

    Nahm, Eun-Shim; Resnick, Barbara; Mills, Mary Etta

    2006-01-01

    With an increasing number of older adult online users, the Internet has become recognized as an efficient medium to disseminate health information to these individuals. Usability of health Web sites is particularly important for older adults who have unique Web design needs. Although several Web usability questionnaires have been developed for younger adults, there is a lack of such measure for older adults. In this study, based on prior research findings and consultation with usability experts, a 12-item Perceived Health Web Site Usability Questionnaire (PHWSUQ) was developed for older adults. The preliminary reliability and validity of this measure was assessed in a study that tested the usability of three health Web sites employing 10 older adult online users. The findings provided some evidence of internal consistency and construct validity for the PHWSUQ. The major limitation of this study was its small sample size, hence further psychometric testing is needed with larger samples. PMID:17102214

  19. Adult-Infant Ratios in Day Care Centers--What Evidence?

    ERIC Educational Resources Information Center

    Hollomon, John W.

    This paper investigates the evidence for adult-infant ratios in day care centers, finding that current evidence is based largely on the premise that a low number of infants per adult should result in greater interaction between the adults and the infants, and, thereby, better infant care. Support for this premise is derived from three main…

  20. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  1. Gender differences in adult health: an international comparison.

    PubMed

    Rahman, O; Strauss, J; Gertler, P; Ashley, D; Fox, K

    1994-08-01

    This article uses data from the United States, Jamaica, Malaysia, and Bangladesh to explore gender differences in adult health. The results show that women fare worse than men across a variety of self-reported health measures in all four countries studies. These health status disparities between men and women persist even after appropriate corrections are made for the impact of (a) differential mortality selection by gender and (b) sociodemographic factors. Data from Jamaica indicate that gender disparities in adult health arise early and persist throughout the life cycle, with different age profiles for different measures.

  2. Mechanisms by which Childhood Personality Traits Influence Adult Health Status

    PubMed Central

    Hampson, Sarah E.; Goldberg, Lewis R.; Vogt, Thomas M.; Dubanoski, Joan P.

    2008-01-01

    Objective To test a lifespan health-behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. Design The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. Outcome Self-reported health status as a latent construct indicated by general health, functional status, and body mass index. Results Childhood Agreeableness, Conscientiousness, and Intellect/Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. Conclusion The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health-behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health-behavior mechanisms may not provide a complete account of relations between personality and health. PMID:17209705

  3. Making Evidence on Health Policy Issues Accessible to the Media

    PubMed Central

    Roos, Noralou P.; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla

    2012-01-01

    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pieces on current health policy issues in both French and English. We track who follows and uses the EvidenceNetwork.ca website and monitor the impact of our efforts. PMID:23968614

  4. Making evidence on health policy issues accessible to the media.

    PubMed

    Roos, Noralou P; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla

    2012-11-01

    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pieces on current health policy issues in both French and English. We track who follows and uses the EvidenceNetwork.ca website and monitor the impact of our efforts.

  5. Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities

    ERIC Educational Resources Information Center

    Young, Nancy L.; Barden, Wendy S.; Mills, Wendy A.; Burke, Tricia A.; Law, Mary; Boydell, Katherine

    2009-01-01

    Introduction: The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. Methods: We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain…

  6. Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities

    ERIC Educational Resources Information Center

    Gorter, Jan Willem

    2009-01-01

    In their qualitative study, Young and colleagues (2009) found that youth and adults with cerebral palsy (CP), spina bifida, and acquired brain injuries of childhood in the province of Ontario, Canada, perceive or have perceived their transfer from pediatric to adult-oriented health care services as a struggle. Although publications on transition…

  7. Use of technology to enhance mental health for older adults.

    PubMed

    Cangelosi, Pamela R; Sorrell, Jeanne M

    2014-09-01

    Recent research suggests that older adults may gain significant mental health benefits from health resources made available through emerging modern technologies, especially because this population is becoming more Internet savvy. Technology-enhanced interventions for older adults have been shown to be helpful not only for general wellness activities (i.e., exercise), but also to specifically enhance mental health. This article focuses on two types of interventions for mental health: (a) cognitive-behavioral therapy for depression and anxiety and (b) assistive technology for individuals with dementia. Nurses should reevaluate their assumptions that older adults fear technology and explore whether different types of modern technology might be effective in enhancing mental health for these clients.

  8. Are Health Answers Online for Older Adults?

    ERIC Educational Resources Information Center

    Cresci, Mary K.; Jarosz, Patricia A.; Templin, Thomas N.

    2012-01-01

    The Internet has the potential for engaging urban seniors in managing their health. This study examined computer and Internet use among urban seniors and their interest in using the Internet as a health-management tool. Findings indicated that many participants were interested in storing and accessing health-related information using an…

  9. Disclosing personal health information relating to adults who lack capacity.

    PubMed

    Griffith, Richard

    2014-03-01

    The need to share information about patients is vital to effective care and protection, especially where it relates to adults who lack decision-making capacity but it has to be balanced against the right to confidentiality. Like other health professionals, district nurses have a duty to maintain the confidentiality of patient information, and incapable adults have the right to expect their personal health information to be kept private. This right is guaranteed by the common-law duty of confidence, the Data Protection Act 1998 and the NHS Care Record Guarantee and confidentiality policy. This article discusses the district nurse's legal obligations when considering sharing information in relation to an incapable adult

  10. CHANGING HEALTH STATUS AND HEALTH EXPECTANCIES AMONG OLDER ADULTS IN CHINA: GENDER DIFFERENCES FROM 1992 to 2002

    PubMed Central

    Dupre, Matthew E; Warner, David F; Zeng, Yi

    2009-01-01

    Numerous studies document improvements in health status and health expectancies among older adults over time. However, most evidence is from developed nations and gender differences in health trends are often inconsistent. It remains unknown whether changes in health in developing countries resemble Western trends or whether patterns of health improvement are unique to the country’s epidemiologic transition and gender norms. Using two nationally representative samples of non-institutionalized adults in China ages 65 and older, this study investigates gender differences in the improvements in disability, chronic disease prevalence, and self-rated health from 1992 to 2002. Results from multivariate logistic regression models show that all three indicators of health improved over the 10-year period, with the largest improvement in self-rated health. With the exception of disability, the health of women improved more than men. Using Sullivan’s decomposition methods, we also show that active life expectancy, disease-free life expectancy, and healthy life expectancy increased over this decade and were patterned differently according to gender. Overall, the findings demonstrate that China experienced broad health-improvements during its early stages of the epidemiologic transition and that these changes were not uniform by gender. We discuss the public health implications of the findings in the context of China’s rapidly aging population. PMID:19394120

  11. Life in varying environments: experimental evidence for delayed effects of juvenile environment on adult life history.

    PubMed

    Helle, Heikki; Koskela, Esa; Mappes, Tapio

    2012-05-01

    1. The effects of environment experienced during early development on phenotype as an adult has started to gain vast amounts of interest in various taxa. Some evidence on long-term effects of juvenile environment is available, but replicated experimental studies in wild animals are still lacking. 2. Here we report the first replicated experiment in wild mammals which examines the long-term effects of juvenile and adult environments on individual fitness (reproduction, survival and health). The early development of bank vole (Myodes glareolus) individuals took place in either food-supplemented or un-supplemented outdoor enclosures. After the summer, adult individuals were reciprocally changed to either a similar or opposite resource environment to overwinter. 3. Adult environment had an overriding effect on reproductive success of females so that females overwintering in food-supplemented enclosures had a higher probability of breeding and advanced the initiation of breeding. However, the characteristics of their litters were determined by juvenile environment: females initially grown in food-supplemented conditions subsequently produced larger litters with bigger pups and a male-biased sex ratio. 4. In males, individuals growing in un-supplemented conditions had the highest survival irrespective of adult environment during winter, whereas in females, neither the juvenile nor adult environments affected their survival significantly. The physiological condition of voles in spring, as determined by haematological parameters, was also differentially affected by juvenile (plasma proteins and male testosterone) and adult (haematocrit) environments. 5. Our results suggest that (i) life-history trajectories of voles are not strictly specialized to a certain environment and (ii) the plastic life-history responses to present conditions can actually be caused by delayed effects of the juvenile environment. More generally, the results are important for understanding

  12. Rituximab use in adult primary glomerulopathy: where is the evidence?

    PubMed Central

    Mallat, Samir G; Itani, Houssam S; Abou-Mrad, Rana M; Abou Arkoub, Rima; Tanios, Bassem Y

    2016-01-01

    Rituximab is a chimeric anti-CD20 antibody that results in depletion of B-cell lymphocytes. It is currently used in the treatment of a variety of autoimmune diseases, in addition to CD20-positive lymphomas. The use of rituximab in the treatment of the adult primary glomerular diseases has emerged recently, although not yet established as first-line therapy in international guidelines. In patients with steroid-dependent minimal change disease or frequently relapsing disease, and in patients with idiopathic membranous nephropathy (IMN), several retrospective and prospective studies support the use of rituximab to induce remission, whereas in idiopathic focal and segmental glomerulosclerosis (FSGS), the use of rituximab has resulted in variable results. Evidence is still lacking for the use of rituximab in patients with immunoglobulin A nephropathy (IgAN) and idiopathic membranoproliferative glomerulonephritis (MPGN), as only few reports used rituximab in these two entities. Randomized controlled trials (RCTs) are warranted and clearly needed to establish the definitive role of rituximab in the management of steroid-dependent and frequently relapsing minimal change disease, IMN, both as first-line and second-line treatment, and in MPGN. We await the results of an ongoing RCT of rituximab use in IgAN. Although current evidence for the use of rituximab in patients with idiopathic FSGS is poor, more RCTs are needed to clarify its role, if any, in the management of steroid-resistant or steroid-dependent FSGS. PMID:27621641

  13. Rituximab use in adult primary glomerulopathy: where is the evidence?

    PubMed Central

    Mallat, Samir G; Itani, Houssam S; Abou-Mrad, Rana M; Abou Arkoub, Rima; Tanios, Bassem Y

    2016-01-01

    Rituximab is a chimeric anti-CD20 antibody that results in depletion of B-cell lymphocytes. It is currently used in the treatment of a variety of autoimmune diseases, in addition to CD20-positive lymphomas. The use of rituximab in the treatment of the adult primary glomerular diseases has emerged recently, although not yet established as first-line therapy in international guidelines. In patients with steroid-dependent minimal change disease or frequently relapsing disease, and in patients with idiopathic membranous nephropathy (IMN), several retrospective and prospective studies support the use of rituximab to induce remission, whereas in idiopathic focal and segmental glomerulosclerosis (FSGS), the use of rituximab has resulted in variable results. Evidence is still lacking for the use of rituximab in patients with immunoglobulin A nephropathy (IgAN) and idiopathic membranoproliferative glomerulonephritis (MPGN), as only few reports used rituximab in these two entities. Randomized controlled trials (RCTs) are warranted and clearly needed to establish the definitive role of rituximab in the management of steroid-dependent and frequently relapsing minimal change disease, IMN, both as first-line and second-line treatment, and in MPGN. We await the results of an ongoing RCT of rituximab use in IgAN. Although current evidence for the use of rituximab in patients with idiopathic FSGS is poor, more RCTs are needed to clarify its role, if any, in the management of steroid-resistant or steroid-dependent FSGS.

  14. Pathways to Health Risk Exposure in Adult Film Performers

    PubMed Central

    Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  15. Dimensions of self-rated health in older adults

    PubMed Central

    Borim, Flávia Silva Arbex; Neri, Anita Liberalesso; Francisco, Priscila Maria Stolses Bergamo; Barros, Marilisa Berti de Azevedo

    2014-01-01

    OBJECTIVE To analyze the association between negative self-rated health and indicators of health, wellbeing and sociodemographic variables in older adults. METHODS Cross-sectional study that used data from a population-based health survey with a probability cluster sample that was carried out in Campinas, SP, Southeastern Brazil,, in 2008 and 2009. The participants were older adults (≥ 60 years) and the dependent variable was self-rated health, categorized as: excellent, very good, good, bad and very bad. The adjusted prevalence ratios were estimated by means of Poisson multiple regression. RESULTS The highest prevalences of bad/very bad self-rated health were observed in the individuals who never attended school, in those with lower level of schooling, with monthly per capita family income lower than one minimum salary. Individuals who scored five or more in the physical health indicator also had bad self-rated health, as well as those who scored five or more in the Self-Reporting Questionnaire 20 and those who did not refer feeling happiness all the time. CONCLUSIONS The independent effects of material life conditions, physical and mental health and subjective wellbeing, observed in self-rated health, suggest that older adults can benefit by health policies supported by a global and integrative view of old age. PMID:25372161

  16. Health Disparities Among Young Adult Sexual Minorities in the US

    PubMed Central

    Strutz, Kelly L.; Herring, Amy H.; Halpern, Carolyn Tucker

    2014-01-01

    Background Emerging research suggests that young adult sexual minorities (identifying as lesbian, gay, or bisexual or engaging in same-sex attractions or behaviors) experience poorer health than their majority counterparts, but many measures of health inequity remain unexamined in population-based research. Purpose To describe a wide range of health status and healthcare access characteristics of sexual minorities in comparison with those of the majority population in a national sample of U.S. young adults. Methods Binary and multinomial logistic regression analyses of Wave IV data (2008) from the National Longitudinal Study of Adolescent Health (participants aged 24–32 years, n=13,088) were conducted. Health measures were self-rated health; diagnosis of any of several physical or mental illnesses or sexually transmitted infections; measured body mass index; depression classified from self-reported symptoms; use of antidepressant and anxiolytic medication; uninsured; forgone care; and receipt of physical, dental, and psychological services. Analyses were conducted in 2012–2013. Results Sexual minority women had elevated odds of most adverse health conditions and lower odds of receiving a physical or dental examination. Sexual minority men had elevated odds of fewer adverse health conditions. Conclusions Young adult sexual minorities are at higher risk of poor physical and mental health. The results highlight the multidimensionality of sexual minority status and respond to calls for greater understanding of the health of this population. PMID:25241194

  17. Health and Access to Care among Employed and Unemployed Adults: United States, 2009-2010

    MedlinePlus

    ... 2010 were more likely to have fair or poor health than employed adults across all categories of ... adults aged 18–64 years had fair or poor health compared with 5.3% of employed adults ( ...

  18. Mental health system historians: adults with schizophrenia describe changes in community mental health care over time.

    PubMed

    Stein, Catherine H; Leith, Jaclyn E; Osborn, Lawrence A; Greenberg, Sarah; Petrowski, Catherine E; Jesse, Samantha; Kraus, Shane W; May, Michael C

    2015-03-01

    This qualitative study examined changes in community mental health care as described by adults diagnosed with schizophrenia with long-term involvement in the mental health system to situate their experiences within the context of mental health reform movements in the United States. A sample of 14 adults with schizophrenia who had been consumers of mental health services from 12 to 40 years completed interviews about their hospital and outpatient experiences over time and factors that contributed most to their mental health. Overall, adults noted gradual changes in mental health care over time that included higher quality of care, more humane treatment, increased partnership with providers, shorter hospital stays, and better conditions in inpatient settings. Regardless of the mental health reform era in which they were hospitalized, participants described negative hospitalization experiences resulting in considerable personal distress, powerlessness, and trauma. Adults with less than 27 years involvement in the system reported relationships with friends and family as most important to their mental health, while adults with more than 27 years involvement reported mental health services and relationships with professionals as the most important factors in their mental health. The sample did not differ in self-reported use of services during their initial and most recent hospitalization experiences, but differences were found in participants' reported use of outpatient services over time. Findings underscore the importance of the lived experience of adults with schizophrenia in grounding current discourse on mental health care reform.

  19. Child Health and Young Adult Outcomes

    ERIC Educational Resources Information Center

    Currie, Janet; Stabile, Mark; Manivong, Phongsack; Roos, Leslie L.

    2010-01-01

    Research has shown a strong connection between birth weight and future outcomes. We ask how health problems after birth affect outcomes using data from public health insurance records for 50,000 children born between 1979 and 1987 in the Canadian province of Manitoba. We compare children to siblings born an average of three years apart. We find…

  20. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  1. Do oral health conditions adversely impact young adults?

    PubMed

    Carvalho, Joana C; Mestrinho, Heliana D; Stevens, Sophie; van Wijk, Arjen J

    2015-01-01

    This study assessed the extent to which clinically measured oral health conditions, adjusted for sociodemographic and oral health behavior determinants, impact adversely on the oral health-related quality of life (OHRQoL) in a sample of Belgian young adults. The null hypothesis was that, among young adults, the oral health conditions would have no impact on their quality of life. The participants were 611 new patients aged 16-32 years seeking consultation at the Saint-Luc University Hospital in Brussels in 2010-2011. The patients (56.0% female) were examined for their oral health conditions and answered a validated questionnaire about sociodemographic and oral health behavior determinants in addition to questions about their OHRQoL. The abridged Oral Health Impact Profile-14 was used to assess the OHRQoL. Interexaminer reliability for caries was 0.86 (95% CI 0.84-0.89, nonweighted κ). The outcome was a high score on the OHRQoL (median split). Hierarchical logistic regression analysis showed that young adults with clinical absolute D1MFS scores between 9 and 16 (OR = 2.14, p = 0.031) and between 17 and 24 (OR = 3.10, p = 0.003) were significantly more likely to report a high impact on their quality of life than those with lower scores. Also, periodontal conditions compromised significantly (OR = 1.79, p = 0.011) the quality of life of young adults. In conclusion, this study identified oral health conditions with a significant adverse effect on the OHRQoL of young adults. However, the prevalence of young adults reporting impacts on at least 1 performance affected fairly often or very often was limited to 18.7% of the sample. PMID:25832802

  2. [Health among teenagers and young adults].

    PubMed

    Hernán, Mariano; Fernández, Alberto; Ramos, María

    2004-05-01

    The objective of this article is to analyse different behaviours and opinions about health and health determinants of Spanish young people by age, sex, and place of residence. They have a broad concept of their health, tending to identify health as physical activity and healthy eating behaviours. Most of them (91%) declared enjoying good or very good health. Depending upon the age, sex, and place of residence 10 to 20% could have mental health problems. Young people consider illegal drugs as their main health problem. Boys have higher prevalence of overweight and obesity than girls. However, girls reported more often than boys that they perceived themselves as obese. Practice of sporting activities is influenced by family and friends. The proportion of young people that practice sport declines after the age of 15, both in boys and girls. Young people perceive cannabis consumption as normal, but remain ambivalent towards other illegal drugs and asked for more information about drugs. We found a high proportion of young people declaring that they not would try illegal drugs. In the urban settings, smoking is more common among girls than among boys, but the contrary happens in rural areas. Most of them know that smoking is harmful for health, and among those who are smokers, 20 to 40% declared that they want to stop smoking. They consider that health care services are useless for preventing health problems. It is necessary to improve behaviours involving safety, such as use of seat belts and helmets, mainly in rural areas. Young people associated traffic accidents with driving conditions rather than with identification of risk.

  3. Mental Health and High-Cost Health Care Utilization: New Evidence from Axis II Disorders

    PubMed Central

    Maclean, Johanna Catherine; Xu, Haiyong; French, Michael T; Ettner, Susan L

    2014-01-01

    Objective To analyze the associations between Axis II (A2) disorders and two measures of health care utilization with relatively high cost: emergency department (ED) episodes and hospital admissions. Data Source/Study Setting Wave I (2001/2002) and Wave II (2004/2005) of the National Longitudinal Survey on Alcohol and Related Conditions (NESARC). Study Design A national probability sample of adults. Gender-stratified regression analysis adjusted for a range of covariates associated with health care utilization. Data Collection The target population of the NESARC is the civilian noninstitutionalized population aged 18 years and older residing in the United States. The cumulative survey response rate is 70.2 percent with a response rate of 81 percent (N = 43,093) in Wave I and 86.7 percent (N = 34,653) in Wave II. Principal Findings Both men and women with A2 disorders are at elevated risk for ED episodes and hospital admissions. Associations are robust after adjusting for a rich set of confounding factors, including Axis I (clinical) psychiatric disorders. We find evidence of a dose–response relationship, while antisocial and borderline disorders exhibit the strongest associations with both measures of health care utilization. Conclusions This study provides the first published estimates of the associations between A2 disorders and high-cost health care utilization in a large, nationally representative survey. The findings underscore the potential implications of these disorders on health care expenditures. PMID:24117342

  4. Variations in Health Insurance Coverage for Rural and Urban Nonelderly Adult Residents of Florida, Indiana, and Kansas

    ERIC Educational Resources Information Center

    Mei Hu, Hsou; Duncan, R. Paul; Radcliff, Tiffany A.; Porter, Colleen K.; Hall, Allyson G.

    2006-01-01

    Context: Evidence exists for differences in health insurance coverage among states, but less is known about variations across different kinds of communities within states. Purpose: This article assesses the role of residential setting (metropolitan county, rural adjacent, and rural nonadjacent) in health insurance coverage for adult residents,…

  5. Adult T-Cell Leukemia: A Review of Epidemiological Evidence

    PubMed Central

    Iwanaga, Masako; Watanabe, Toshiki; Yamaguchi, Kazunari

    2012-01-01

    Adult T-cell leukemia (ATL) is an aggressive T-cell malignancy caused by human T-cell leukemia virus type I (HTLV-1) infection and often occurs in HTLV-1-endemic areas, such as southwestern Japan, the Caribbean islands, Central and South America, Intertropical Africa, and Middle East. To date, many epidemiological studies have been conducted to investigate the incidence of ATL among general population or HTLV-1 carriers and to identify a variety of laboratory, molecular, and host-specific markers to be possible predictive factors for developing ATL because HTLV-1 infection alone is not sufficient to develop ATL. This literature review focuses on the epidemiology of ATL and the risk factors for the development of ATL from HTLV-1 carriers, while keeping information on the epidemiology of HTLV-1 to a minimum. The main lines of epidemiological evidence are: (1) ATL occurs mostly in adults, at least 20–30 years after the HTLV-1 infection, (2) age at onset differs across geographic areas: the average age in the Central and South America (around 40 years old) is younger than that in Japan (around 60 years old), (3) ATL occurs in those infected in childhood, but seldom occurs in those infected in adulthood, (4) male carriers have about a three- to fivefold higher risk of developing ATL than female, (5) the estimated lifetime risk of developing ATL in HTLV-1 carriers is 6–7% for men and 2–3% for women in Japan, (6) a low anti-Tax reactivity, a high soluble interleukin-2 receptor level, a high anti-HTLV-1 titer, and high levels of circulating abnormal lymphocytes and white blood cell count are accepted risk factors for the development of ATL, and (7) a higher proviral load (more than 4 copies/100 peripheral blood mononuclear cells) is an independent risk factor for progression of ATL. Nevertheless, the current epidemiological evidence is insufficient to fully understand the oncogenesis of ATL. Further well-designed epidemiological studies are needed. PMID

  6. What about the mental health of adults?

    PubMed

    Maeda, Masaharu; Yabe, Hirooki; Yasumura, Seiji; Abe, Masafumi

    2014-01-01

    Mental health problems such as post-traumatic stress disorder (PTSD) and depression have surfaced and are affecting many residents in Fukushima prefecture as a result of the Great East Japan Earthquake and tsunami and the subsequent nuclear disaster. It has also been reported that such mental health problems appeared and persisted after large-scale nuclear accidents in the past, such as the Chernobyl and Three Mile Island accidents, widely affecting the disaster victims. PMID:25747615

  7. Health-related social control within older adults' relationships.

    PubMed

    Tucker, Joan S

    2002-09-01

    This study examined the size and composition of older adults' social control networks and investigated behavioral and affective responses to the experience of social control. Social control in the health domain refers to regulatory attempts by others (direct), and feelings of obligation and responsibility to others (indirect), that encourage engagement in a healthy lifestyle. Participants were 181 adults aged 65-80 years who completed a mail survey. On average, older adults reported having 3-5 people in their social network who exerted a positive influence on their health behaviors, with the size and composition of this network varying somewhat by marital and parental statuses. Social control was associated with both positive and negative behavioral and affective responses, depending on both the type of social control (direct vs indirect) and level of relationship satisfaction. Results indicate the importance of better understanding the conditions under which social relationships have beneficial versus detrimental effects on the well-being of older adults.

  8. Health-related social control within older adults' relationships.

    PubMed

    Tucker, Joan S

    2002-09-01

    This study examined the size and composition of older adults' social control networks and investigated behavioral and affective responses to the experience of social control. Social control in the health domain refers to regulatory attempts by others (direct), and feelings of obligation and responsibility to others (indirect), that encourage engagement in a healthy lifestyle. Participants were 181 adults aged 65-80 years who completed a mail survey. On average, older adults reported having 3-5 people in their social network who exerted a positive influence on their health behaviors, with the size and composition of this network varying somewhat by marital and parental statuses. Social control was associated with both positive and negative behavioral and affective responses, depending on both the type of social control (direct vs indirect) and level of relationship satisfaction. Results indicate the importance of better understanding the conditions under which social relationships have beneficial versus detrimental effects on the well-being of older adults. PMID:12198097

  9. Health equity in humanitarian emergencies: a role for evidence aid.

    PubMed

    Pottie, Kevin

    2015-02-01

    Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India.

  10. Adolescence as a gateway to adult health outcomes.

    PubMed

    Raphael, Dennis

    2013-06-01

    Adolescence has long been regarded as a transition from childhood to adulthood. More recently it is become a concern of those wishing to avoid adverse health outcomes during middle and late adulthood. Most of this effort has been focused on behavioural risk factors such as tobacco and excessive alcohol use, physical exercise habits, dietary habits, as well as sexual and injury-related behaviours. The concern is that these habits are established during adolescence, continue into adulthood, and come to constitute ongoing risk factors for adverse health outcomes during middle and late adulthood. There is good reason to criticize this approach. These behaviours are themselves shaped by adolescents' living and working conditions and even then constitute a small proportion of the variance predicting adverse health outcomes during adulthood. More complex models of how adolescence serves as a gateway to adult health outcomes are presented. These are the socio-environmental, public policy, and political economy approaches. The argument is made that adolescence is a period during which public policy plays an especially important role in predicting future health outcomes. Yet, these public policies influence health all across the life span with adolescence providing only one of many important periods during which public policy shapes health prospects during middle and later adulthood. Ultimately one should consider a range of approaches ranging from the behavioural to the political to examine how adolescence serves as a gateway towards future adult prospects. An Adolescent Gateway Towards Adult Health Model is provided to assist in this process.

  11. Loneliness and Health in Older Adults: A Mini-Review and Synthesis.

    PubMed

    Ong, Anthony D; Uchino, Bert N; Wethington, Elaine

    2016-01-01

    Increasing evidence suggests that perceived social isolation or loneliness is a major risk factor for physical and mental illness in later life. This review assesses the status of research on loneliness and health in older adults. Key concepts and definitions of loneliness are identified, and the prevalence, correlates, and health effects of loneliness in older individuals are reviewed. Theoretical mechanisms that underlie the association between loneliness and health are also described, and illustrative studies examining these mechanisms are summarized. Intervention approaches to reduce loneliness in old age are highlighted, and priority recommendations for future research are presented. PMID:26539997

  12. Health effects of urea formaldehyde foam insulation: evidence of causation.

    PubMed Central

    Norman, G R; Newhouse, M T

    1986-01-01

    Studies of health effects of urea formaldehyde foam insulation (UFFI) were critically reviewed by means of accepted rules for evidence of causation. Three categories of health effects were examined: reported symptoms, primarily of the upper respiratory tract, lower respiratory tract disease and cancer. Most of the studies purporting to demonstrate health effects of UFFI failed to meet minimal methodologic criteria for evidence of causation. Evidence from the adequate studies provides little support for the hypothesis of a causative role of UFFI in health problems. PMID:3512066

  13. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided. PMID:27179348

  14. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided.

  15. Evidence Valued and Used by Health Promotion Practitioners

    ERIC Educational Resources Information Center

    Li, V.; Carter, S. M.; Rychetnik, L.

    2015-01-01

    The use of evidence has become a foundational part of health promotion practice. Although there is a general consensus that adopting an evidence-based approach is necessary for practice, disagreement remains about what types of evidence practitioners should use to guide their work. An empirical understanding of how practitioners conceptualize and…

  16. Early-life conditions and older adult health in low- and middle-income countries: a review.

    PubMed

    McEniry, M

    2013-02-01

    Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health.

  17. The Effect of Parental Divorce on the Health of Adult Children1

    PubMed Central

    Thomas, Jason R.; Högnäs, Robin S.

    2015-01-01

    Decades of research have produced evidence that parental divorce is negatively associated with offspring outcomes from early childhood, through adolescence, and into the adult years. This study adds to the literature on the effects of parental divorce by examining how the timing of a parental divorce influences the total effect on adult health. Furthermore, we look at how this long-term effect of parental divorce depends on mediators such as the family’s socioeconomic status, parental involvement, cognitive test scores, behavioural problems, smoking, and the offspring’s own experience with divorce. The analyses use data from the National Child Development Study, which includes nine waves of data beginning at birth in 1958 and continuing through age 50. Results from a structural equation model suggest that a parental divorce experienced before age 7 does influence adult health by operating primarily through family socioeconomic status and smoking in adulthood. PMID:26594245

  18. NIHSeniorHealth: a free tool for online health information for older adults.

    PubMed

    Linares, Brenda M

    2013-01-01

    NIHSeniorHealth is a free, consumer health website that covers health topics affecting older adults. The website was created and is maintained by the National Library of Medicine (NLM) and features more than 55 health topics and nearly 150 videos. The easy-to-use navigational and visual tools create a user-friendly experience for older adults, their families, and caregivers who seek senior-specific information on the web. This column will include an overview of the website, a simple search, and a review of the features of NIHSeniorHealth. PMID:23607468

  19. Corruption in the health care system: the circumstantial evidence.

    PubMed

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

  20. Tools to support evidence-informed public health decision making

    PubMed Central

    2014-01-01

    Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing

  1. The Healthy Ageing Model: health behaviour change for older adults.

    PubMed

    Potempa, Kathleen M; Butterworth, Susan W; Flaherty-Robb, Marna K; Gaynor, William L

    2010-01-01

    Proposed is a model of primary care for older adults with chronic health conditions that focuses on active engagement in health care. The Healthy Ageing Model is anchored in established theory on motivation and health behaviour change. The model draws on empirical and applied clinical underpinnings in such diverse areas as health promotion and education, treatment of addictions or obesity, management of chronic diseases, goal-setting, and coaching techniques. The conceptual foundation for the Healthy Ageing Model is described first, followed by a brief description of the key characteristics of the model. In conclusion, suggestions are offered for the clinical application and for further developing the model.

  2. Evidence, Ethics, and Values: A Framework for Health Promotion

    PubMed Central

    Rychetnik, Lucie; Dietetics, PGradDip; Lloyd, Beverley; Kerridge, Ian H.; Baur, Louise; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

    2011-01-01

    We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession. PMID:21233436

  3. Evidence, ethics, and values: a framework for health promotion.

    PubMed

    Carter, Stacy M; Rychetnik, Lucie; Lloyd, Beverley; Kerridge, Ian H; Baur, Louise; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

    2011-03-01

    We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession.

  4. National Dissemination of Multiple Evidence-Based Disease Prevention Programs: Reach to Vulnerable Older Adults

    PubMed Central

    Towne, Samuel D.; Smith, Matthew Lee; Ahn, SangNam; Altpeter, Mary; Belza, Basia; Kulinski, Kristie Patton; Ory, Marcia G.

    2015-01-01

    Older adults, who are racial/ethnic minorities, report multiple chronic conditions, reside in medically underserved rural areas, or have low incomes carry a high burden of chronic illness but traditionally lack access to disease prevention programs. The Chronic Disease Self-Management Program (CDSMP), A Matter of Balance/Volunteer Lay Leader (AMOB/VLL), and EnhanceFitness (EF) are widely disseminated evidence-based programs (EBP), but the extent to which they are simultaneously delivered in communities to reach vulnerable populations has not been documented. We conducted cross-sectional analyses of three EBP disseminated within 27 states throughout the United States (US) (2006–2009) as part of the Administration on Aging (AoA) Evidence-Based Disease and Disability Prevention Initiative, which received co-funding from the Atlantic Philanthropies. This study measures the extent to which CDSMP, AMOB/VLL, and EF reached vulnerable older adults. It also examines characteristics of communities offering one of these programs relative to those simultaneously offering two or all three programs. Minority/ethnic participants represented 38% for CDSMP, 26% for AMOB/VLL, and 43% for EF. Rural participation was 18% for CDSMP, 17% for AMOB/VLL, and 25% for EF. Those with comorbidities included 63.2% for CDSMP, 58.7% for AMOB/VLL, and 63.6% for EF while approximately one-quarter of participants had incomes under $15,000 for all programs. Rural areas and health professional shortage areas (HPSA) tended to deliver fewer EBP relative to urban areas and non-HPSA. These EBP attract diverse older adult participants. Findings highlight the capability of communities to serve potentially vulnerable older adults by offering multiple EBP. Because each program addresses unique issues facing this older population, further research is needed to better understand how communities can introduce, embed, and sustain multiple EBP to ensure widespread access and utilization, especially to

  5. Health literacy and nutrition behaviors among low-income adults.

    PubMed

    Speirs, Katherine E; Messina, Lauren A; Munger, Ashley L; Grutzmacher, Stephanie K

    2012-08-01

    The purpose of this study was to explore the relationship between health literacy and nutrition behaviors using a low-income sample. Face-to-face surveys at 11 social services offices generated a convenience sample of 154 Supplemental Nutrition Assistance Program (SNAP)-eligible adults. We assessed health literacy, fruit and vegetable intake, food label use, consumption of healthy foods, and demographic characteristics. Thirty seven percent of the sample had adequate health literacy as measured by the Newest Vital Sign (NVS). Race and parenthood were significantly related to health literacy scores. Adequate health literacy, as measured by the NVS, was associated with frying chicken less often and eating the peels of fresh fruit more often. The findings suggest that health practitioners should ensure nutrition-related messages are accessible to all of their clients, especially those with the lowest health literacy levels. PMID:24212161

  6. Chinese older adults' Internet use for health information.

    PubMed

    Wong, Carmen K M; Yeung, Dannii Y; Ho, Henry C Y; Tse, Kin-Po; Lam, Chun-Yiu

    2014-04-01

    Technological advancement benefits Internet users with the convenience of social connection and information search. This study aimed at investigating the predictors of Internet use to search for online health information among Chinese older adults. The Technology Acceptance Model (TAM) was applied to examine the predictiveness of perceived ease of use, perceived usefulness, and attitudes toward Internet use on behavioral intention to search for health information online. Ninety-eight Chinese older adults were recruited from an academic institute for older people and community centers. Frequency of Internet use and physical and psychological health were also assessed. Results showed that perceived ease of use and attitudes significantly predicted behavioral intention of Internet use. The potential influences of traditional Chinese values and beliefs in health were also discussed. PMID:24717738

  7. Chinese older adults' Internet use for health information.

    PubMed

    Wong, Carmen K M; Yeung, Dannii Y; Ho, Henry C Y; Tse, Kin-Po; Lam, Chun-Yiu

    2014-04-01

    Technological advancement benefits Internet users with the convenience of social connection and information search. This study aimed at investigating the predictors of Internet use to search for online health information among Chinese older adults. The Technology Acceptance Model (TAM) was applied to examine the predictiveness of perceived ease of use, perceived usefulness, and attitudes toward Internet use on behavioral intention to search for health information online. Ninety-eight Chinese older adults were recruited from an academic institute for older people and community centers. Frequency of Internet use and physical and psychological health were also assessed. Results showed that perceived ease of use and attitudes significantly predicted behavioral intention of Internet use. The potential influences of traditional Chinese values and beliefs in health were also discussed.

  8. The psychosocial work environment and evidence utilization by health professionals.

    PubMed

    Lavoie-Tremblay, Mélanie; Sounan, Charles; Lavigne, Geneviève L; Bonin, Jean-Pierre; Lesage, Alain D; Denis, Pascale L; Renaud, Martine; Maisy, Nadège; Farand, Lambert; Racine, Hélène

    2008-12-01

    The purpose of this study was to investigate the relationships between dimensions of the psychosocial work environment and health professionals' use of evidence in their practice. A correlational descriptive design was developed. Health professionals working in mental health units at 2 hospitals were asked to complete a questionnaire about their perceptions of the psychosocial work environment and their use of evidence. Correlations and regression analyses were performed. Use of evidence was found to be correlated with social support and decision latitude. Results of multiple regression analyses found perceived social support (beta = .27, p < .01) and perceived decision latitude (beta = .25,p < .01) to be significant predictors of the use of evidence. The authors conclude that good social support and decision latitude among interprofessional groups may promote use of evidence by health professions in their practice.

  9. Resilience to Adult Psychopathology Following Childhood Maltreatment: Evidence from a Community Sample

    ERIC Educational Resources Information Center

    Collishaw, Stephan; Pickles, Andrew; Messer, Julie; Rutter, Michael; Shearer, Christina; Maughan, Barbara

    2007-01-01

    Objective: Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. Methods:…

  10. Health financing in Malawi: Evidence from National Health Accounts

    PubMed Central

    2010-01-01

    Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens. PMID:21062503

  11. Effectiveness of Health System Services and Programs for Youth to Adult Transitions in Mental Health Care: A Systematic Review of Academic Literature.

    PubMed

    Embrett, Mark G; Randall, Glen E; Longo, Christopher J; Nguyen, Tram; Mulvale, Gillian

    2016-03-01

    Youth shifting to adult mental health services often report experiencing frustrations with accessing care that adequately replaces the youth services they had received. This systematic review assesses the peer reviewed evidence on services/programs aimed at addressing youth to adult transitions in mental health services. Findings suggest little data exists on the effectiveness of transition services/programs. While the available evidence supports meetings between youth and youth caseworkers prior to transitions occurring, it also verifies that this is not common practice. Other identified barriers to effective transitions were categorized as logistical (ineffective system communication), organizational (negative incentives), and related to clinical governance.

  12. [Social health care for older adults in Peru].

    PubMed

    Casas-Vasquez, Paola; Apaza-Pino, Rossana; Del Canto Y Dorador, Juan; Chávez-Jimeno, Helver

    2016-06-01

    Demographic and epidemiological changes have led to restructuring of the local and global health systems, changes that focus on broader coverage in which importance is given to an individual's physical well-being as well as social welfare in an effort to ensure healthy aging. In this review, the current social health care approach is analyzed from the different institutions that care for older populations and the changes that have resulted from boarding and caring for older adults. PMID:27656937

  13. Empirical evidence of senescence in adult damselflies (Odonata: Zygoptera).

    PubMed

    Sherratt, T N; Laird, R A; Hassall, C; Lowe, C D; Harvey, I F; Watts, P C; Cordero-Rivera, A; Thompson, D J

    2010-09-01

    1. Age-dependent increases in mortality have been documented in a variety of species of insect under laboratory conditions. However, while strong statistical evidence has been presented for senescence in vertebrate populations in the wild, we know little about the rate and shape of senescence in wild populations of insects. 2. Odonates (damselflies and dragonflies) provide excellent candidate species for evaluating demographic senescence as they are large enough to be marked individually and they are easily re-sighted without recapture. The prevailing opinion - based entirely on qualitative examination of the declines in log numbers alive with time since marking - is that odonates exhibit age-independent daily survivorship. 3. Here, we examine mark-recapture data on the Azure Damselfly Coenagrion puella over two consecutive seasons. For the first time, we evaluate and compare the fit of quantitative models that not only account for weather-dependent daily variation in daily re-sighting rates, but also age-dependent variation in daily survivorship. 4. Models with age-dependent declines in daily survivorship provide a more parsimonious explanation for the data than similar models without these age-dependent effects. In general, models in which mortality increases in an exponential (Gompertz) fashion explain the mark-recapture sequences more efficiently than a range of alternative models, including those in which mortality increases as a power function (Weibull) or reaches a plateau (logistic). These results are indicative of a general senescent decline in physiological functioning, which is particularly marked after 15 days as a mature adult. 5. Weather (temperature, sun and precipitation) and initial mite load influenced the probability of daily re-sighting. Weather and mite load also influenced daily survivorship, but their effects differed between seasons. 6. Overall, fitting models with age as an explicit covariate demonstrates that odonates do indeed senesce

  14. Hmong adults self-rated oral health: a pilot study.

    PubMed

    Okunseri, Christopher; Yang, Marcie; Gonzalez, Cesar; LeMay, Warren; Iacopino, Anthony M

    2008-02-01

    Since 1975, the Hmong refugee population in the U.S. has increased over 200%. However, little is known about their dental needs or self-rated oral health (SROH). The study aims were to: (1) describe the SROH, self-rated general health (SRGH), and use of dental/physician services; and (2) identify the factors associated with SROH among Hmong adults. A cross-sectional study design with locating sampling methodology was used. Oral health questionnaire was administered to assess SROH and SRGH, past dental and physician visits, and language preference. One hundred twenty adults aged 18-50+ were recruited and 118 had useable information. Of these, 49% rated their oral health as poor/fair and 30% rated their general health as poor/fair. Thirty-nine percent reported that they did not have a regular source of dental care, 46% rated their access to dental care as poor/fair, 43% visited a dentist and 66% visited a physician within the past 12 months. Bivariate analyses demonstrated that access to dental care, past dental visits, age and SRGH were significantly associated with SROH (P < 0.05). Multivariate analyses demonstrated a strong association between access to dental care and good/excellent SROH. About half of Hmong adults rated their oral health and access to dental care as poor. Dental insurance, access to dental care, past preventive dental/physician visits and SRGH were associated with SROH.

  15. Conditional health threats: health beliefs, decisions, and behaviors among adults.

    PubMed

    Ronis, D L

    1992-01-01

    We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed. PMID:1582381

  16. THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR*

    PubMed Central

    Finkelstein, Amy; Taubman, Sarah; Wright, Bill; Bernstein, Mira; Gruber, Jonathan; Newhouse, Joseph P.; Allen, Heidi; Baicker, Katherine

    2012-01-01

    In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group. PMID:23293397

  17. 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

  18. 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.

  19. Disclosing personal health information relating to adults who lack capacity.

    PubMed

    Griffith, Richard

    2014-03-01

    The need to share information about patients is vital to effective care and protection, especially where it relates to adults who lack decision-making capacity but it has to be balanced against the right to confidentiality. Like other health professionals, district nurses have a duty to maintain the confidentiality of patient information, and incapable adults have the right to expect their personal health information to be kept private. This right is guaranteed by the common-law duty of confidence, the Data Protection Act 1998 and the NHS Care Record Guarantee and confidentiality policy. This article discusses the district nurse's legal obligations when considering sharing information in relation to an incapable adult PMID:24897837

  20. Lifestyle and Health Behaviours of Adults with an Intellectual Disability

    ERIC Educational Resources Information Center

    McGuire, B. E.; Daly, P.; Smyth, F.

    2007-01-01

    Background: There is currently no published research in Ireland on the health behaviours of adults with an intellectual disability (ID). With an increasing age profile and similar patterns of morbidity to the general population, the ID population would benefit from baseline data from which to establish risk factors. Methods: A questionnaire survey…

  1. Early-Childhood Poverty and Adult Attainment, Behavior, and Health

    ERIC Educational Resources Information Center

    Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel

    2010-01-01

    This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic…

  2. The Health Status of Adults on the Autism Spectrum

    ERIC Educational Resources Information Center

    Croen, Lisa A.; Zerbo, Ousseny; Qian, Yinge; Massolo, Maria L.; Rich, Steve; Sidney, Stephen; Kripke, Clarissa

    2015-01-01

    Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured…

  3. Diabetes Literacy: Health and Adult Literacy Practitioners in Partnership

    ERIC Educational Resources Information Center

    Black, Stephen

    2012-01-01

    This paper describes pedagogy in a series of "diabetes literacy" programs involving culturally and linguistically diverse (CALD) communities. The programs were jointly delivered in local community sites, including neighbourhood centres and public housing halls, by qualified nutritionists from a public health service and adult literacy teachers…

  4. The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483

    ERIC Educational Resources Information Center

    Kutner, Mark; Greenburg, Elizabeth; Jin, Ying; Paulsen, Christine

    2006-01-01

    Understanding the health literacy of America's adults is important because so many aspects of finding health care and health information, and maintaining health, depend on understanding written information. Many reports have suggested that low health literacy is associated with poor communication between patients and health care providers and with…

  5. Global health: the importance of evidence-based medicine

    PubMed Central

    2013-01-01

    Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes. PMID:24228722

  6. Global health: the importance of evidence-based medicine.

    PubMed

    Birbeck, Gretchen L; Wiysonge, Charles S; Mills, Edward J; Frenk, Julio J; Zhou, Xiao-Nong; Jha, Prabhat

    2013-01-01

    Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes. PMID:24228722

  7. The neurologist's role in supporting transition to adult health care: A consensus statement.

    PubMed

    Brown, Lawrence W; Camfield, Peter; Capers, Melissa; Cascino, Greg; Ciccarelli, Mary; de Gusmao, Claudio M; Downs, Stephen M; Majnemer, Annette; Miller, Amy Brin; SanInocencio, Christina; Schultz, Rebecca; Tilton, Anne; Winokur, Annick; Zupanc, Mary

    2016-08-23

    The child neurologist has a critical role in planning and coordinating the successful transition from the pediatric to adult health care system for youth with neurologic conditions. Leadership in appropriately planning a youth's transition and in care coordination among health care, educational, vocational, and community services providers may assist in preventing gaps in care, delayed entry into the adult care system, and/or health crises for their adolescent patients. Youth whose neurologic conditions result in cognitive or physical disability and their families may need additional support during this transition, given the legal and financial considerations that may be required. Eight common principles that define the child neurologist's role in a successful transition process have been outlined by a multidisciplinary panel convened by the Child Neurology Foundation are introduced and described. The authors of this consensus statement recognize the current paucity of evidence for successful transition models and outline areas for future consideration. PMID:27466477

  8. Health promotion overview: evidence-based strategies for occupational health nursing practice.

    PubMed

    Dombrowski, Jill J; Snelling, Anastasia M; Kalicki, Michelle

    2014-08-01

    Health promotion practice has evolved over the past four decades in response to the rising rates of chronic disease. The focus of health promotion is attaining wellness by managing modifiable risk factors, such as smoking, diet, or physical activity. Occupational health nurses are often asked to conduct worksite health promotion programs for individuals or groups, yet may be unfamiliar with evidence-based strategies. Occupational health nurses should lead interprofessional groups in designing and implementing worksite health promotion programs. This article introduces occupational health nurses to health promotion concepts and discusses evidence-based theories and planning models that can be easily introduced into practice.

  9. Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services

    PubMed Central

    Richards, Chesley L.; Shenson, Douglas

    2012-01-01

    Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505

  10. Potential for intensive volunteering to promote the health of older adults in fair health.

    PubMed

    Barron, Jeremy S; Tan, Erwin J; Yu, Qilu; Song, Meilin; McGill, Sylvia; Fried, Linda P

    2009-07-01

    Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served > or =15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported "good" and 12% "fair" or "poor" health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.

  11. Evidence-based psychological interventions for adult survivors of torture and trauma: a 30-year review.

    PubMed

    McFarlane, Colleen A; Kaplan, Ida

    2012-07-01

    In this paper we review research evidence on psychosocial interventions for adult survivors of torture and trauma. We identified 40 studies from 1980 to 2010 that investigated interventions for adult survivors of torture and trauma. Population subtypes include resettled refugees, asylum seekers, displaced persons, and persons resident in their country of origin. Settings include specialized services for torture and trauma, specialized tertiary referral clinics, community settings, university settings, as well as psychiatric and multidisciplinary mental health services. Interventions were delivered as individual or group treatments and lasted from a single session to 19 years duration. The studies employed randomized controlled trials, nonrandomized comparison studies and single cohort follow-up studies. In all, 36 of the 40 studies (90%) demonstrated significant improvements on at least one outcome indicator after an intervention. Most studies (60%) included participants who had high levels of posttraumatic stress symptomatology. Improvements in symptoms of posttraumatic stress, depression, anxiety, and somatic symptoms were found following a range of interventions. Little evidence was available with regard to the effect on treatment outcomes of the amount, type, or length of treatment, the influence of patient characteristics, maintenance of treatment effects, and treatment outcomes other than psychiatric symptomatology. The review highlights the need for more carefully designed research that addresses the shortcomings of current studies and that integrates the experience of expert practitioners.

  12. The impact of social support networks on adult health.

    PubMed

    Asher, C C

    1984-04-01

    Knowledge of the determinants of adult health offers important implications for planning policy that may affect the overall level of health and thus the costs of health care. One potentially important factor that has not been incorporated in previous research is the amount of information individuals have concerning health care or methods of preventive care. This study uses the number of social support networks and the degree of contact individuals have with them as an alternative measure of information. This measure of information is incorporated into an economic model based partly on Becker's Human Capital framework. Social support networks are found to have virtually no impact in explaining health outcomes for illnesses over which the individual has little control. However, when a broader range of illnesses is considered, social support networks do play a role in producing better health.

  13. Social capital, economics, and health: new evidence.

    PubMed

    Scheffler, Richard M; Brown, Timothy T

    2008-10-01

    In introducing this Special Issue on Social Capital and Health, this article tracks the popularization of the term and sheds light on the controversy surrounding the term and its definitions. It sets out four mechanisms that link social capital with health: making information available to community members, impacting social norms, enhancing the health care services and their accessibility in a community, and offering psychosocial support networks. Approaches to the measurement of social capital include the Social Capital Community Benchmark Survey (SCCBS) developed by Robert Putnam, and the Petris Social Capital Index (PSCI), which looks at community voluntary organizations using public data available for the entire United States. The article defines community social capital (CSC) as the extent and density of trust, cooperation, and associational links and activity within a given population. Four articles on CSC are introduced in two categories: those that address behaviors -- particularly utilization of health services and use of tobacco, alcohol, and drugs; and those that look at links between social capital and physical or mental health. Policy implications include: funding and/or tax subsidies that would support the creation of social capital; laws and regulations; and generation of enthusiasm among communities and leaders to develop social capital. The next steps in the research programme are to continue testing the mechanisms; to look for natural experiments; and to find better public policies to foster social capital.

  14. Health, functioning and disability in older adults – current status and future implications

    PubMed Central

    Chatterji, Somnath; Byles, Julie; Cutler, David; Seeman, Teresa; Verdes, Emese

    2016-01-01

    Summary Aging is a dynamic process with trends in health status of older adults varying over time due to a range of factors. We examined reported trends in morbidity and mortality among older adults over the past two decades in order to determine patterns of ageing across the world. We found some evidence for compression of morbidity, i.e., less amount of time spent in worse health, when: a) studies were of a good quality based on evaluation criteria scores; b) a disability- or impairment-related measure of morbidity was used; c) studies were longitudinal or; d) studies were conducted in the United States and some other high income countries. Many studies reported evidence to the contrary, i.e., for an expansion of morbidity but with different methods these are not directly comparable. Expansion of morbidity was more common when trends in chronic disease prevalence were studied. Our secondary analysis of data from longitudinal ageing surveys present a similar picture. However, there are considerable variations across countries in patterns of limitations in functioning and within countries over time with no discernible explanations. Data from low income countries is very sparse and efforts to collect information on the health of older adults in less-developed regions of the world is urgently required. Studies focussing on refining measurement with a core set of domains of functioning and studying the impacts of these evolving patterns on the health care system and their economic implications are needed. PMID:25468158

  15. A Qualitative Study of Multiple Health Behaviors in Adults with Multiple Sclerosis

    PubMed Central

    Golding, Meghan

    2016-01-01

    Background: Evidence regarding inflammatory pathways, elevated cardiovascular risk, and negative effects of secondary conditions on disability progression provide a strong rationale for promoting multiple health behaviors in adults with multiple sclerosis (MS). However, many unanswered questions remain about the best ways to design multiple behavior change interventions for adults with MS. We sought to identify facilitators and barriers to engaging in multiple health behaviors (physical activity, nutrition, and sleep) and to gain further insights into how to develop multiple health behavior change interventions based on preferences of adults with MS. Methods: Focus groups and one-on-one interviews were conducted with 17 participants with MS. Results: Five qualitative themes were identified as either facilitating or hindering engagement in multiple health behaviors: 1) roles, priorities, and preferences; 2) sense of duty; 3) the fatigue and mobility problem; 4) taking control; and 5) resiliency. Participants identified advantages and disadvantages of delivery formats (eg, face-to-face group vs. telephone), frequency of contacts, and intervention strategies based on their individual circumstances and obligations. Participants felt that discussing the benefits of engaging in multiple health behaviors, developing action plans, accommodating preferences, and addressing health problems would be helpful strategies to include in a multiple behavior change intervention. Conclusions: These findings indicate that there may be common facilitators and barriers that can be targeted to promote multiple behavior changes. Future research should explore the best ways to tailor multiple behavior change interventions to preferences, symptoms, psychological traits, and social cognitions. PMID:27803640

  16. Toward Achieving Health Equity: Emerging Evidence and Program Practice.

    PubMed

    Dicent Taillepierre, Julio C; Liburd, Leandris; OʼConnor, Ann; Valentine, Jo; Bouye, Karen; McCree, Donna Hubbard; Chapel, Thomas; Hahn, Robert

    2016-01-01

    Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, health equity, and social determinants of health. PMID:26599028

  17. Abortion and Mental Health: Evaluating the Evidence

    ERIC Educational Resources Information Center

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  18. Evidence-based medicine in health care reform.

    PubMed

    Hughes, Gordon B

    2011-10-01

    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care.

  19. Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash

    PubMed Central

    Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor

    2005-01-01

    OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to

  20. Impact of the Oregon Health Plan on Access and Satisfaction of Adults with Low-income

    PubMed Central

    Mitchell, Janet B; Haber, Susan G; Khatutsky, Galina; Donoghue, Suzanne

    2002-01-01

    Objective To evaluate the effects of the Oregon Health Plan (OHP) on beneficiary access and satisfaction. Data Sources Telephone survey of nondisabled adults in 1998. Study Design Two groups of adults were surveyed: OHP enrollees and Food Stamp recipients not enrolled in OHP. The Food Stamp sample included both privately insured and uninsured recipients. This allowed us to disentangle the insurance effects of OHP from other effects such as its reliance on managed care and the priority list. OHP and Food Stamp adults were compared along the following measures: usual source of care, utilization of health care services, unmet need, and satisfaction with care. Data Collection The survey was conducted by telephone, using computer-assisted telephone interviewing techniques. Principal Findings Much of OHP's impact has been realized by its extension of health insurance coverage to Oregon's low-income residents. The availability of health insurance significantly increased the utilization of many health care services and reduced unmet need for care. OHP was associated within a higher percentage of enrollees having a usual source of care and higher rates of Pap test screening among women compared with Food Stamp recipients. OHP enrollees also reported significantly higher use of dental care and prescription drugs; use we attribute to the expanded benefit package under the priority list. At the same time, OHP enrollees reported a greater unmet need for prescription drugs. Drug treatment for below-the-line conditions was one reason for this unmet need, but often the specific drug simply was not in the plan's formulary. OHP enrollees were as satisfied with their health care as those Food Stamp recipients with private health insurance. Conclusions Despite the negative publicity prior to its implementation, there is no evidence that “rationing” under OHP's priority list has substantially restricted access to needed services. OHP adults appear to enjoy access equal to or better

  1. Low health literacy and older adults: meanings, problems, and recommendations for social work.

    PubMed

    Findley, Aaron

    2015-01-01

    Many older adults struggle to manage their health care problems. Low health literacy exacerbates such struggles and contributes to a variety of adverse health behaviors and outcomes. Addressing how health literacy impinges on the lives of older adults is a neglected area of social work practice and knowledge. This article explores seven areas: defining health literacy, the problem and prevalence of low health literacy among older adults, health inequalities and health literacy, a brief literature review, neglected issues in the literature, suggestions for macro and micro social work interventions to improve health literacy for older adult populations, and conclusion.

  2. Perceptions of Body Habitus and Cultural Health Among Hispanic Adults.

    PubMed

    Franzen-Castle, Lisa; Aguirre, Trina

    2015-08-01

    To investigate whether perceptions of health and health outcomes are impacted by acculturation level, nativity, and years in the United States (US) for Hispanic adults in the Nebraska Panhandle. Focus groups (n = 10), surveys (demographics, body image silhouettes, and acculturation), and anthropometric measurements were conducted. US-born (n = 36) had higher household incomes, education level, and acculturation scores compared to foreign-born (n = 23). Years in the US was positively correlated with acculturation and anthropometrics. No significant differences were detected between groups for rating infant and adolescent health, indicating mid-sized infants were considered healthy and heavier adolescents had increased health risks. However, qualitative data revealed misconceptions regarding obesity and chronic disease and a cultural preference for heavier infants. Despite differences between groups, qualitative data indicated cultural perceptions of health still persist. Data indicates a need for behavioral modification using culturally appropriate methods and for collecting quantitative and qualitative data.

  3. Social Relationships, Leisure Activity, and Health in Older Adults

    PubMed Central

    Chang, Po-Ju; Wray, Linda; Lin, Yeqiang

    2015-01-01

    Objective Although the link between enhanced social relationships and better health has generally been well established, few studies have examined the role of leisure activity in this link. This study examined how leisure influences the link between social relationships and health in older age. Methods Using data from the 2006 and 2010 waves of the nationally representative U.S. Health and Retirement Study and structural equation modelling analyses, we examined data on 2,965 older participants to determine if leisure activities mediated the link between social relationships and health in 2010, controlling for race, education level, and health in 2006. Results The results demonstrated that leisure activities mediate the link between social relationships and health in these age groups. Perceptions of positive social relationships were associated with greater involvement in leisure activities, and greater involvement in leisure activities was associated with better health in older age. Discussion & Conclusions The contribution of leisure to health in these age groups is receiving increasing attention, and the results of this study add to the literature on this topic, by identifying the mediating effect of leisure activity on the link between social relationships and health. Future studies aimed at increasing leisure activity may contribute to improved health outcomes in older adults. PMID:24884905

  4. Crisis-induced depression, physical activity and dietary intake among young adults: evidence from the 9/11 terrorist attacks.

    PubMed

    Wang, Yang; Yang, Muzhe

    2013-03-01

    Using data from the National Longitudinal Study of Adolescent Health, we provide evidence that young adults respond to crisis-induced depression by exercising less and having breakfast less often. Exogenous variation in the crisis-induced depression is obtained through a unique event in our sample period - the 9/11 terrorist attacks. We compare those who were interviewed just before and just after 9/11 and find a significant and sharp increase in the symptoms of depression. We also provide evidence that this increase is not a September effect, but an effect of the external traumatic event.

  5. Review of the Evidence for Oral Health Promotion Effectiveness

    ERIC Educational Resources Information Center

    Satur, Julie G.; Gussy, Mark G.; Morgan, Michael V.; Calache, Hanny; Wright, Clive

    2010-01-01

    Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects, quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of…

  6. Does Income Inequality Harm Health? New Cross-National Evidence

    ERIC Educational Resources Information Center

    Beckfield, Jason

    2004-01-01

    The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the…

  7. Measuring health-related quality of life in adults with chronic conditions in primary care settings

    PubMed Central

    Hand, Carri

    2016-01-01

    Abstract Objective To describe health-related quality of life (HRQOL) conceptual frameworks, critically review 3 commonly used HRQOL scales relevant to adults with chronic conditions in primary care settings, and make recommendations for using HRQOL scales in primary care practice. Data sources Information was accessed regarding HRQOL conceptual and theoretical approaches. A comprehensive search strategy identified 3 commonly used scales that met the review criteria and evidence regarding use of the scales in adults with chronic conditions in community settings. Scale selection Scales were selected if they were designed for clinical use; were easy to administer; were generic and broad in content areas; and contained some individualized items. Scales were critiqued according to content development, theoretical basis, psychometric properties, scoring, feasibility, the concepts being measured, and the number of items that measured an individualized concept. Synthesis Early HRQOL approaches focused on health and functional status while recent approaches incorporate individualized concepts such as the person’s own values and the environment. The abbreviated World Health Organization Quality of Life Scale (WHOQOL-BREF), the 36-Item Short Form Health Survey (SF-36), and the Duke Health Profile were critiqued. All address physical, mental, and social domains, while the WHOQOL-BREF also addresses environment. Psychometric evidence supports use of the SF-36 and WHOQOL-BREF with this population. The SF-36 has the most evidence of responsiveness but has some floor and ceiling effects, while the WHOQOL-BREF does not appear to have floor or ceiling effects but has limited evidence of responsiveness. The WHOQOL-BREF has the highest proportion of individualized items. Conclusion Measurement of HRQOL in adults with chronic conditions can support patient management and contribute to primary care service evaluation. Scales that are based on a broad definition of health and that

  8. [Health hazards in childhood obesity: Evidence based on Chinese population].

    PubMed

    Ye, Peiyu; Chen, Fangfang; Mi, Jie

    2016-01-01

    Childhood obesity has become a critical issue in public health area. We searched Wanfang Data and PubMed databases for published studies on health hazards of childhood obesity in China during 2000-2015. From the evidence of the Chinese population studies, we know childhood obesity brings not only cardiovascular, endocrine and respiratory system health hazards, but also other health hazards to liver, moving skeleton, psychological behavior and cognition intelligence, et al. Only to understand the health hazards of childhood obesity, and put the key preventable period of chronic diseases forward to childhood, can pandemic of chronic diseases be controlled from the sources.

  9. Health Status and Health Risks of the "Hidden Majority" of Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Emerson, Eric

    2011-01-01

    Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco…

  10. Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults

    MedlinePlus

    ... 08, 2015* Combinations of types of mental health services received in the past year among young adults Combinations of types of mental health services received in the past year among young adults ...

  11. A knowledge management tool for public health: health-evidence.ca

    PubMed Central

    2010-01-01

    Background The ultimate goal of knowledge translation and exchange (KTE) activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM) is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present) of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are among the largest groups of

  12. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review

    PubMed Central

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Introduction There is a critical need for public health interventions to support the independence of older adults as the world’s population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 1998–2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263

  13. Associations of grandparental schooling with adult grandchildren's health status, smoking, and obesity.

    PubMed

    Lê-Scherban, Félice; Diez Roux, Ana V; Li, Yun; Morgenstern, Hal

    2014-09-01

    Despite persistent schooling-related health disparities in the United States, little is known about the multigenerational effects of schooling on adult health. As expected lifespans increase, direct influences of grandparental schooling on grandchildren's health may become increasingly important. We used multigenerational data spanning 41 years from a national sample of US families to investigate associations of grandparents' educational attainment with global health status, smoking, and obesity in their grandchildren who were aged 25-55 years in 2009. We estimated total effects of grandparental schooling and, by using marginal structural models, we estimated controlled direct effects that were independent of parents' and participants' schooling. Among whites, lower levels of grandparental schooling were monotonically associated with poor health status, current smoking, and obesity in adult grandchildren. There was also evidence suggesting direct effects, which was stronger for poor health status among participants whose highest-educated grandparent lived in the same state. Among blacks, the only association suggesting a total or direct effect of grandparental schooling was for smoking. Despite the relative imprecision of our estimates and possible residual bias, these results suggest that higher levels of grandparental schooling may benefit the health of grandchildren in adulthood, especially among whites. Furthermore, part of those apparent effects, especially for obesity, may not be mediated by parents' and grandchildren's schooling.

  14. Discrimination and racial disparities in health: evidence and needed research

    PubMed Central

    Mohammed, Selina A.

    2010-01-01

    This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health. PMID:19030981

  15. Discrimination and racial disparities in health: evidence and needed research.

    PubMed

    Williams, David R; Mohammed, Selina A

    2009-02-01

    This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

  16. Health-related variables and functional fitness among older adults.

    PubMed

    Wilkin, Linda D; Haddock, Bryan L

    2010-01-01

    This study assesses the functional fitness of a convenient sample of older adults (>70 years), to examine correlations between functional fitness and several other health-related variables and to compare with criterion performance data as established by Rikli and Jones (2001). One hundred and seven community-dwelling older adults with an average age of 78.36 +/- 5.60 years performed the Senior Fitness Test (SFT) and responded to several health-related questionnaires. The SFT scores were similar to the scores in the low-active group data published by Rikli and Jones (1999b). There was a strong correlation between the 30-second arm curl and the 2-minute step-in-place (r = .54, p < .01). More than one-half of the participants performed in the normal range or above normal range, according to the criterion performance data. This demonstrates a high level of functional fitness.

  17. Child physical abuse and adult mental health: a national study.

    PubMed

    Sugaya, Luisa; Hasin, Deborah S; Olfson, Mark; Lin, Keng-Han; Grant, Bridget F; Blanco, Carlos

    2012-08-01

    This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000-2001 and 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16-2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention.

  18. [Dietary phytoestrogen and its potential benefits in adult human health].

    PubMed

    Garrido, Argelia; de la Maza, María Pía; Valladares, Luis

    2003-11-01

    Human diet contains a series of bioactive vegetal compounds that can improve human health. Among these, there has been a special interest for phytoestrogens. This article reviews the evidence about the potential benefits of phytoestrogens for human health. Forty eight manuscripts were selected for their study design and relevance to human health. The cell growth inhibitory effects of phytoestrogens and their implication in breast cancer are reviewed. Also the effects of these compounds on serum lipid levels and the effectiveness of a phytoestrogen derivate, ipriflavone, on the prevention of osteoporosis are analyzed. Although these compounds have a great potential for improving health, there is still not enough evidence to recommend the routine use of phytoestrogens.

  19. Is Social Capital a Determinant of Oral Health among Older Adults? Findings from the English Longitudinal Study of Ageing.

    PubMed

    Rouxel, Patrick; Tsakos, Georgios; Demakakos, Panayotes; Zaninotto, Paola; Chandola, Tarani; Watt, Richard Geddie

    2015-01-01

    There are a number of studies linking social capital to oral health among older adults, although the evidence base mainly relies on cross-sectional study designs. The possibility of reverse causality is seldom discussed, even though oral health problems could potentially lead to lower social participation. Furthermore, few studies clearly distinguish between the effects of different dimensions of social capital on oral health. The objective of the study was to examine the longitudinal associations between individual social capital and oral health among older adults. We analyzed longitudinal data from the 3rd and 5th waves of the English Longitudinal Study of Ageing (ELSA). Structural social capital was operationalized using measures of social participation, and volunteering. Number of close ties and perceived emotional support comprised the functional dimension of social capital. Oral health measures were having no natural teeth (edentate vs. dentate), self-rated oral health and oral health-related quality of life. Time-lag and autoregressive models were used to explore the longitudinal associations between social capital and oral health. We imputed all missing data, using multivariate imputation by chained equations. We found evidence of bi-directional longitudinal associations between self-rated oral health, volunteering and functional social capital. Functional social capital was a strong predictor of change in oral health-related quality of life - the adjusted odds ratio of reporting poor oral health-related quality of life was 1.75 (1.33-2.30) for older adults with low vs. high social support. However in the reverse direction, poor oral health-related quality of life was not associated with changes in social capital. This suggests that oral health may not be a determinant of social capital. In conclusion, social capital may be a determinant of subjective oral health among older adults rather than edentulousness, despite many cross-sectional studies on the

  20. The Nurse-Family Partnership: evidence-based public health in response to child maltreatment.

    PubMed

    Tonmyr, L

    2015-01-01

    Too many Canadian children are exposed to child maltreatment-neglect, emotional maltreatment, exposure to intimate partner violence, and physical and sexual abuse. Retrospective data indicates that 32% of Canadian adults have experienced childhood abuse. There is evidence that child maltreatment is associated with a wide array of negative health consequences across the life span. These consequences expand across physical, mental, developmental and social domains to include suicide, substance abuse, anxiety, depression and physical health problems. Experts have asked for coordinated national leadership in protecting children from maltreatment. They also envision broadening the mandate for injury prevention to include not only physical injury but also emotional injury and harm.

  1. The Nurse-Family Partnership: evidence-based public health in response to child maltreatment.

    PubMed

    Tonmyr, L

    2015-01-01

    Too many Canadian children are exposed to child maltreatment-neglect, emotional maltreatment, exposure to intimate partner violence, and physical and sexual abuse. Retrospective data indicates that 32% of Canadian adults have experienced childhood abuse. There is evidence that child maltreatment is associated with a wide array of negative health consequences across the life span. These consequences expand across physical, mental, developmental and social domains to include suicide, substance abuse, anxiety, depression and physical health problems. Experts have asked for coordinated national leadership in protecting children from maltreatment. They also envision broadening the mandate for injury prevention to include not only physical injury but also emotional injury and harm. PMID:26605562

  2. Incentivizing health care behaviors in emerging adults: a systematic review

    PubMed Central

    Yu, Catherine H; Guarna, Giuliana; Tsao, Pamela; Jesuthasan, Jude R; Lau, Adrian NC; Siddiqi, Ferhan S; Gilmour, Julie Anne; Ladha, Danyal; Halapy, Henry; Advani, Andrew

    2016-01-01

    Purpose For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases. Methods The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years) with chronic medical conditions including addictions, were included. Results A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated. Conclusion While the majority of studies reported positive outcomes, these studies focused on promoting the cessation of adverse behaviors rather than promoting positive behaviors. In addition, conclusions were limited by the high risk of bias present in the majority of studies, as well as lack of follow-up after the incentive period. Whether behavioral incentives facilitate the adoption of positive health choices in this population remains to be determined. PMID:27069356

  3. Speech Perception Abilities of Adults with Dyslexia: Is There Any Evidence for a True Deficit?

    ERIC Educational Resources Information Center

    Hazan, Valerie; Messaoud-Galusi, Souhila; Rosen, Stuart; Nouwens, Suzan; Shakespeare, Bethanie

    2009-01-01

    Purpose: This study investigated whether adults with dyslexia show evidence of a consistent speech perception deficit by testing phoneme categorization and word perception in noise. Method: Seventeen adults with dyslexia and 20 average readers underwent a test battery including standardized reading, language and phonological awareness tests, and…

  4. Home Health Care With Telemonitoring Improves Health Status for Older Adults with Heart Failure

    PubMed Central

    Madigan, Elizabeth; Schmotzer, Brian J.; Struk, Cynthia J.; DiCarlo, Christina M.; Kikano, George; Piña, Ileana L.; Boxer, Rebecca S.

    2014-01-01

    Home telemonitoring can augment home health care services during a patient's transition from hospital to home. Home health care agencies commonly use telemonitors for patients with heart failure although studies have shown mixed results in the use of telemonitors to reduce rehospitalizations. This randomized trial investigated if older patients with heart failure admitted to home health care following a hospitalization would have a reduction in rehospitalizations and improved health status if they received telemonitoring. Patients were followed up to 180 days post-discharge from home health care services. Results showed no difference in the time to rehospitalizations or emergency visits between those who received a telemonitoring vs. usual care. Older heart failure patients who received telemonitoring had better health status by home health care discharge than those who received usual care. Therefore for older adults with heart failure telemonitoring may be important adjunct to home health care services to improve health status. PMID:23438509

  5. Investigating the myth of the "model minority": a participatory community health assessment of Chinese and Vietnamese adults.

    PubMed

    Tendulkar, Shalini Ahuja; Hamilton, Renée Cammarata; Chu, Chieh; Arsenault, Lisa; Duffy, Kevin; Huynh, Van; Hung, Mei; Lee, Eric; Jane, Shwuling; Friedman, Elisa

    2012-10-01

    Despite the persistent belief that Asians are the "model minority" there is accumulating evidence of health concerns within Asian subgroups. In this study, we implemented a cross-sectional participatory community health assessment in an urban city in Massachusetts, to understand differences and similarities in demographics, health and healthcare access in Chinese and Vietnamese adults. We gathered qualitative data from community stakeholders to inform the development of a community health assessment tool. The tool elicited information on healthcare access, health status, behavioral health and chronic disease history and treatment. Healthcare access issues and poor health status, particularly among Chinese participants and mental health symptomotology in both groups were areas of concern. These findings revealed important health concerns in two Asian ethnic groups. Studies are needed to better understand these concerns and inform programs and policies to improve health outcomes in these Asian ethnic groups.

  6. Type of insurance and use of preventive health services among older adults in Mexico

    PubMed Central

    Rivera-Hernandez, Maricruz; Galarraga, Omar

    2016-01-01

    Objectives The main purpose of this paper was to assess the differences between Seguro Popular (SP) and employer-based health insurance in the use of preventive services, including screening tests for diabetes, cholesterol, hypertension, cervical cancer and prostate cancer among older adults at more than a decade of health care reform in Mexico. Methods Logistic regression models were used with data from the Mexican Health and Nutrition Survey 2012. Results After adjusting for other factors influencing preventive service utilization, SP enrollees were more likely to use screening tests for diabetes, cholesterol, hypertension and cervical cancer than the uninsured; however, those in employment-based and private insurances had higher odds of using preventive care for most of these services, except Pap smears. Discussion Despite all the evidence that suggests that Seguro Popular has increased access to health insurance for the poor, inequalities in healthcare access still exist in Mexico. PMID:25804897

  7. Phonologic Processing in Adults Who Stutter: Electrophysiological and Behavioral Evidence.

    ERIC Educational Resources Information Center

    Weber-Fox, Christine; Spencer, Rebecca M.C.; Spruill, John E., III; Smith, Anne

    2004-01-01

    Event-related brain potentials (ERPs), judgment accuracy, and reaction times (RTs) were obtained for 11 adults who stutter and 11 normally fluent speakers as they performed a rhyme judgment task of visually presented word pairs. Half of the word pairs (i.e., prime and target) were phonologically and orthographically congruent across words. That…

  8. Rural-to-Urban Migration and Changes in Health Among Young Adults in Thailand.

    PubMed

    Nauman, Elizabeth; VanLandingham, Mark; Anglewicz, Philip; Patthavanit, Umaporn; Punpuing, Sureeporn

    2015-02-01

    We investigate the impacts of rural-to-urban migration on the health of young adult migrants. A key methodological challenge involves the potentially confounding effects of selection on the relationship between migration and health. Our study addresses this challenge in two ways. To control for potential effects of prior health status on post-migration health outcomes, we employ a longitudinal approach. To control for static unobserved characteristics that can affect migration propensity as well as health outcomes, we use fixed-effects analyses. Data were collected in 2005 and 2007 for a cohort of young adults in rural Kanchanaburi province, western Thailand. The migrant sample includes individuals who subsequently moved to urban destinations where they were reinterviewed in 2007. Return migrants were interviewed in rural Kanchanaburi in both years but moved to an urban area and returned in the meantime. A rural comparison group comprises respondents who remained in the origin villages. An urban comparison sample includes longer-term residents of the urban destination communities. Physical and mental health measures are based on the SF-36 health survey. Findings support the "healthy migrant hypothesis." Migrants are physically healthier than their nonmigrant counterparts both before and after moving to the city. We did not find an effect of migration on physical health. Rural-to-urban migrants who stayed at destination experienced a significant improvement in mental health status. Fixed-effects analyses indicate that rural-to-urban migration positively affects mental health. Return migrants do not fare as well as migrants who stayed at destination on both physical and mental health status--evidence of selective return migration. PMID:25604845

  9. Rural-to-Urban Migration and Changes in Health Among Young Adults in Thailand.

    PubMed

    Nauman, Elizabeth; VanLandingham, Mark; Anglewicz, Philip; Patthavanit, Umaporn; Punpuing, Sureeporn

    2015-02-01

    We investigate the impacts of rural-to-urban migration on the health of young adult migrants. A key methodological challenge involves the potentially confounding effects of selection on the relationship between migration and health. Our study addresses this challenge in two ways. To control for potential effects of prior health status on post-migration health outcomes, we employ a longitudinal approach. To control for static unobserved characteristics that can affect migration propensity as well as health outcomes, we use fixed-effects analyses. Data were collected in 2005 and 2007 for a cohort of young adults in rural Kanchanaburi province, western Thailand. The migrant sample includes individuals who subsequently moved to urban destinations where they were reinterviewed in 2007. Return migrants were interviewed in rural Kanchanaburi in both years but moved to an urban area and returned in the meantime. A rural comparison group comprises respondents who remained in the origin villages. An urban comparison sample includes longer-term residents of the urban destination communities. Physical and mental health measures are based on the SF-36 health survey. Findings support the "healthy migrant hypothesis." Migrants are physically healthier than their nonmigrant counterparts both before and after moving to the city. We did not find an effect of migration on physical health. Rural-to-urban migrants who stayed at destination experienced a significant improvement in mental health status. Fixed-effects analyses indicate that rural-to-urban migration positively affects mental health. Return migrants do not fare as well as migrants who stayed at destination on both physical and mental health status--evidence of selective return migration.

  10. Rural-to-Urban Migration and Changes in Health Among Young Adults in Thailand

    PubMed Central

    Nauman, Elizabeth; VanLandingham, Mark; Anglewicz, Philip; Patthavanit, Umaporn; Punpuing, Sureeporn

    2015-01-01

    We investigate the impacts of rural-to-urban migration on the health of young adult migrants. A key methodological challenge involves the potentially confounding effects of selection on the relationship between migration and health. Our study addresses this challenge in two ways. To control for potential effects of prior health status on post-migration health outcomes, we employ a longitudinal approach. To control for static unobserved characteristics that can affect migration propensity as well as health outcomes, we use fixed-effects analyses. Data were collected in 2005 and 2007 for a cohort of young adults in rural Kanchanaburi province, western Thailand. The migrant sample includes individuals who subsequently moved to urban destinations where they were reinterviewed in 2007. Return migrants were interviewed in rural Kanchanaburi in both years but moved to an urban area and returned in the meantime. A rural comparison group comprises respondents who remained in the origin villages. An urban comparison sample includes longer-term residents of the urban destination communities. Physical and mental health measures are based on the SF-36 health survey. Findings support the “healthy migrant hypothesis.” Migrants are physically healthier than their nonmigrant counterparts both before and after moving to the city. We did not find an effect of migration on physical health. Rural-to-urban migrants who stayed at destination experienced a significant improvement in mental health status. Fixed-effects analyses indicate that rural-to-urban migration positively affects mental health. Return migrants do not fare as well as migrants who stayed at destination on both physical and mental health status—evidence of selective return migration. PMID:25604845

  11. Health Care Resources: You Are the Consumer. Teacher's Guide. Health Promotion for Adult Literacy Students: An Empowering Approach.

    ERIC Educational Resources Information Center

    Hudson River Center for Program Development, Glenmont, NY.

    This teaching guide is part of a series of materials developed, with input from adult learners, to aid adult literacy teachers in incorporating health education into the curriculum. This guide aims to help teachers to provide adult students with information about the variety of health care resources available, accessing these resources, and…

  12. The Relationship between Age, Gender, Historical Change, and Adults' Perceptions of Mental Health and Mental Health Services

    ERIC Educational Resources Information Center

    Currin, James B.; Hayslip, Bert, Jr.; Temple, Jeff R.

    2011-01-01

    The purpose of this study was to explore the impact of age, historical change, and gender on perceptions of mental health and mental health services. Using multidimensional measures to assess such perceptions among older adults (1977, 1991, 2000), and younger adults (1991, 2000), we expected that older adults would have less positive mental health…

  13. Marriage and Health in the Transition to Adulthood: Evidence for African Americans in Add Health.

    PubMed

    Harris, Kathleen Mullan; Lee, Hedwig; Deleone, Felicia Yang

    2010-08-01

    This paper examines the relationship between early marriage (before age 26), cohabitation, and health for African Americans and whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). We examine three categories of health outcomes relevant to young adulthood: physical health, mental health, and health risk behaviors. Lagged dependent variable models are used to examine the health effects of early marriage and cohabitation accounting for potential health selection into unions. Our results indicate that early marriage by young adults does not have protective effects for African Americans, and finds more negative effects for African American men than women. There are mixed results for whites with some protective effects of marriage for binge drinking. Early marriage for both African Americans and whites is associated with increased Body Mass Index (BMI). Cohabitation is uniformly associated with negative health outcomes for all race and sex groups.

  14. Evidence for Health II: Overcoming barriers to using evidence in policy and practice.

    PubMed

    Andermann, Anne; Pang, Tikki; Newton, John N; Davis, Adrian; Panisset, Ulysses

    2016-03-14

    Even the highest quality evidence will have little impact unless it is incorporated into decision-making for health. It is therefore critical to overcome the many barriers to using evidence in decision-making, including (1) missing the window of opportunity, (2) knowledge gaps and uncertainty, (3) controversy, irrelevant and conflicting evidence, as well as (4) vested interests and conflicts of interest. While this is certainly not a comprehensive list, it covers a number of main themes discussed in the knowledge translation literature on this topic, and better understanding these barriers can help readers of the evidence to be more savvy knowledge users and help researchers overcome challenges to getting their evidence into practice. Thus, the first step in being able to use research evidence for improving population health is ensuring that the evidence is available at the right time and in the right format and language so that knowledge users can take the evidence into consideration alongside a multitude of other factors that also influence decision-making. The sheer volume of scientific publications makes it difficult to find the evidence that can actually help inform decisions for health. Policymakers, especially in low- and middle-income countries, require context-specific evidence to ensure local relevance. Knowledge synthesis and dissemination of policy-relevant local evidence is important, but it is still not enough. There are times when the interpretation of the evidence leads to various controversies and disagreements, which act as barriers to the uptake of evidence. Research evidence can also be influenced and misused for various aims and agendas. It is therefore important to ensure that any new evidence comes from reliable sources and is interpreted in light of the overall body of scientific literature. It is not enough to simply produce evidence, nor even to synthesize and package evidence into a more user-friendly format. Particularly at the policy

  15. Evidence for Health II: Overcoming barriers to using evidence in policy and practice.

    PubMed

    Andermann, Anne; Pang, Tikki; Newton, John N; Davis, Adrian; Panisset, Ulysses

    2016-01-01

    Even the highest quality evidence will have little impact unless it is incorporated into decision-making for health. It is therefore critical to overcome the many barriers to using evidence in decision-making, including (1) missing the window of opportunity, (2) knowledge gaps and uncertainty, (3) controversy, irrelevant and conflicting evidence, as well as (4) vested interests and conflicts of interest. While this is certainly not a comprehensive list, it covers a number of main themes discussed in the knowledge translation literature on this topic, and better understanding these barriers can help readers of the evidence to be more savvy knowledge users and help researchers overcome challenges to getting their evidence into practice. Thus, the first step in being able to use research evidence for improving population health is ensuring that the evidence is available at the right time and in the right format and language so that knowledge users can take the evidence into consideration alongside a multitude of other factors that also influence decision-making. The sheer volume of scientific publications makes it difficult to find the evidence that can actually help inform decisions for health. Policymakers, especially in low- and middle-income countries, require context-specific evidence to ensure local relevance. Knowledge synthesis and dissemination of policy-relevant local evidence is important, but it is still not enough. There are times when the interpretation of the evidence leads to various controversies and disagreements, which act as barriers to the uptake of evidence. Research evidence can also be influenced and misused for various aims and agendas. It is therefore important to ensure that any new evidence comes from reliable sources and is interpreted in light of the overall body of scientific literature. It is not enough to simply produce evidence, nor even to synthesize and package evidence into a more user-friendly format. Particularly at the policy

  16. Skill mix in the health care workforce: reviewing the evidence.

    PubMed Central

    Buchan, James; Dal Poz, Mario R.

    2002-01-01

    This paper discusses the reasons for skill mix among health workers being important for health systems. It examines the evidence base (identifying its limitations), summarizes the main findings from a literature review, and highlights the evidence on skill mix that is available to inform health system managers, health professionals, health policy-makers and other stakeholders. Many published studies are merely descriptive accounts or have methodological weaknesses. With few exceptions, the published analytical studies were undertaken in the USA, and the findings may not be relevant to other health systems. The results from even the most rigorous of studies cannot necessarily be applied to a different setting. This reflects the basis on which skill mix should be examined--identifying the care needs of a specific patient population and using these to determine the required skills of staff. It is therefore not possible to prescribe in detail a "universal" ideal mix of health personnel. With these limitations in mind, the paper examines two main areas in which investigating current evidence can make a significant contribution to a better understanding of skill mix. For the mix of nursing staff, the evidence suggests that increased use of less qualified staff will not be effective in all situations, although in some cases increased use of care assistants has led to greater organizational effectiveness. Evidence on the doctor-nurse overlap indicates that there is unrealized scope in many systems for extending the use of nursing staff. The effectiveness of different skill mixes across other groups of health workers and professions, and the associated issue of developing new roles remain relatively unexplored. PMID:12163922

  17. Risk aversion, time preference and health production: theory and empirical evidence from Cambodia.

    PubMed

    Rieger, Matthias

    2015-04-01

    This paper quantifies the relationship between risk aversion and discount rates on the one hand and height and weight on the other. It studies this link in the context of poor households in Cambodia. Evidence is based on an original dataset that contains both experimental measures of risk taking and impatience along with anthropometric measurements of children and adults. The aim of the paper is to (i) explore the importance of risk and time preferences in explaining undernutrition and (ii) compare the evidence stemming from poor households to strikingly similar findings from industrialized countries. It uses an inter-generational approach to explain observed correlations in adults and children that is inspired by the height premium on labor markets. Parents can invest in the health capital of their child to increase future earnings and their consumption when old: better nutrition during infancy translates into better human capital and better wages, and ultimately better financial means to take care of elderly parents. However this investment is subject to considerable uncertainty, since parents neither perfectly foresee economic conditions when the child starts earning nor fully observe the ability to transform nutritional investments into long-term health capital. As a result, risk taking households have taller and heavier children. Conversely, impatience does not affect child health. In the case of adults, only weight and the body mass index (BMI), but not height, are positively and moderately correlated with risk taking and impatience. PMID:25589376

  18. Use of Mobile Health Applications for Health-Seeking Behavior Among US Adults.

    PubMed

    Bhuyan, Soumitra S; Lu, Ning; Chandak, Aastha; Kim, Hyunmin; Wyant, David; Bhatt, Jay; Kedia, Satish; Chang, Cyril F

    2016-06-01

    This study explores the use of mobile health applications (mHealth apps) on smartphones or tablets for health-seeking behavior among US adults. Data was obtained from cycle 4 of the 4th edition of the Health Information National Trends Survey (HINTS 4). Weighted multivariate logistic regression models examined predictors of 1) having mHealth apps, 2) usefulness of mHealth apps in achieving health behavior goals, 3) helpfulness in medical care decision-making, and 4) asking a physician new questions or seeking a second opinion. Using the Andersen Model of health services utilization, independent variables of interest were grouped under predisposing factors (age, gender, race, ethnicity, and marital status), enabling factors (education, employment, income, regular provider, health insurance, and rural/urban location of residence), and need factors (general health, confidence in their ability to take care of health, Body Mass Index, smoking status, and number of comorbidities). In a national sample of adults who had smartphones or tablets, 36 % had mHealth apps on their devices. Among those with apps, 60 % reported the usefulness of mHealth apps in achieving health behavior goals, 35 % reported their helpfulness for medical care decision-making, and 38 % reported their usefulness in asking their physicians new questions or seeking a second opinion. The multivariate models revealed that respondents were more likely to have mHealth apps if they had more education, health insurance, were confident in their ability to take good care of themselves, or had comorbidities, and were less likely to have them if they were older, had higher income, or lived in rural areas. In terms of usefulness of mHealth apps, those who were older and had higher income were less likely to report their usefulness in achieving health behavior goals. Those who were older, African American, and had confidence in their ability to take care of their health were more likely to respond that the mHealth

  19. Are Older Adults Receiving Evidence-Based Advice to Prevent Falls Post-Discharge from Hospital?

    ERIC Educational Resources Information Center

    Lee, Den-Ching A.; Brown, Ted; Stolwyk, Rene; O'Connor, Daniel W.; Haines, Terry P.

    2016-01-01

    Background: Older adults experience a high rate of falls when they transition to community-living following discharge from hospital. Objectives: To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe…

  20. Social capital and health among older adults in South Africa

    PubMed Central

    2013-01-01

    Background Little is known about social capital and health among older adults in South Africa. This study investigates the association between social capital and several health variables, namely: self-rated health, depressive symptoms, cognitive functioning and physical inactivity, among older South Africans. Methods We conducted a national population-based cross-sectional study with a national probability sample of 3840 individuals aged 50 years or older who participated in the Study of Global Ageing and Adults Health (SAGE wave 1) in 2008 in South Africa. Measures included socio-demographic characteristics, health variables, cognitive functioning and physical activity. Social capital was assessed with six components, namely: marital status, social action, sociability, trust and solidarity, safety, and civic engagement. Results The social capital assessment revealed that 56% of the respondents were married or cohabiting, 45% reported low (0) social action, 42% reported medium (2–3) sociability, 43% reported high (2) trust and solidarity, 50% reported high (2–4) civic engagement and 42% reported medium (6) psychological resources. In multivariate analysis, self-reported good health was associated with younger age, having secondary education and higher social capital (being married or cohabiting, high trust and solidarity and greater psychological resources). Depressive symptoms were associated with lower social capital (not being married or cohabiting, lack of high trust and solidarity and low psychological resources). Better cognitive functioning was associated with younger age, higher educational level, greater wealth and higher social capital (being married or cohabiting, high trust and solidarity, lack of safety, higher civic engagement and greater psychological resources). Physical inactivity was associated with older age and lower social capital (lower social action, lack of safety, lower civic engagement and poorer psychological resources). Conclusions

  1. The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome

    PubMed Central

    Canetta, Pietro A. A.; Radhakrishnan, Jai

    2015-01-01

    Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach. PMID:26442238

  2. Associations of eHealth Literacy With Health Behavior Among Adult Internet Users

    PubMed Central

    Shibata, Ai; Ishii, Kaori; Oka, Koichiro

    2016-01-01

    Background In the rapidly developing use of the Internet in society, eHealth literacy—having the skills to utilize health information on the Internet—has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. Objective The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. Methods The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. Results We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis

  3. Evidence-based health policy-making, hospital funding and health insurance.

    PubMed

    Palmer, G R

    2000-02-01

    An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-based approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various disciplines involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political assessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of evidence on the impact of policy options for improving the health status of the community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiatives shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by initiatives such as greater exposure of health professionals to educational inputs with a policy focus; increased contribution of doctors to health services research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.

  4. Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash

    PubMed Central

    Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor

    2005-01-01

    OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to

  5. Health risk appraisal: review of evidence for effectiveness.

    PubMed Central

    Schoenbach, V J; Wagner, E H; Beery, W L

    1987-01-01

    Since its introduction some two decades ago, health risk appraisal (HRA) has become a standard offering in the health promotion repertoire. The technique's distinctive feature is its use of epidemiologic data to generate quantitative risk messages for the client. Yet despite the dedication and considerable investments that have gone into HRA's development, dissemination, and use, there is only limited empirical evidence that these quantitative risk messages have any effect on clients. There do not appear to be any formal studies of HRA's effect on participation in health promotion programs, although increasing recruitment is regarded as a major benefit of using HRA. There are few indications of HRA effects on health beliefs. Most positive reports of effects on behavior change come from uncontrolled studies; several randomized controlled trials have yielded ambiguous findings. Virtually no data exist concerning the impact of the quantitative risk messages that distinguish HRA from other assessment techniques and that have motivated the substantial efforts toward developing and refining HRA. HRA has evident appeal and is probably a useful health education device for middle-class, middle-aged, nonminority clients. It may well have desirable effects on health-related beliefs, attitudes, and behaviors when accompanied by counseling or education, but available evidence has not established its effectiveness. Given the difficulty of obtaining definitive evidence of the effectiveness of HRA and specifically of its use of quantitative risk projections, the need for such evidence is debatable. An adequately funded and reviewed research program to examine whether projections of absolute risk affect knowledge, beliefs, attitudes, and intention to change is recommended as the most fruitful next step. Epidemiologically based HRA procedures that provide feedback in terms of qualitative statements or relative risk may be a promising approach to prospective health assessment. PMID

  6. Evidence-based public health: an evolving concept.

    PubMed

    Kohatsu, Neal D; Robinson, Jennifer G; Torner, James C

    2004-12-01

    Evidence-based public health (EBPH) has been proposed as a practice model that builds upon the success of evidence-based medicine (EBM). EBM has been described as a more scientific and systematic approach to the practice of medicine. It has enhanced medical training and practice in many settings. Both EBM and EBPH systematically use data, information, and scientific principles to enhance clinical care and population health, respectively. In this paper, we review the evolution of EBPH, propose a new definition for EBPH, and discuss developments that may support its further advancement.

  7. Finding Qualitative Research Evidence for Health Technology Assessment.

    PubMed

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making.

  8. Clowning in Health Care Settings: The Point of View of Adults

    PubMed Central

    Dionigi, Alberto; Canestrari, Carla

    2016-01-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient’s well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261

  9. Clowning in Health Care Settings: The Point of View of Adults.

    PubMed

    Dionigi, Alberto; Canestrari, Carla

    2016-08-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient's well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261

  10. Clowning in Health Care Settings: The Point of View of Adults.

    PubMed

    Dionigi, Alberto; Canestrari, Carla

    2016-08-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient's well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research.

  11. Health equity: evidence synthesis and knowledge translation methods

    PubMed Central

    2013-01-01

    Background At the Rio Summit in 2011 on Social Determinants of Health, the global community recognized a pressing need to take action on reducing health inequities. This requires an improved evidence base on the effects of national and international policies on health inequities. Although systematic reviews are recognized as an important source for evidence-informed policy, they have been criticized for failing to assess effects on health equity. Methods This article summarizes guidance on both conducting systematic reviews with a focus on health equity and on methods to translate their findings to different audiences. This guidance was developed based on a series of methodology meetings, previous guidance, a recently developed reporting guideline for equity-focused systematic reviews (PRISMA-Equity 2012) and a systematic review of methods to assess health equity in systematic reviews. Results We make ten recommendations for conducting equity-focused systematic reviews; and five considerations for knowledge translation. Illustrative examples of equity-focused reviews are provided where these methods have been used. Conclusions Implementation of the recommendations in this article is one step toward monitoring the impact of national and international policies and programs on health equity, as recommended by the 2011 World Conference on Social Determinants of Health. PMID:23799964

  12. Will our children be healthy adults? Applying science to public health policy.

    PubMed

    Law, Catherine

    2010-12-01

    Cardiovascular disease is predicted to be a leading cause of death and disability worldwide for the foreseeable future. Observational studies link a variety of prevalent early life experiences (for example, smoking in pregnancy, child poverty) to increased risk of adult cardiovascular disease. Experimental animal studies suggest plausible causal relationships. However, there has been little consideration of how to use this wealth of information to benefit children's futures. Policy documents have drawn on research evidence to recognise that early experience influences life chances, the development of human capital, and long-term health. This has led to a general policy emphasis on prevention and early intervention. To date, there are few examples of the evidence base being useful in shaping specific policies, despite potential to do so, and some examples of policy misunderstanding of science. Minor changes to the perspectives of epidemiological research in this area might greatly increase the potential for evidence-based policy. PMID:21413485

  13. Characterisation of User-Defined Health Status in Older Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Starr, J. M.; Marsden, L.

    2008-01-01

    Background: Older adults with Intellectual Disabilities (ID) have an excess disease burden that standard health assessments are designed to detect. Older adults with ID have a broader concept of health with dimensions of well being in addition to absence of disease in line with the World Health Organization's health definition. We sought to…

  14. Selected Health Status Indicators and Behaviors of Young Adults, United States-2003

    ERIC Educational Resources Information Center

    Eaton, Danice K.; Kann, Laura; Okoro, Catherine A.; Collins, Janet

    2007-01-01

    This study examined the prevalence of selected clinical preventive health services, health status indicators, health risk behaviors, and health-promoting behaviors among adults aged 18 to 24 years in the general U.S. population. The study analyzed data from the 2003 Behavioral Risk Factor Surveillance System. Nearly 30% of young adults lacked…

  15. In vivo evidence for neuroplasticity in older adults.

    PubMed

    Porto, Fábio Henrique de Gobbi; Fox, Anne Murphy; Tusch, Erich S; Sorond, Farzaneh; Mohammed, Abdul H; Daffner, Kirk R

    2015-05-01

    Neuroplasticity can be conceptualized as an intrinsic property of the brain that enables modification of function and structure in response to environmental demands. Neuroplastic strengthening of synapses is believed to serve as a critical mechanism underlying learning, memory, and other cognitive functions. Ex vivo work investigating neuroplasticity has been done on hippocampal slices using high frequency stimulation. However, in vivo neuroplasticity in humans has been difficult to demonstrate. Recently, a long-term potentiation-like phenomenon, a form of neuroplastic change, was identified in young adults by differences in visual evoked potentials (VEPs) that were measured before and after tetanic visual stimulation (TVS). The current study investigated whether neuroplastic changes in the visual pathway can persist in older adults. Seventeen healthy subjects, 65 years and older, were recruited from the community. Subjects had a mean age of 77.4 years, mean education of 17 years, mean MMSE of 29.1, and demonstrated normal performance on neuropsychological tests. 1Hz checkerboard stimulation, presented randomly to the right or left visual hemi-field, was followed by 2min of 9Hz stimulation (TVS) to one hemi-field. After 2min of rest, 1Hz stimulation was repeated. Temporospatial principal component analysis was used to identify the N1b component of the VEPs, at lateral occipital locations, in response to 1Hz stimulation pre- and post-TVS. Results showed that the amplitude of factors representing the early and late N1b component was substantially larger after tetanic stimulation. These findings indicate that high frequency visual stimulation can enhance the N1b in cognitively high functioning old adults, suggesting that neuroplastic changes in visual pathways can continue into late life. Future studies are needed to determine the extent to which this marker of neuroplasticity is sustained over a longer period of time, and is influenced by age, cognitive status, and

  16. Health Conception and Health-Promoting Lifestyle among Older Adults: The Validation of a Structural Equation Model.

    ERIC Educational Resources Information Center

    Volkan, Kevin

    Using data from the Older Adult Project within the Health Promotion Research Program at Northern Illinois University, this study examined four dimensions of health conception and their relationship to six dimensions of health-promoting lifestyle in a population of older adults (n=364). A battery of instruments was administred to all subjects to…

  17. Relationships among the perceived health status, family support and life satisfaction of older Korean adults.

    PubMed

    Kim, Sook-Young; Sok, Sohyune R

    2012-08-01

    The objective of this study was to examine the perceived health status, family support and life satisfaction of older Korean adults and the relationships among them. This study was designed to be a descriptive correlation study using questionnaire. Subjects were 246 older people who were over 65 years of age in Seoul and Daegu metropolitan city, Korea. Measures were the Cornell Medical Index-Simple Korean Form to measure the perceived health status, the Family Support Instrument to measure the family support and the Standard Life Satisfaction Instrument for Korean people to measure the life satisfaction. Perceived health state was worse as average 3.3, family support was good as average 3.4 and life satisfaction was low as average 3.1. There were statistically significant positive correlations among perceived health state, family support and life satisfaction and between family support and life satisfaction. The predictors of life satisfaction in elderly were family support, age, monthly allowance and perceived health state. These factors explained 37.5% of the total variance. The major influencing factor was family support. This cross-sectional study provides preliminary evidence that to develop nursing strategy to increase family support of older Korean adults is needed. PMID:22845631

  18. Theoretical Foundations for Evidence-Based Health Informatics: Why? How?

    PubMed

    Scott, Philip J; Georgiou, Andrew; Hyppönen, Hannele; Craven, Catherine K; Rigby, Michael; Brender McNair, Jytte

    2016-01-01

    A scientific approach to health informatics requires sound theoretical foundations. Health informatics implementation would be more effective if evidence-based and guided by theories about what is likely to work in what circumstances. We report on a Medinfo 2015 workshop on this topic jointly organized by the EFMI Working Group on Assessment of Health Information Systems and the IMIA Working Group on Technology Assessment and Quality Development. We discuss the findings of the workshop and propose an approach to consolidate empirical knowledge into testable middle-range theories. PMID:27577457

  19. Policy and evidence in Canadian health human resources planning.

    PubMed

    Wilson, C Ruth

    2013-01-01

    The health human resources supply in Canada swings reactively between over- and under-supply. There are numerous policy actors in this arena, each of whom could contribute to good data collection and an agreed-on process for decision-making. This could form the basis for evidence-informed policy. Absent these tools for pan-Canadian health human resources policy development, smaller health jurisdictions are experimenting with quality improvement initiatives which, when properly evaluated, can discover useful methods of aligning patient and community needs with healthcare resources.

  20. Social contagion of mental health: Evidence from college roommates

    PubMed Central

    Golberstein, Ezra; Whitlock, Janis L.; Downs, Marilyn F.

    2015-01-01

    From a policy standpoint the spread of health conditions in social networks is important to quantify, because it implies externalities and possible market failures in the consumption of health interventions. Recent studies conclude that happiness and depression may be highly contagious across social ties. The results may be biased, however, due to selection and common shocks. We provide unbiased estimates by using exogenous variation from college roommate assignments. Our findings are consistent with no significant overall contagion of mental health and no more than small contagion effects for specific mental health measures, with no evidence for happiness contagion and modest evidence for anxiety and depression contagion. The weakness of the contagion effects cannot be explained by avoidance of roommates with poor mental health or by generally low social contact among roommates. We also find that similarity of baseline mental health predicts the closeness of roommate relationships, which highlights the potential for selection biases in studies of peer effects that do not have a clearly exogenous source of variation. Overall our results suggest that mental health contagion is lower, or at least more context-specific, than implied by the recent studies in the medical literature. PMID:23055446

  1. Social contagion of mental health: evidence from college roommates.

    PubMed

    Eisenberg, Daniel; Golberstein, Ezra; Whitlock, Janis L; Downs, Marilyn F

    2013-08-01

    From a policy standpoint, the spread of health conditions in social networks is important to quantify, because it implies externalities and possible market failures in the consumption of health interventions. Recent studies conclude that happiness and depression may be highly contagious across social ties. The results may be biased, however, because of selection and common shocks. We provide unbiased estimates by using exogenous variation from college roommate assignments. Our findings are consistent with no significant overall contagion of mental health and no more than small contagion effects for specific mental health measures, with no evidence for happiness contagion and modest evidence for anxiety and depression contagion. The weakness of the contagion effects cannot be explained by avoidance of roommates with poor mental health or by generally low social contact among roommates. We also find that similarity of baseline mental health predicts the closeness of roommate relationships, which highlights the potential for selection biases in studies of peer effects that do not have a clearly exogenous source of variation. Overall, our results suggest that mental health contagion is lower, or at least more context specific, than implied by the recent studies in the medical literature.

  2. Interdisciplinary collaboration in geriatrics: advancing health for older adults.

    PubMed

    Young, Heather M; Siegel, Elena O; McCormick, Wayne C; Fulmer, Terry; Harootyan, Linda K; Dorr, David A

    2011-01-01

    The call for interdisciplinary research, education, and practice is heightened by the recognition of the potential it holds in generating creative solutions to complex problems in health care and to improving quality and effectiveness of care. With the aging of the population and the complex issues in caring for older adults, interdisciplinary collaboration is particularly salient to the field of geriatrics. However, despite interest in this approach for several decades, adoption has been slow and dissemination is not widespread. This article provides examples of recent initiatives and presents driving and restraining forces involved in adoption of interdisciplinary approaches. PMID:21757083

  3. Evidence-Based Treatments for Adults with Migraine

    PubMed Central

    Gooriah, Rubesh; Nimeri, Randa; Ahmed, Fayyaz

    2015-01-01

    Migraine, a significantly disabling condition, is treated with acute and preventive medications. However, some individuals are refractory to standard treatments. Although there is a host of alternative management options available, these are not always backed by strong evidence. In fact, most of the drugs used in migraine were initially designed for other purposes. Whilst effective, the benefits from these medications are modest, reflecting the need for newer and migraine-specific therapeutic agents. In recent years, we have witnessed the emergence of novel treatments, of which noninvasive neuromodulation appears to be the most attractive given its ease of use and excellent tolerability profile. This paper reviews the evidence behind the available treatments for migraine. PMID:26839703

  4. Evidence-based practice: management of adult sensorineural hearing loss.

    PubMed

    Chau, Justin K; Cho, John J W; Fritz, Dieter K

    2012-10-01

    Sensorineural hearing loss is a complex disease state influenced by genetics, age, noise, and many other factors. This article reviews our current knowledge regarding the causes of sensorineural hearing loss and reviews the more challenging clinical presentations of sensorineural hearing loss. We have reviewed the latest medical literature in an attempt to provide an evidence-based strategy for the assessment and management of sudden sensorineural hearing loss, rapidly progressive sensorineural hearing loss, and asymmetric/unilateral sensorineural hearing loss.

  5. Older Adults' Perceptions of Physical Activity and Cognitive Health: Implications for Health Communication

    ERIC Educational Resources Information Center

    Price, Anna E.; Corwin, Sara J.; Friedman, Daniela B.; Laditka, Sarah B.; Colabianchi, Natalie; Montgomery, Kara M.

    2011-01-01

    Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined older adults' perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men (N = 55), ages 65 to 74 in South Carolina. Constant comparison methods…

  6. Using the law to promote the mental health of older adults during disasters.

    PubMed

    Rutkow, Lainie; Vernick, Jon S; Spira, Adam P; Barnett, Daniel J

    2013-03-01

    Disasters may disproportionately impact older adults due to sensory deficits, diminished social support networks, financial limitations, and displacement from familiar environments. During and shortly after a disaster, older adults' mental health needs may be overlooked for varied reasons, including concerns about stigma and lack of information about available services. Law can protect the mental health of older adults in disaster and non-disaster circumstances, but it sometimes may frustrate efforts to address older adults' mental health concerns. This article analyzes three areas - Medicare services, staffing shortages, and continuity of prescription medications - in which the law has the potential to promote the mental health of older adults during disasters.

  7. Learning Journeys: A Resource Handbook on Adult Learning and Mental Health.

    ERIC Educational Resources Information Center

    Mather, Joy; Atkinson, Sue

    This document explains how tutors and managers in adult education programs across the United Kingdom can smooth the journeys of adults with mental health difficulties who are returning to learning. The handbook begins with suggestions for its use and case studies of two adult learners with mental health difficulties. Sections 1 through 4 discuss…

  8. Orphanhood and fertility in young adults: Evidence from South Africa.

    PubMed

    Bozzoli, Carlos G

    2016-09-01

    I study the relation between orphanhood and fertility patterns in young adults using a longitudinal survey from the city of Cape Town, South Africa. The data set combines two survey waves with a year-by-year life history calendar that records key outcomes (e.g., schooling, work, fertility). It also provides information on so-called 'parental investments' (time and material support), family background, and literacy and numeracy test scores. I find that orphans exhibit significantly higher rates of teenage pregnancy. In particular, teenage motherhood is 19% points more likely among (female) orphans. These results suggest that orphanhood may leave a long-lasting 'imprint' in terms of premature fertility, especially in teenage females. PMID:27239730

  9. Epistemonikos: a free, relational, collaborative, multilingual database of health evidence.

    PubMed

    Rada, Gabriel; Pérez, Daniel; Capurro, Daniel

    2013-01-01

    Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers. PMID:23920602

  10. Evidence for Health III: Making evidence-informed decisions that integrate values and context.

    PubMed

    Andermann, Anne; Pang, Tikki; Newton, John N; Davis, Adrian; Panisset, Ulysses

    2016-03-14

    Making evidence-informed decisions with the aim of improving the health of individuals or populations can be facilitated by using a systematic approach. While a number of algorithms already exist, and while there is no single 'right' way of summarizing or ordering the various elements that should be involved in making such health-related decisions, an algorithm is presented here that lays out many of the key issues that should be considered, and which adds a special emphasis on balancing the values of individual patients and entire populations, as well as the importance of incorporating contextual considerations. Indeed many different types of evidence and value judgements are needed during the decision-making process to answer a wide range of questions, including (1) What is the priority health problem? (2) What causes this health problem? (3) What are the different strategies or interventions that can be used to address this health problem? (4) Which of these options, as compared to the status quo, has an added benefit that outweighs the harms? (5) Which options would be acceptable to the individuals or populations involved? (6) What are the costs and opportunity costs? (7) Would these options be feasible and sustainable in this specific context? (8) What are the ethical, legal and social implications of choosing one option over another? (9) What do different stakeholders stand to gain or lose from each option? and (10) Taking into account the multiple perspectives and considerations involved, which option is most likely to improve health while minimizing harms? This third and final article in the 'Evidence for Health' series will go through each of the steps in the algorithm in greater detail to promote more evidence-informed decisions that aim to improve health and reduce inequities.

  11. Evidence-based health information and risk competence

    PubMed Central

    Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke

    2015-01-01

    Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions. PMID:26195924

  12. Politics, welfare regimes, and population health: controversies and evidence.

    PubMed

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research. PMID:21899562

  13. Social capital: theory, evidence, and implications for oral health.

    PubMed

    Rouxel, Patrick L; Heilmann, Anja; Aida, Jun; Tsakos, Georgios; Watt, Richard G

    2015-04-01

    In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions.

  14. Politics, welfare regimes, and population health: controversies and evidence.

    PubMed

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research.

  15. Linguistic Stereotyping in Older Adults' Perceptions of Health Care Aides.

    PubMed

    Rubin, Donald; Coles, Valerie Berenice; Barnett, Joshua Trey

    2016-07-01

    The cultural and linguistic diversity of the U.S. health care provider workforce is expanding. Diversity among health care personnel such as paraprofessional health care assistants (HCAs)-many of whom are immigrants-means that intimate, high-stakes cross-cultural and cross-linguistic contact characterizes many health interactions. In particular, nonmainstream HCAs may face negative patient expectations because of patients' language stereotypes. In other contexts, reverse linguistic stereotyping has been shown to result in negative speaker evaluations and even reduced listening comprehension quite independently of the actual language performance of the speaker. The present study extends the language and attitude paradigm to older adults' perceptions of HCAs. Listeners heard the identical speaker of Standard American English as they watched interactions between an HCA and an older patient. Ethnolinguistic identities-either an Anglo native speaker of English or a Mexican nonnative speaker-were ascribed to HCAs by means of fabricated personnel files. Dependent variables included measures of perceived HCA language proficiency, personal characteristics, and professional competence, as well as listeners' comprehension of a health message delivered by the putative HCA. For most of these outcomes, moderate effect sizes were found such that the HCA with an ascribed Anglo identity-relative to the Mexican guise-was judged more proficient in English, socially superior, interpersonally more attractive, more dynamic, and a more satisfactory home health aide. No difference in listening comprehension emerged, but the Anglo guise tended to engender a more compliant listening mind set. Results of this study can inform both provider-directed and patient-directed efforts to improve health care services for members of all linguistic and cultural groups. PMID:26606170

  16. Linguistic Stereotyping in Older Adults' Perceptions of Health Care Aides.

    PubMed

    Rubin, Donald; Coles, Valerie Berenice; Barnett, Joshua Trey

    2016-07-01

    The cultural and linguistic diversity of the U.S. health care provider workforce is expanding. Diversity among health care personnel such as paraprofessional health care assistants (HCAs)-many of whom are immigrants-means that intimate, high-stakes cross-cultural and cross-linguistic contact characterizes many health interactions. In particular, nonmainstream HCAs may face negative patient expectations because of patients' language stereotypes. In other contexts, reverse linguistic stereotyping has been shown to result in negative speaker evaluations and even reduced listening comprehension quite independently of the actual language performance of the speaker. The present study extends the language and attitude paradigm to older adults' perceptions of HCAs. Listeners heard the identical speaker of Standard American English as they watched interactions between an HCA and an older patient. Ethnolinguistic identities-either an Anglo native speaker of English or a Mexican nonnative speaker-were ascribed to HCAs by means of fabricated personnel files. Dependent variables included measures of perceived HCA language proficiency, personal characteristics, and professional competence, as well as listeners' comprehension of a health message delivered by the putative HCA. For most of these outcomes, moderate effect sizes were found such that the HCA with an ascribed Anglo identity-relative to the Mexican guise-was judged more proficient in English, socially superior, interpersonally more attractive, more dynamic, and a more satisfactory home health aide. No difference in listening comprehension emerged, but the Anglo guise tended to engender a more compliant listening mind set. Results of this study can inform both provider-directed and patient-directed efforts to improve health care services for members of all linguistic and cultural groups.

  17. "Love" and the mental health professions: toward understanding adult love.

    PubMed

    Levine, S B

    1996-01-01

    This essay explores three aspects of the normal processes of adult-adult love: falling in love, being in love, and staying in love. It describes the emotions, defenses, and challenges inherent in each phase. Love is an ordinary but immensely powerful adult aspiration. As a term it is impossible to define in any singular sense. The attainment of its lofty purposes requires profound intrapsychic adjustments involving creative acts of imagination, the integration of ideals with reality, evolving adaptations to the partner, the maintenance of a positive internal image of the partner, and ongoing struggles to overcome self-interest. These adjustments have not been well characterized by the mental health professions. This is ironic since a large portion of our work involves caring for love's casualties--that is, people whose miseries relate to their inability to successfully negotiate the phases of love or whose happiness is limited by their partners who cannot. Six arguments for ending professional avoidance of the topic are offered, the most compelling of which are love's relevance to both the pathogenesis of mental suffering and to the art of psychotherapeutic healing.

  18. Revitalising the evidence base for public health: an assets model.

    PubMed

    Morgan, Antony; Ziglio, Erio

    2007-01-01

    Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective

  19. Revitalising the evidence base for public health: an assets model.

    PubMed

    Morgan, Antony; Ziglio, Erio

    2007-01-01

    Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective

  20. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults.

    PubMed

    Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

    2015-01-01

    Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October-November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction. PMID:26844135

  1. Mental health and dual sensory loss in older adults: a systematic review.

    PubMed

    Heine, Chyrisse; Browning, Colette J

    2014-01-01

    Mental health is a core component of quality of life in old age. Dual Sensory Loss (DSL; combined vision and hearing loss) is prevalent in older adults and has been correlated with decreased levels of well-being. This systematic review aimed to critically review and summarize the evidence from studies that examined the mental health of older adults with DSL. In accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement, specific databases were searched and eight articles were selected for final review. Seven studies investigated the association between DSL and depression or depressive symptoms, whilst one study explored the relationship between DSL and quality of life. No studies investigated the impact of DSL on anxiety. Overall, results of this review suggested that there is a significant relationship between DSL and decreased mental health with those with DSL either displaying depressive symptoms or being at risk for developing depression. Future research should focus on comparative studies of older people with and without sensory loss, as well as targeted studies of older people with dual sensory loss, that incorporate well-defined and valid measures of sensory loss and mental health.

  2. Correlates of Health-Related Social Media Use Among Adults

    PubMed Central

    2013-01-01

    Background Sixty percent of Internet users report using the Internet to look for health information. Social media sites are emerging as a potential source for online health information. However, little is known about how people use social media for such purposes. Objectives The purpose of this study was two-fold: (1) to establish the frequency of various types of online health-seeking behaviors, and (2) to identify correlates of 2 health-related online activities, social networking sites (SNS) for health-related activities and consulting online user-generated content for answers about health care providers, health facilities, or medical treatment. Methods The study consisted of a telephone survey of 1745 adults who reported going online to look for health-related information. Four subscales were created to measure use of online resources for (1) using SNS for health-related activities; (2) consulting online rankings and reviews of doctors, hospitals or medical facilities, and drugs or medical treatments; (3) posting a review online of doctors, hospitals or medical facilities, and drugs or medical treatments, and (4) posting a comment or question about health or medical issues on various social media. Univariate and multivariate logistic regression analyses were performed. Results Respondents consulted online rankings or reviews (41.15%), used SNS for health (31.58%), posted reviews (9.91%), and posted a comment, question, or information (15.19%). Respondents with a chronic disease were nearly twice as likely to consult online rankings (odds ratio [OR] 2.09, 95% CI 1.66-2.63, P<.001). Lower odds of consulting online reviews were associated with less formal education (OR 0.49, 95% CI 0.37-0.65, P<.001) and being male (OR 0.71, 95% CI 0.57-0.87, P<.001). Respondents with higher incomes were 1.5 times as likely to consult online rankings or reviews (OR 1.49, 95% CI 0.10-2.24, P=.05), than respondents with a regular provider (OR 2.05, 95% CI 1.52-2.78, P<.001), or

  3. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions.

    PubMed

    Font, Sarah A; Maguire-Jack, Kathryn

    2016-01-01

    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact.

  4. Persistent Psychological Well-being Predicts Improved Self-Rated Health Over 9-10 Years: Longitudinal Evidence from MIDUS

    PubMed Central

    Ryff, Carol D.; Radler, Barry T.; Friedman, Elliot M.

    2015-01-01

    Psychological well-being has been linked with better health, but mostly with cross-sectional evidence. Using MIDUS, a national sample of U.S. adults (N = 4,963), longitudinal profiles of well-being were used to predict in cross-time change over a 9-10 years in self-reported health. Well-being was largely stable, although adults differed in whether they had persistently high versus persistently low or moderate levels of well-being. After adjusting for sociodemographic factors, those with persistently high well-being reported better health (subjective health, chronic conditions, symptoms, functional impairment) across time compared to those with persistently low well-being. Further, persistently high well-being was protective of improved health especially among the educationally disadvantaged. The findings underscore the importance of intervention and educational programs designed to promote well-being for greater segments of society. PMID:26617988

  5. Does income inequality harm health? New cross-national evidence.

    PubMed

    Beckfield, Jason

    2004-09-01

    The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the cross-national work has been criticized for several methodological shortcomings. This study replicates previous work using a larger sample (692 observations from 115 countries over the 1947-1996 period), a wider range of statistical controls, and fixed-effects models that address heterogeneity bias. The relationship between health and inequality shrinks when controls are included. In fixed-effects models that capture unmeasured heterogeneity, the association between income inequality and health disappears. The null findings hold for two measures of income inequality: the Gini coefficient and the share of income received by the poorest quintile of the population. Analysis of a sample of wealthy countries also fails to support the hypothesis.

  6. Translating evidence into population health improvement: strategies and barriers.

    PubMed

    Woolf, Steven H; Purnell, Jason Q; Simon, Sarah M; Zimmerman, Emily B; Camberos, Gabriela J; Haley, Amber; Fields, Robert P

    2015-03-18

    Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconnect is a problem particularly for population health, where the change agents who can make the biggest difference in improving health behaviors and social and environmental conditions are generally nonscientists outside of the health professions. To persuade an audience that does not read scientific journals, strong science may not be enough to elicit change. Achieving influence in population health often requires four ingredients for success: research that is responsive to user needs, an understanding of the decision-making environment, effective stakeholder engagement, and strategic communication. This article reviews the principles and provides examples from a national and local initiative.

  7. Climate change and respiratory health: current evidence and knowledge gaps.

    PubMed

    Takaro, Tim K; Knowlton, Kim; Balmes, John R

    2013-08-01

    Climate change is a key driver of the accelerating environmental change affecting populations around the world. Many of these changes and our response to them can affect respiratory health. This is an expert opinion review of recent peer-reviewed literature, focused on more recent medical journals and climate-health relevant modeling results from non-biomedical journals pertaining to climate interactions with air pollution. Global health impacts in low resource countries and migration precipitated by environmental change are addressed. The major findings are of respiratory health effects related to heat, air pollution, shifts in infectious diseases and allergens, flooding, water, food security and migration. The review concludes with knowledge gaps and research need that will support the evidence-base required to address the challenges ahead.

  8. Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults

    PubMed Central

    Cochran, Susan D.; Mays, Vickie M.; Alegria, Magarita; Ortega, Alexander N.; Takeuchi, David

    2009-01-01

    Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. We report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. PMID:17907860

  9. Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. Participants: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. Evidence: The ...

  10. Strengthening the evidence base for health programming in humanitarian crises.

    PubMed

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial.

  11. The Need for Health Promotion for Adults Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Capella-McDonnall, Michele

    2007-01-01

    Health promotion interventions for adults who are visually impaired have received little attention. This article reports what is currently known about the health, overweight and obesity, and levels of physical activity reported by these adults. Conclusions about the need for health promotion activities based on this information are provided, and…

  12. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  13. An Investigation of the Relationship between Health Literacy and Social Communication Skills in Older Adults

    ERIC Educational Resources Information Center

    Hester, Eva Jackson

    2009-01-01

    The purpose of this study was to examine connections between health literacy and social communication skills in older adults, a population that experiences chronic health conditions but is reported to have low health literacy and declines in communication skills. Sixty-three older adults were administered the "Social Communication" subtest of the…

  14. Genome sequencing: a systematic review of health economic evidence

    PubMed Central

    2013-01-01

    Recently the sequencing of the human genome has become a major biological and clinical research field. However, the public health impact of this new technology with focus on the financial effect is not yet to be foreseen. To provide an overview of the current health economic evidence for genome sequencing, we conducted a thorough systematic review of the literature from 17 databases. In addition, we conducted a hand search. Starting with 5 520 records we ultimately included five full-text publications and one internet source, all focused on cost calculations. The results were very heterogeneous and, therefore, difficult to compare. Furthermore, because the methodology of the publications was quite poor, the reliability and validity of the results were questionable. The real costs for the whole sequencing workflow, including data management and analysis, remain unknown. Overall, our review indicates that the current health economic evidence for genome sequencing is quite poor. Therefore, we listed aspects that needed to be considered when conducting health economic analyses of genome sequencing. Thereby, specifics regarding the overall aim, technology, population, indication, comparator, alternatives after sequencing, outcomes, probabilities, and costs with respect to genome sequencing are discussed. For further research, at the outset, a comprehensive cost calculation of genome sequencing is needed, because all further health economic studies rely on valid cost data. The results will serve as an input parameter for budget-impact analyses or cost-effectiveness analyses. PMID:24330507

  15. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes. PMID:26650919

  16. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes.

  17. Stress trajectories, health behaviors, and the mental health of black and white young adults.

    PubMed

    Boardman, Jason D; Alexander, Kari B

    2011-05-01

    This paper uses data from the National Longitudinal Study of Adolescent Health to examine the mental health of non-Hispanic black and white young adults in the US. We use latent growth curve modeling to characterize the typical stress trajectories experienced by black and white young adults spanning the bulk of their lives. We identify the following four stress trajectories: 1) relatively stress free; 2) stress peak at age 15 and a subsequent decline; 3) stress peak at age 17 and a subsequent decline; and 4) a moderately high chronic stress. Results indicate that black adolescents have significantly higher risk of being in all three of the stressful classes compared to white adolescents. Stress exposure is strongly associated with depression and the race differences in stress profiles account for a modest amount of the observed race differences in mental health. We do not observe any race differences in behavioral responses to stressors; black youth are no more likely than white youth to engage in poor health behaviors (e.g., smoking, drinking, or obesity) in response to stress. We provide tentative support for the notion that poor health behaviors partially reduce the association between stress and depression for blacks but not whites. These findings contribute to unresolved issues regarding mental and physical health disparities among blacks and whites.

  18. The Associations between Health Literacy, Reasons for Seeking Health Information, and Information Sources Utilized by Taiwanese Adults

    ERIC Educational Resources Information Center

    Wei, Mi-Hsiu

    2014-01-01

    Objective: To determine the associations between health literacy, the reasons for seeking health information, and the information sources utilized by Taiwanese adults. Method: A cross-sectional survey of 752 adults residing in rural and urban areas of Taiwan was conducted via questionnaires. Chi-squared tests and logistic regression were used for…

  19. Neurotological Findings at a Health Unit for Adults with Cervicalgia

    PubMed Central

    Zeigelboim, Bianca Simone; Fonseca, Vinicius Ribas; Mesti, Juliana Cristina; Gorski, Leslie Palma; Faryniuk, João Henrique; Marques, Jair Mendes

    2016-01-01

    Introduction The cervical spine is a flexible link between the sensory platform of the skull and torso. The fundamental principle of its operation is due to the balance between muscle strength and flexibility, and any dysfunction of this balance causes neck pain, known as cervicalgia. Objective The objective of this study is to analyze the most prevalent neurotological findings in adults with neck pain. Method A cross-sectional study in which 33 adults from 50 to 83 years of age with neck pain were evaluated and underwent the following procedures: anamnesis, as well as ENT, audiological, and vestibular exams. Results The most evident neurotological symptoms were dizziness (75.7%), tinnitus, neck cracking, tingling in the extremities, and auditory problems (36.3% for each). The most frequently reported clinical symptoms were related to cardiovascular (69.7%), endocrine-metabolic (48.5%), and rheumatic (30.3%) systems. In the audiological assessment, 30 subjects (91.0%) presented hearing impairment in at least one ear, with sensorineural impairment being the most prevalent (88.0%). In the vestibular assessment, there were alterations in 13 subjects (39.0%) found in the caloric test. There was a prevalence of alterations in the peripheral vestibular system with a predominance of irritative peripheral vestibular dysfunction. Conclusion Neurotological complaints were frequent in this population, verifying the importance of these tests in the dysfunctions of the cervical region or the craniocervical junction. PMID:27096014

  20. Neurotological Findings at a Health Unit for Adults with Cervicalgia.

    PubMed

    Zeigelboim, Bianca Simone; Fonseca, Vinicius Ribas; Mesti, Juliana Cristina; Gorski, Leslie Palma; Faryniuk, João Henrique; Marques, Jair Mendes

    2016-04-01

    Introduction The cervical spine is a flexible link between the sensory platform of the skull and torso. The fundamental principle of its operation is due to the balance between muscle strength and flexibility, and any dysfunction of this balance causes neck pain, known as cervicalgia. Objective The objective of this study is to analyze the most prevalent neurotological findings in adults with neck pain. Method A cross-sectional study in which 33 adults from 50 to 83 years of age with neck pain were evaluated and underwent the following procedures: anamnesis, as well as ENT, audiological, and vestibular exams. Results The most evident neurotological symptoms were dizziness (75.7%), tinnitus, neck cracking, tingling in the extremities, and auditory problems (36.3% for each). The most frequently reported clinical symptoms were related to cardiovascular (69.7%), endocrine-metabolic (48.5%), and rheumatic (30.3%) systems. In the audiological assessment, 30 subjects (91.0%) presented hearing impairment in at least one ear, with sensorineural impairment being the most prevalent (88.0%). In the vestibular assessment, there were alterations in 13 subjects (39.0%) found in the caloric test. There was a prevalence of alterations in the peripheral vestibular system with a predominance of irritative peripheral vestibular dysfunction. Conclusion Neurotological complaints were frequent in this population, verifying the importance of these tests in the dysfunctions of the cervical region or the craniocervical junction. PMID:27096014

  1. Cohort Profile: Longitudinal Study of Adult Health (ELSA-Brasil)

    PubMed Central

    Schmidt, Maria Inês; Duncan, Bruce B; Mill, José Geraldo; Lotufo, Paulo A; Chor, Dóra; Barreto, Sandhi Maria; Aquino, Estela ML; Passos, Valéria Maria Azeredo; Matos, Sheila MA; Molina, Maria del Carmen B; Carvalho, Marilia S; Bensenor, Isabela M

    2015-01-01

    Chronic diseases are a global problem, yet information on their determinants is generally scant in low- and middle-income countries. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information regarding the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes, in one such setting. At Visit 1, we enrolled 15 105 civil servants from predefined universities or research institutes. Baseline assessment (2008–10) included detailed interviews and measurements to assess social and biological determinants of health, as well as various clinical and subclinical conditions related to diabetes, cardiovascular diseases and mental health. A second visit of interviews and examinations is under way (2012–14) to enrich the assessment of cohort exposures and to detect initial incident events. Annual surveillance has been conducted since 2009 for the ascertainment of incident events. Biological samples (sera, plasma, urine and DNA) obtained at both visits have been placed in long-term storage. Baseline data are available for analyses, and collaboration via specific research proposals directed to study investigators is welcome. PMID:24585730

  2. Self-Esteem, Oral Health Behaviours, and Clinical Oral Health Status in Chinese Adults: An Exploratory Study

    ERIC Educational Resources Information Center

    Chin, Luzy Siu-Hei; Chan, Joanne Chung-Yan

    2013-01-01

    Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…

  3. The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

    PubMed Central

    Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

    2016-01-01

    Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be

  4. [Explanation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma].

    PubMed

    Jiao, Yue; Wu, Zhongchao; Zhou, Wenna; Si, Xiaohua; Wang, Jingjing; Zhou, Jincao; Chen, Zhongjie; Li, Rongjun; Zhao, Xiaoguang; Xiao, Liwei

    2016-05-01

    The development and compilation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma are introduced from three aspects, named the guideline methodology, the guideline structure and the guideline content. Based on the acupuncture-moxibustion practice and clinical research, the evidence-based medicine method is adopted. During the development and compilation of the guideline, the characteristics and advantages of acupuncture and moxibustion are specially considered in the treatment of this disease; the latest optimum evidences at home and abroad, experts' experience and patients' value are closely integrated with each other. Additionally, the worldwide accepted assessments of evidence quality and the recommendation (GRADE system) are combined with the clinical evidences of the ancient and modern famous acupuncture-moxibustion experts, and the clinical research evidences are with the experts' consensus to the large extent. The purpose of the guideline is to provide the maximal guidance to the clinical physicians.

  5. [Explanation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma].

    PubMed

    Jiao, Yue; Wu, Zhongchao; Zhou, Wenna; Si, Xiaohua; Wang, Jingjing; Zhou, Jincao; Chen, Zhongjie; Li, Rongjun; Zhao, Xiaoguang; Xiao, Liwei

    2016-05-01

    The development and compilation of Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion: Adult Bronchial Asthma are introduced from three aspects, named the guideline methodology, the guideline structure and the guideline content. Based on the acupuncture-moxibustion practice and clinical research, the evidence-based medicine method is adopted. During the development and compilation of the guideline, the characteristics and advantages of acupuncture and moxibustion are specially considered in the treatment of this disease; the latest optimum evidences at home and abroad, experts' experience and patients' value are closely integrated with each other. Additionally, the worldwide accepted assessments of evidence quality and the recommendation (GRADE system) are combined with the clinical evidences of the ancient and modern famous acupuncture-moxibustion experts, and the clinical research evidences are with the experts' consensus to the large extent. The purpose of the guideline is to provide the maximal guidance to the clinical physicians. PMID:27509620

  6. Haemophilia Joint Health Score in healthy adults playing sports.

    PubMed

    Sluiter, D; Foppen, W; de Kleijn, P; Fischer, K

    2014-03-01

    To evaluate outcome of prophylactic clotting factor replacement in children with haemophilia, the Haemophilia Joint Health Score (HJHS) was developed aiming at scoring early joint changes in children aged 4-18. The HJHS has been used for adults on long-term prophylaxis but interpretation of small changes remains difficult. Some changes in these patients may be due to sports-related injuries. Evaluation of HJHS score in healthy adults playing sports could improve the interpretation of this score in haemophilic patients. The aim of this study was to evaluate the HJHS scores in a cohort of young, healthy men participating in sports. Concomitant with a project collecting MRI images of ankles and knees in normal young adults, HJHS scores were assessed in 30 healthy men aged 18-26, participating in sports one to three times per week. One physiotherapist assessed their clinical function using the HJHS 2.1. History of joint injuries was documented. MRI images were scored by a single radiologist, using the International Prophylaxis Study Group additive MRI score. Median age of the study group was 24.3 years (range 19.0-26.4) and median frequency of sports activities was three times per week (range 1-4). Six joints (five knees, one ankle) had a history of sports-related injury. The median overall HJHS score was 0 out of 124 (range 0-3), with 60% of subjects showing no abnormalities on HJHS. All joints were normal on MRI. These results suggest that frequent sports participation and related injuries are not related with abnormalities in HJHS scores.

  7. Metabolic Health Status and the Obesity Paradox in Older Adults.

    PubMed

    Cheng, Feon W; Gao, Xiang; Mitchell, Diane C; Wood, Craig; Rolston, David D K; Still, Christopher D; Jensen, Gordon L

    2016-01-01

    The explanation for reduced mortality among older persons with overweight or class I obesity compared to those of desirable weight remains unclear. Our objective was to investigate the joint effects of body mass index (BMI) and metabolic health status on all-cause mortality in a cohort of advanced age. Adults aged 74 ± 4.7 (mean ± SD) years at baseline (n = 4551) were categorized according to BMI (18.5-24.9, 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m(2)) and the presence or absence of a metabolically healthy phenotype (i.e., 0 or 1 risk factors based on a modified Adult Treatment Panel III). Metabolically unhealthy was ≥2 risk factors. There were 2294 deaths over a mean 10.9 years of follow up. Relative to metabolically healthy desirable weight, metabolically healthy overweight or class I obesity was not associated with a greater mortality risk (HR 0.90; 95 CI% 0.73-1.13 and HR 0.58; 95 CI% 0.42-0.80, respectively) (P-interaction <0.001). Results remained consistent in rigorous sensitivity analyses. The "obesity paradox" may be partially explained by the inclusion of metabolically healthy overweight and obese older persons, who do not have elevated mortality risk, in population studies of BMI and mortality. PMID:27559852

  8. Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

    PubMed Central

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties; Yawson, A.; Mensah, G.; Yong, J.; Guo, Y.; Zheng, Y.; Parasuraman, P.; Lhungdim, H.; Sekher, TV.; Rosa, R.; Belov, VB.; Lushkina, NP; Peltzer, K.; Makiwane, M.; Zuma, K.; Ramlagan, S.; Davids, A.; Mbelle, N.; Matseke, G.; Schneider, M.; Tabane, C.; Tollman, S.; Kahn, K.; Ng, N.; Juvekar, S.; Sankoh, O.; Debpuur, CY.; Nguyen, TK Chuc; Gomez-Olive, FX.; Hakimi, M.; Hirve, S.; Abdullah, S.; Hodgson, A.; Kyobutungi, C.; Egondi, T.; Mayombana, C.; Minh, HV.; Mwanyangala, MA.; Razzaque, A.; Wilopo, S.; Streatfield, PK.; Byass, P.; Wall, S.; Scholten, F.; Mugisha, J.; Seeley, J.; Kinyanda, E.; Nyirenda, M.; Mutevedzi, P.; Newell, M-L.

    2012-01-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization’s Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18–49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007–2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18–49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO’s SAGE website (www.who.int/healthinfo/systems/sage) and WHO’s archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata). PMID:23283715

  9. Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE).

    PubMed

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties

    2012-12-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

  10. Beyond evidence--to ethics: a decision-making framework for health promotion, public health and health improvement.

    PubMed

    Tannahill, Andrew

    2008-12-01

    Echoing the rise of 'evidence-based medicine', the concept of evidence-based policy and practice in the inter-related fields of health promotion, public health and health improvement has attracted increasing attention over the past two decades. More recently, again with roots traceable to biomedical thinking, there has been growing interest in ethics in relation to these fields. This paper links these two topical themes in a practical way. It explores the extent to which policies and activities 'on the ground' can and should be based on evidence, and considers the relative places of evidence and ethics in decision-making. It goes on to present the 'decision-making triangle', a framework that gives primacy to a set of ethical principles--with available evidence and plausible theory being used to inform the application of these. After introducing the concept of 'ethical logic modelling', the paper concludes by suggesting an 'ethical imperative' for health promotion, public health and health improvement: to make decisions based on the explicit application of ethical principles, using available evidence and theory appropriately.

  11. Clinical evidence on high flow oxygen therapy and active humidification in adults.

    PubMed

    Gotera, C; Díaz Lobato, S; Pinto, T; Winck, J C

    2013-01-01

    Recently there has been growing interest in an alternative to conventional oxygen therapy: the heated, humidified high flow nasal cannula oxygen therapy (HFNC). A number of physiological effects have been described with HFNC: pharyngeal dead space washout, reduction of nasopharyngeal resistance, a positive expiratory pressure effect, an alveolar recruitment, greater humidification, more comfort and better tolerance by the patient, better control of FiO2 and mucociliary clearance. There is limited experience of HFNC in adults. There are no established guidelines or decision-making pathways to guide use of the HFNC therapy for adults. In this article we review the existing evidence of HFNC oxygen therapy in adult patients, its advantages, limitations and the current literature on clinical applications. Further research is required to determine the long-term effect of this therapy and identify the adult patient population to whom it is most beneficial.

  12. Does early-life income inequality predict self-reported health in later life? Evidence from the United States.

    PubMed

    Lillard, Dean R; Burkhauser, Richard V; Hahn, Markus H; Wilkins, Roger

    2015-03-01

    We investigate the association between adult health and the income inequality they experienced as children up to 80 years earlier. Our inequality data track shares of national income held by top percentiles from 1913 to 2009. We average those data over the same early-life years and merge them to individual data from the Panel Study of Income Dynamics data for 1984-2009. Controlling for demographic and economic factors, we find both men and women are statistically more likely to report poorer health if income was more unequally distributed during the first years of their lives. The association is robust to alternative specifications of income inequality and time trends and remains significant even when we control for differences in overall childhood health. Our results constitute prima facie evidence that adults' health may be adversely affected by the income inequality they experienced as children.

  13. Age-related face processing bias in infancy: evidence of perceptual narrowing for adult faces.

    PubMed

    Macchi Cassia, Viola; Bulf, Hermann; Quadrelli, Ermanno; Proietti, Valentina

    2014-02-01

    Recent data demonstrate a perceptual processing advantage for adult faces in both adults and young children, suggesting that face representation is shaped by visual experience accumulated with different face-age groups. As for species and race, this age bias may emerge during the first year of life as part of the general process of perceptual narrowing, given the extensive amount of social and perceptual experience accumulated with caregivers and/or other adult individuals. Using infant-controlled habituation and visual-paired comparison at test, two experiments were carried out to examine 3- and 9-month-olds' ability to discriminate within adult and infant faces. Results showed that, when they are provided with adequate time to visually compare the stimuli during test trials (Experiment 2), 3-month-olds exhibit above-chance discrimination of adult and infant faces. Instead, 9-month-olds discriminate adult faces but not infant faces (Experiments 1 and 2). Results provide the first evidence of age-related face processing biases in infancy, and show that by 9 months face representations tune to adult human faces. PMID:24374735

  14. Dual practice in the health sector: review of the evidence

    PubMed Central

    Ferrinho, Paulo; Van Lerberghe, Wim; Fronteira, Inês; Hipólito, Fátima; Biscaia, André

    2004-01-01

    This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1) conceptual, regarding what is meant by dual practice; (2) descriptive, trying to develop a typology of dual practices; (3) quantitative, trying to determine its prevalence; (4) impact on personal income, the health care system and health status; (5) qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6) possible interventions to deal with dual practice. PMID:15509305

  15. Evidence-based uncertainty in mental health nursing.

    PubMed

    Franks, V

    2004-02-01

    The drive towards evidence-based practice is part of a modern reflective and caring service. However there is a paradox at the heart of the notion of evidence-based care. In order to perform any systemized examination of treatment there has to be a conscious acknowledgement of uncertainty about that treatment. This is uncomfortable and when research does find evidence in favour of a treatment, there is a relief and a return to conviction about what is the best. The paradox is that it seems the most valued research practices are predicated on generalizations about patient treatments and categories. However, nursing care is based on the notion of the uniqueness of the patient and the nurse-patient relationship. Sometimes it is necessary to address the particular and not to rush to generalizations and certainty. The psychoanalytic framework promotes a capacity to tolerate uncertainty and provides a model for understanding conflicting feelings, which can occur within the nurse-patient relationship. The author proposes the psychoanalytic observational method as an adjunct to other research methods. This method places certain kinds of evidence within the rubric of evidence-based nursing practice. The evidence collected in this method is the evidence of the conscious and unconscious experience within the nurse-patient relationship. The author will describe and argue for the place of this research method within the canon of other more widely practised methods within mental health practice. She will propose that for safe practice it is necessary to value and examine the veracity of the feelings and tacit understanding of the nurse. She contends that the current climate of excessive bureaucracy and persecutory risk management is having a damaging effect on both the research process and effective nursing care.

  16. Guidance for evidence-informed policies about health systems: assessing how much confidence to place in the research evidence.

    PubMed

    Lewin, Simon; Bosch-Capblanch, Xavier; Oliver, Sandy; Akl, Elie A; Vist, Gunn E; Lavis, John N; Ghersi, Davina; Røttingen, John-Arne; Steinmann, Peter; Gulmezoglu, Metin; Tugwell, Peter; El-Jardali, Fadi; Haines, Andy

    2012-01-01

    In the third paper in a three-part series on health systems guidance, Simon Lewin and colleagues explore the challenge of assessing how much confidence to place in evidence on health systems interventions.

  17. Weight management in Canada: an environmental scan of health services for adults with obesity

    PubMed Central

    2014-01-01

    Background Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care. Methods We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ). Results A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling. Conclusions With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults. PMID:24521300

  18. Relationships and Health among Emerging Adults with and without Type 1 Diabetes

    PubMed Central

    Helgeson, Vicki S.; Palladino, Dianne K.; Reynolds, Kerry A.; Becker, Dorothy J.; Escobar, Oscar; Siminerio, Linda

    2016-01-01

    Objective The study's goal was to examine the impact of parent and peer relationships on health behaviors and psychological well-being of those with and without type 1 diabetes over the transition to emerging adulthood. Emerging adulthood is an understudied developmental period and a high risk period—especially for those with type 1 diabetes. Methods Youth with (n = 117) and without type 1 diabetes (n = 122) completed questionnaires during their senior year of high school and one year later. Measures included supportive and problematic aspects of parent and peer relationships, health behaviors, psychological well-being, and, for those with diabetes, self-care behavior and glycemic control. Results Prospective multiple and logistic regression analysis revealed that friend conflict was a more potent predictor than friend support of changes in health behaviors and psychological well-being. Parent support was associated with positive changes in psychological well-being and decreases in smoking, whereas parent control was related to increases in smoking and depressive symptoms. There was some evidence of cross-domain buffering such that supportive relationships in one domain buffered adverse effects of problematic relationships in the other domain on health outcomes. Conclusions This longitudinal study showed that parent relationships remain an important influence on and peer relationships continue to influence the health behaviors and psychological well-being of emerging adults with and without type 1 diabetes. Parent relationships also have the potential to buffer the adverse effects of difficulties with peers. PMID:23914816

  19. Integrating funds for health and social care: an evidence review

    PubMed Central

    Goddard, Maria; Weatherly, Helen; Chalkley, Martin

    2015-01-01

    Objectives Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice. Methods We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice. We searched eight electronic databases and relevant websites, and checked reference lists of reviews and empirical studies. We extracted data on the types of funding integration used by schemes, their benefits and costs (including unintended effects), and the barriers to implementation. We interpreted our findings with reference to our framework. Results The review included 38 schemes from eight countries. Most of the randomized evidence came from Australia, with nonrandomized comparative evidence available from Australia, Canada, England, Sweden and the US. None of the comparative evidence isolated the effect of integrated funding; instead, studies assessed the effects of ‘integrated financing plus integrated care’ (i.e. ‘integration’) relative to usual care. Most schemes (24/38) assessed health outcomes, of which over half found no significant impact on health. The impact of integration on secondary care costs or use was assessed in 34 schemes. In 11 schemes, integration had no significant effect on secondary care costs or utilisation. Only three schemes reported significantly lower secondary care use compared with usual care. In the remaining 19 schemes, the evidence was mixed or unclear. Some schemes achieved short-term reductions in delayed discharges, but there was anecdotal evidence of

  20. Racism and Health I: Pathways and Scientific Evidence

    PubMed Central

    Williams, David R.; Mohammed, Selina A.

    2013-01-01

    This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks. PMID:24347666

  1. Racism and Health I: Pathways and Scientific Evidence.

    PubMed

    Williams, David R; Mohammed, Selina A

    2013-08-01

    This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks.

  2. Racism and Health I: Pathways and Scientific Evidence.

    PubMed

    Williams, David R; Mohammed, Selina A

    2013-08-01

    This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks. PMID:24347666

  3. Managing evidence-based health care: a diagnostic framework.

    PubMed

    Newman, K; Pyne, T; Cowling, A

    1998-01-01

    This paper proposes a diagnostic framework useful to Trust managers who are faced with the task of devising and implementing strategies for improvements in clinical effectiveness, and is based on a recent study incorporating clinicians, managers, and professional staff in four NHS Trusts in the North Thames Region. The gap framework is inspired by the gap model developed by Zeithaml, Parasuraman and Berry from their research into service quality and incorporates Dave Sackett's schema as well as a personal competency profile needed for the practice of evidence based health-care (EBHC). The paper highlights the four organisational and personal failures (gaps) which contribute to the fifth gap, namely the discrepancy between clinically relevant research evidence and its implementation in health care. To close the gaps, Trusts need to set the goal and tackle the cultural, organisational, attitudinal and more material aspects such as investment in the information infrastructure, education and training of doctors. Doctors need to go through a process from awareness to action facilitated through a combination of personal and organisational incentives and rewards as well as training in the requisite skills. Researchers should take steps to improve the quality of the evidence and its accessibility and purchasers should reinforce the use of EBHC by withdrawing funding for care which has proved to be ineffective, inappropriate or inferior.

  4. Information systems: the key to evidence-based health practice.

    PubMed Central

    Rodrigues, R. J.

    2000-01-01

    Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

  5. Health economics of weight management: evidence and cost.

    PubMed

    Kouris-Blazos, Antigone; Wahlqvist, Mark L

    2007-01-01

    The World Health Organization estimates that around one billion people throughout the world are overweight and that over 300 million of these are obese and if current trends continue, the number of overweight persons will increase to 1.5 billion by 2015. The number of obese adults in Australia is estimated to have risen from 2.0 million in 1992/93 to 3.1 million in 2005. The prevalence of obesity has been increasing due to a convergence of factors--the rise of TV viewing, our preference for takeaway and pre-prepared foods, the trend towards more computer-bound sedentary jobs, and fewer opportunities for sport and physical exercise. Obesity is not only linked to lack of self esteem, social and work discrimination, but also to illnesses such as the metabolic syndrome and hyperinsulinaemia (which increases the risk of developing heart disease, diabetes, hypertension, fatty liver), cancer, asthma, dementia, arthritis and kidney disease. It has been estimated that the cost of obesity in Australia in 2005 was $1,721 million. Of this amount, $1,084 million were direct health costs, and $637 million indirect health costs (due to lost work productivity, absenteeism and unemployment). The prevalence cost per year for each obese adult has been estimated at $554 and the value of an obesity cure is about $6,903 per obese person. Government efforts at reducing the burden remain inadequate and a more radical approach is needed. The Australian government, for example, has made changes to Medicare so that GPs can refer people with chronic illness due to obesity to an exercise physiologist and dietitian and receive a Medicare rebate, but so far these measures are having no perceptible effect on obesity levels. There is a growing recognition that both Public Health and Clinical approaches, and Private and Public resources, need to be brought to this growing problem. Australian health economist, Paul Gross, from the Institute of Health Economics and Technology Assessment claims there

  6. Enhancing Evidence-Based Public Health Policy: Developing and Using Policy Narratives.

    PubMed

    Troy, Lisa M; Kietzman, Kathryn G

    2016-06-01

    Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.].

  7. Green tea and bone health: Evidence from laboratory studies.

    PubMed

    Shen, Chwan-Li; Yeh, James K; Cao, Jay J; Chyu, Ming-Chien; Wang, Jia-Sheng

    2011-08-01

    Osteoporosis is a major health problem in the elderly. Epidemiological evidence has shown an association between tea consumption and the prevention of bone loss in the elderly population. Ingestion of green tea and green tea bioactive compounds may be beneficial in mitigating bone loss of this population and decreasing their risk of osteoporotic fractures. This review describes the effect of green tea with its bioactive components on bone health with an emphasis on the following: (i) the etiology of osteoporosis, (ii) evidence of osteo-protective impacts of green tea on bone mass and microarchitecture in various bone loss models in which induced by aging, sex hormone deficiency, and chronic inflammation, (iii) discussion of impacts of green tea on bone mass in two obesity models, (iv) observation of short-term green tea supplementation given to postmenopausal women with low bone mass, (v) possible mechanisms for the osteo-protective effects of green tea bioactive compounds, and (vi) a summary and future research direction of green tea and bone health.

  8. Evidence based practice profiles: Differences among allied health professions

    PubMed Central

    2010-01-01

    Background Most previous studies of allied health professionals' evidence based practice (EBP) attitudes, knowledge and behaviours have been conducted with profession specific questionnaires of variable psychometric strength. This study compared the self-report EBP profiles of allied health professionals/trainees in an Australian university. Methods The Evidence-Based Practice Profile (EBP2) questionnaire assessed five domains (Relevance, Terminology, Practice, Confidence, Sympathy) in 918 subjects from five professional disciplines. One and 2-way factorial analysis of variance (ANOVA) and t-tests analysed differences based on prior exposure to EBP, stage of training, professional discipline, age and gender. Results There were significant differences between stages of training (p < 0.001) for all domains and between EBP exposure groups for all but one domain (Sympathy). Professional discipline groups differed for Relevance, Terminology, Practice (p < 0.001) and Confidence (p = 0.006). Males scored higher for Confidence (p = 0.002) and females for Sympathy (p = 0.04), older subjects (> 24 years) scored higher for all domains (p < 0.05). Age and exposure affected all domains (p < 0.02). Differences in stages of training largely explained age-related differences in Confidence and Practice (p ≤ 0.001) and exposure-related differences in Confidence, Practice and Sympathy (p ≤ 0.023). Conclusions Across five allied health professions, self-report EBP characteristics varied with EBP exposure, across stages of training, with profession and with age. PMID:20937140

  9. The need for evidence-based health policy to address health care variations.

    PubMed

    Etheredge, Lynn

    2003-01-01

    Medicare policy making now deals mostly with price-setting issues. However, as Warren Buffet has noted: "Price is what you pay. Value is what you get." Victor Fuchs's studies raise fundamental issues for a value-oriented Medicare program. Florida offers one of many regional patterns of Medicare mortality that are not yet adequately explained. Valued-oriented, evidence-based Medicare policies would target opportunities to improve population health and would foster greater use of evidence-based medicine.

  10. Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

    PubMed

    Jurewicz, Izabela

    2015-04-01

    In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults.

  11. Assessment of mercury health risks to adults from coal combustion

    SciTech Connect

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  12. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    PubMed

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. PMID:24072881

  13. Undergraduate Public Health Capstone Course: Teaching Evidence-Based Public Health

    PubMed Central

    Fitzpatrick, Veronica Eileen; Mayer, Christen; Sherman, Barry R.

    2016-01-01

    The University at Albany School of Public Health has offered a Bachelor of Science in Public Health (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based public health class designed to culminate the degree program. This capstone course is framed by identifying a public health problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a public health problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys. PMID:27148516

  14. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    PubMed

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy.

  15. Older adult mental health: Teaching senior-level baccalaureate nursing students what they need to know.

    PubMed

    Puentes, William J; Bradway, Christine K; Aselage, Melissa

    2010-07-01

    Within the older adult population, certain idiosyncratic aspects of mental illness add to the challenges of helping clients manage these disorders. Older adults are more likely than younger populations to experience physiologically based comorbidities, a dynamic that further strains coping capacities. Barriers to the provision of comprehensive mental health nursing care for older adults include myths and stigmas about aging and mental health. Nurse educators are challenged to move students toward a more positive, empirically based approach to the care of older adults' mental health. In this article, background information supporting the importance of working to improve students' knowledge of and attitudes toward mental illness in older adults is provided. Specific teaching strategies in the areas of older adult mental health, dementia, and delirium are discussed. Resources to support the incorporation of these strategies into nursing curricula are described.

  16. A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks

    PubMed Central

    Schleier III, Jerome J.; Marshall, Lucy A.; Davis, Ryan S.

    2015-01-01

    Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin) used for adult mosquito management to generate an overall estimate of risk quotient (RQ). The utility of the Bayesian inference for risk management is that the estimated risk represents a probability distribution from which the probability of exceeding a threshold can be estimated. The mean RQs after all studies were incorporated were 0.4386, with a variance of 0.0163 for malathion and 0.3281 with a variance of 0.0083 for permethrin. After taking into account all of the evidence available on the risks of ULV insecticides, the probability that malathion or permethrin would exceed a level of concern was less than 0.0001. Bayesian estimates can substantially improve decisions by allowing decision makers to estimate the probability that a risk will exceed a level of concern by considering seemingly disparate lines of evidence. PMID:25648367

  17. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    PubMed

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness.

  18. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    PubMed

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. PMID:27015612

  19. High Blood Pressure in Adults with Disabilities: Influence of Gender, Body Weight and Health Behaviors

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Liu, Chien-Ting; Liou, Shih-Wen; Hsu, Shang-Wei; Lin, Jin-Ding

    2012-01-01

    The aims of this study were to explore the mean and distribution of systolic and diastolic blood pressure, and to examine the influence of gender, body weight and health behaviors on hypertension in adults with disabilities. We analyzed the 2010 annual community health examination chart of adults with disabilities in east Taiwan. The study samples…

  20. Multigenerational Perceptions of Mental Health Services of Deaf Adults in Florida

    ERIC Educational Resources Information Center

    Feldman, David M.; Gum, Amber

    2007-01-01

    The objective of the study was to better understand the perceptions and needs of multigenerational Deaf adults related to mental health services. A survey sampled participants who were between 20 and 85 years old and Deaf. Questions were developed to identify the perspectives of Deaf adults related to the availability of mental health services,…

  1. The Learning Needs of Young Adults with Mental Health Difficulties. NIACE Briefing Sheet.

    ERIC Educational Resources Information Center

    National Inst. of Adult Continuing Education, Leicester (England).

    A 1996 report recognized the benefits of effective learning provision and the impact that mental health difficulties can have on quality of life of young adults in the United Kingdom. The range of mental health difficulties experienced by young adults in the United Kingdom and elsewhere is similar to that experienced by the older population and…

  2. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 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 §...

  3. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 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 §...

  4. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 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 §...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 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 §...

  6. Adult Basic Education and Health Literacy: Program Efforts and Perceived Student Needs

    ERIC Educational Resources Information Center

    Mackert, Michael; Poag, Meg

    2011-01-01

    Objective: This project examined health literacy efforts among adult basic education providers in Central Texas. Methods: A survey was conducted with all adult literacy providers in Central Texas (N = 58). Results: Most programs provide health-related information. Literacy programs see needs for helping students communicate with doctors, filling…

  7. Implementation of Health Promotion in the Older Adults in Bangkok, Thailand

    ERIC Educational Resources Information Center

    Assantachai, Prasert; Bunnag, Chaweewan; Piya-Anant, Manee; Thamlikitkul, Visanu

    2006-01-01

    Effective strategies that bring health promotion messages to older adults in a developing country are needed. To evaluate the impact of various education media upon changes in knowledge and health behavior, a double-blind, randomized controlled trial was conducted involving 1,268 older adults in a southwest Bangkok suburb. Group teaching…

  8. Referral Trends in Mental Health Services for Adults with Intellectual Disability and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Tsakanikos, Elias; Sturmey, Peter; Costello, Helen; Holt, Geraldine; Bouras, Nick

    2007-01-01

    Researchers have paid increasing attention to mental health issues in adults with autism spectrum disorders (ASDs) over the last decades. However, little is known about how rates of clinical referrals, types of mental health diagnoses and treatment in adults with ASDs and intellectual disability have changed. We examined patterns of change in…

  9. Strengthening the evidence base for health programming in humanitarian crises.

    PubMed

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. PMID:25214616

  10. The evidence for public health recommendations on infant feeding.

    PubMed

    Fewtrell, M S

    2011-11-01

    Public health recommendations should be based on the best available scientific evidence, and this necessitates careful appraisal of the available data and management of scientific uncertainty. This paper discusses the difficulties in collecting and interpreting scientific data on infant feeding, in particular the fact that since it is not feasible to randomise healthy infants to be breast or formula-fed, the majority of available data come from observational studies with associated methodological limitations. The scientific evidence available to underpin recommendations for breastfeeding and for 6months exclusive breastfeeding are presented in the context of these limitations, noting disagreement between expert groups considering the same scientific data. Finally, the use of science to formulate infant feeding recommendations, and communication of information, including scientific uncertainty, to parents are discussed. PMID:21924566

  11. Adult Dental Health Survey 2009: transformations in British oral health 1968-2009.

    PubMed

    Steele, J G; Treasure, E T; O'Sullivan, I; Morris, J; Murray, J J

    2012-11-01

    This series of four papers reports and interprets the findings of the Adult Dental Health Survey (ADHS), 2009, published in early 2011. This is the fifth in a series of surveys repeated every decade since 1968. The evolution of the surveys and the way the supporting methodology has changed to meet the changing needs and circumstances over the last 40 years is described. In 1968, 37% of adults in England and Wales were edentate. By 2009, only 6% of the combined population of England, Wales and Northern Ireland were edentate. Among the dentate in 1968, there were a mean of 21.9 teeth. By 2009, not only had the dentate increased by 30 percentage points as a fraction of the population, but the number of teeth in this group had also increased by nearly four teeth on average to 25.7. There were significant variations in oral health according to geography and social variables and smaller differences according to sex. The retention of 21 or more teeth is widely used as a way of defining a minimum functional dentition. The proportion of adults with 21+ teeth increased from 73% in 1978 to 86% in 2009. Further huge improvements are projected as younger generations age, assuming future tooth loss continues at current low rates. We might expect that over 90% of those aged 35-44 in 2009 have a realistic prospect of retaining a functional natural dentition of 21 or more teeth by age 80. PMID:23175081

  12. DOES CHILDHOOD NUTRITION PREDICT HEALTH OUTCOMES DURING ADULTHOOD? EVIDENCE FROM A POPULATION-BASED STUDY IN CHINA.

    PubMed

    Qi, Yaqiang; Niu, Jianlin

    2015-09-01

    Using data collected from the 2008 survey of Internal Migration and Health in China, this study examines the impact of late childhood nutrition intakes on a wide range of indicators of adult health. The results show that respondents who consume rich nutrients (meat, fish, milk, etc.) less frequently during late childhood have worse health outcomes when they grow up. They are more likely to rate their health as 'fair/poor', report a greater number of chronic diseases, have a higher incidence of acute illness, perceive greater numbers of physical pains/discomforts and to suffer more from insomnia and depression. With respect to objective biometrics, respondents who have less access to rich nutrients at age 14 tend to attain a shorter stature, gain more weight as an adult, and are more likely to become obese or have low lung capacity. Taken together, the evidence in support of a harmful impact of late childhood undernutrition on adult health is stronger and more consistent for subjective health indicators than for the objective biometrics examined in this study. Moreover, the results also indicate that the long-term health impact of late childhood nutrition deprivation is especially detrimental for females in China. PMID:26217918

  13. Reducing recidivism and symptoms in emerging adults with serious mental health conditions and justice system involvement.

    PubMed

    Davis, Maryann; Sheidow, Ashli J; McCart, Michael R

    2015-04-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers. PMID:25023764

  14. The Link between Dietary Protein Intake, Skeletal Muscle Function and Health in Older Adults

    PubMed Central

    Baum, Jamie I.; Wolfe, Robert R.

    2015-01-01

    Skeletal muscle mass and function are progressively lost with age, a condition referred to as sarcopenia. By the age of 60, many older adults begin to be affected by muscle loss. There is a link between decreased muscle mass and strength and adverse health outcomes such as obesity, diabetes and cardiovascular disease. Data suggest that increasing dietary protein intake at meals may counterbalance muscle loss in older individuals due to the increased availability of amino acids, which stimulate muscle protein synthesis by activating the mammalian target of rapamycin (mTORC1). Increased muscle protein synthesis can lead to increased muscle mass, strength and function over time. This review aims to address the current recommended dietary allowance (RDA) for protein and whether or not this value meets the needs for older adults based upon current scientific evidence. The current RDA for protein is 0.8 g/kg body weight/day. However, literature suggests that consuming protein in amounts greater than the RDA can improve muscle mass, strength and function in older adults. PMID:27417778

  15. Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

    PubMed Central

    Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.

    2014-01-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers. PMID:25023764

  16. Phytoestrogens and human health effects: weighing up the current evidence.

    PubMed

    Humfrey, C D

    1998-01-01

    Phytoestrogens are naturally occurring plant compounds which have oestrogenic and/or anti-oestrogenic activity. They are present in many human foodstuffs including beans, sprouts, cabbage, spinach, soyabean, grains and hops. The main classes are the isoflavones, coumestans and lignans. This review assesses the evidence that these substances may have adverse and/or beneficial impacts on the risk of several hormone-dependent diseases in humans. Evidence from studies of various animal species has demonstrated that ingestion of high levels of phytoestrogens can produce adverse effects on reproductive endpoints including fertility. Studies in laboratory animals have also shown that exposure to high doses of phytoestrogens during development can adversely affect brain differentiation and reproductive development in rodents, but may also have possible beneficial effects. In humans, there is a lack of information concerning the possible effects of high doses of phytoestrogens in infants and this should be addressed as a matter of priority so that any risks (or benefits) can be established. In adults, no current data exist to suggest that consumption of phytoestrogens at the levels normally encountered in the diet is likely to be harmful. Epidemiological studies suggest that foodstuffs containing phytoestrogens may have a beneficial role in protecting against a number of chronic diseases and conditions. For cancer of the prostate, colon, rectum, stomach and lung, the evidence is most consistent for a protective effect resulting from a high intake of grains, legumes, fruits and vegetables; it is not possible to identify particular food types or components that may be responsible. Dietary intervention studies indicate that in women soya and linseed may have beneficial effects on the risk of breast cancer and may help to alleviate postmenopausal symptoms. For osteoporosis, tentative evidence suggests phytoestrogens may have similar effects in maintaining bone density to those

  17. Implementation of Evidence-Based HIV Interventions for Young Adult African American Women in Church Settings

    PubMed Central

    Stewart, Jennifer M.

    2015-01-01

    Objective To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Design Mixed methods cross-sectional design. Setting African American churches in Philadelphia, PA. Participants 142 African American pastors, church leaders, and young adult women ages 18 to 25. Methods Mixed methods convergent parallel design. Results The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Conclusion Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. PMID:25139612

  18. Young, uninsured, and seeking change: health coverage of young adults and their views on health reform. Findings from the Commonwealth fund Survey of Young Adults (2009).

    PubMed

    Nicholson, Jennifer L; Collins, Sara R

    2009-12-01

    Young adults are one of the largest uninsured segments of the population. This analysis of new survey data from The Commonwealth Fund finds almost half are without insurance at some time during the year. As they hit milestones like high school or college graduation, they face loss of coverage as they are dropped from parents' plans or public insurance programs. In the current economic climate, young adults are less likely to find jobs, and when they do, are frequently offered positions that come without benefits. Provisions in the health reform bills could help young adults by expanding Medicaid eligibility, creating a health insurance exchange with premium subsidies, and requiring insurers and employers to allow young adults to remain on parents' plans up to age 26 or 27. These provisions could help young adults obtain and keep affordable, comprehensive coverage through transitions from school to work and from job to job. PMID:20183947

  19. Evidence-based practice in health education and promotion: a review and introduction to resources.

    PubMed

    Hill, Elizabeth K; Alpi, Kristine M; Auerbach, Marilyn

    2010-05-01

    This review examines evidence-based practice (EBP) in health education and promotion with a focus on how academically trained health educators develop EBP skills and how health education and promotion practitioners access the literature to inform their activities. Competencies and credentialing in health education related to evidence-based practice are outlined and sources for evidence-based practice literature in health education and promotion are described. An exploratory questionnaire to consider teaching and resources in evidence-based practice was distributed to faculty and librarians from the top 10 ranked health education doctoral programs. Findings highlighted the integral value of EBP instruction to the curriculum. Growth opportunities in evidence-based health education and health promotion for instructors, practitioners, and librarians include promotion and expansion of online evidence-based public health resources to close the evidence-practice gap.

  20. Adapting evidence-based, cognitive-behavioral interventions for anxiety for use with adults in integrated primary care settings.

    PubMed

    Shepardson, Robyn L; Funderburk, Jennifer S; Weisberg, Risa B

    2016-06-01

    Evidence-based treatments for adult patients with anxiety are greatly needed within primary care settings. Psychotherapy protocols, including those for cognitive-behavioral therapy (CBT), are often disorder-specific and were developed for specialty mental health settings, rendering them infeasible in primary care. Behavioral health consultants (BHCs) integrated into primary care settings are uniquely positioned to provide anxiety treatment. However, due to the dearth of empirically supported brief treatments for anxiety, BHCs are tasked with adapting existing treatments for use in primary care, which is quite challenging due to the abbreviated format and population-based approach to care. CBT protocols are highly effective in the treatment of anxiety and fit well with the self-management emphasis of integrated primary care. We review the rationale and procedure for 6 evidence-based CBT intervention techniques (psycho-education, mindfulness and acceptance-based behavioral techniques, relaxation training, exposure, cognitive restructuring, and behavioral activation) that can be adapted for use in the brief format typical of integrated primary care. We offer tips based on our clinical experience, highlight resources (e.g., handouts, websites, apps), and discuss 2 case examples to aid BHCs in their everyday practice. Our goal is to provide BHCs with practical knowledge that will facilitate the use of evidence-based interventions to improve the treatment of anxiety in primary care settings. (PsycINFO Database Record PMID:27064434

  1. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    ERIC Educational Resources Information Center

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  2. Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

    The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2…

  3. Health Promoting Behaviors of Older Americans Versus Young and Middle Aged Adults

    ERIC Educational Resources Information Center

    Becker, Craig M.; Arnold, William

    2004-01-01

    Health promoting behaviors have become increasingly important as Americans attempt to retain their youth and health. This study collected self-reported data from 559 participants in the Southwest United States using the Health Promoting Lifestyle Profile II to compare the health promoting behaviors of older adults (60-92 years), middle-aged adults…

  4. Health Promoting Behaviors of Older Americans versus Young and Middle Aged Adults

    ERIC Educational Resources Information Center

    Becker, Craig; Arnold, William

    2004-01-01

    Health promoting behaviors have become increasingly important as Americans attempt to retain their youth and health. This study collected self-reported data from 559 participants in the Southwest United States using the Health Promoting Lifestyle Profile II to compare the health promoting behaviors of older adults (60-92 years), middle-aged adults…

  5. Gender and Race Variations in the Intersection of Religious Involvement, Early Trauma, and Adult Health

    PubMed Central

    Reinert, Katia G.; Campbell, Jacquelyn C.; Bandeen-Roche, Karen; Sharps, Phyllis; Lee, Jerry

    2015-01-01

    Purpose This study aimed to determine gender and race variations in regards to the influence of religious involvement (RI) as a moderator of the effects of early traumatic stress (ETS) on health-related quality of life among adult survivors of child abuse. Design A cross-sectional predictive design was used to study Seventh-day Adventist adults in North America (N = 10,283). Methods A secondary analysis of data collected via questionnaires was done using multiple regression. Results Data revealed that women had a significantly higher prevalence of any or all ETS subtypes, except for physical abuse prevalence, which was the same for both genders. Blacks reported a significantly higher prevalence of at least one ETS subtype than did Whites, except for neglect, where Whites had a higher prevalence. Exposure to at least one ETS subtype was associated with worse negative effect on mental health (B = −2.08, p < .0001 vs. B = −1.54, p < .0001) and physical health (B = −2.01, p < .0001 vs. B = −1.11, p < .0001) for women compared to men. Among those exposed to all ETS subtypes (n = 447), Whites had significant worse physical health, with White women having almost two times the negative effect on physical health (B = −4.50, p < .0001) than White men (B = −2.87, p < .05). As for RI moderation, based on tests of three-way interactions of race–RI–ETS, there were no associated differences. However, tests of three-way interactions of gender–RI–ETS showed a significant buffering effect. Among those with high levels of negative religious coping (RC), women exposed to ETS had significantly worse physical health (B = −1.28) than men. Conclusions Results give evidence of gender and racial differences on the magnitude of the ETS–health effect, as well as gender differences in ETS–health buffering by RC. Clinical Relevance Findings suggest gender and racial differences must be considered when devising holistic nursing interventions for improving health

  6. Practising alchemy: the transmutation of evidence into best health care.

    PubMed

    Goodyear-Smith, Felicity

    2011-04-01

    Alchemy was the synthesis or transmutation of all elements in perfect balance to obtain the philosopher's stone, the key to health. Just as alchemists sought this, so health practitioners always seek the best possible practice for optimal health outcomes for our patients. Best practice requires full knowledge--a little information can be dangerous. We need to serve our apprenticeship before we master our profession. Our profession is about improving health care. While the journey may start at medical school, the learning never ceases. It is not only about practising medicine, it is about the development of the practitioner. Professional practice requires systematic thinking combined with capacity to deal morally and creatively in areas of complexity and uncertainty appropriate to a specific context. It requires exemplary communication skills to interact with patients to facilitate collaborative decision making resulting in best practice. The synthesis of scientific and contextual evidence is a concept which applies to all disciplines where theoretical knowledge needs to be transferred to action to inform best practice. Decisions need to be made which take into account a complex array of factors, such as social and legal issues and resource constraints. Therefore, journey towards best practice involves transmutation of these three elements: scientific knowledge, the context in which it is applied and phronesis, the practical wisdom of the practitioner. All science has its limitations and we can never know all possible contextual information. Hence, like the philosopher's stone, best practice is a goal to which we aspire but never quite attain. PMID:21127021

  7. Participatory health system priority setting: Evidence from a budget experiment.

    PubMed

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

    2015-12-01

    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level.

  8. Practising alchemy: the transmutation of evidence into best health care.

    PubMed

    Goodyear-Smith, Felicity

    2011-04-01

    Alchemy was the synthesis or transmutation of all elements in perfect balance to obtain the philosopher's stone, the key to health. Just as alchemists sought this, so health practitioners always seek the best possible practice for optimal health outcomes for our patients. Best practice requires full knowledge--a little information can be dangerous. We need to serve our apprenticeship before we master our profession. Our profession is about improving health care. While the journey may start at medical school, the learning never ceases. It is not only about practising medicine, it is about the development of the practitioner. Professional practice requires systematic thinking combined with capacity to deal morally and creatively in areas of complexity and uncertainty appropriate to a specific context. It requires exemplary communication skills to interact with patients to facilitate collaborative decision making resulting in best practice. The synthesis of scientific and contextual evidence is a concept which applies to all disciplines where theoretical knowledge needs to be transferred to action to inform best practice. Decisions need to be made which take into account a complex array of factors, such as social and legal issues and resource constraints. Therefore, journey towards best practice involves transmutation of these three elements: scientific knowledge, the context in which it is applied and phronesis, the practical wisdom of the practitioner. All science has its limitations and we can never know all possible contextual information. Hence, like the philosopher's stone, best practice is a goal to which we aspire but never quite attain.

  9. Early-Life Conditions, Rapid Demographic Changes, and Older Adult Health in the Developing World.

    PubMed

    McEniry, Mary; McDermott, Jacob

    2015-01-01

    The demographic transition of the 1930s-1960s dramatically improved life expectancy in some developing countries. Cohorts born during this time are increasingly characterized by their survivorship of poor early-life conditions, such as poor nutrition and infectious diseases. As a result, they are potentially more susceptible to the effects of these conditions at older ages. This study examines this conjecture by comparing obesity, diabetes, and hypertension in older adults born in the beginning portion of the 1930s-1960s across different mortality regimes using a subset of harmonized cross-national data from seven low- and middle-income countries (RELATE, n = 16,836). Using birthplace and height as indicators of early-life conditions, the results show (1) higher prevalence of obesity and diabetes and higher likelihood of obesity, diabetes, and hypertension in middle-income countries, but (2) no convincing evidence to indicate stronger effects of early-life conditions on health in these countries. However, shorter adults living in urban areas were more likely to be obese, indicating the overall importance of early-life conditions and the potential negative impact of urban exposures during adulthood. Obesity results may foreshadow the health of future cohorts born in the later portion of the 1930s-1960s as they reach older ages (60+).

  10. A quantitative dynamic systems model of health-related quality of life among older adults

    PubMed Central

    Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela

    2015-01-01

    Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722

  11. A quantitative dynamic systems model of health-related quality of life among older adults.

    PubMed

    Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela

    2015-01-01

    Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722

  12. Early life conditions, rapid demographic changes and older adult health in the developing world

    PubMed Central

    McEniry, Mary; McDermott, Jacob

    2015-01-01

    The demographic transition of the 1930s–1960s dramatically improved life expectancy in some developing countries. Cohorts born during this time are increasingly characterized by their survivorship of poor early life conditions, such as poor nutrition and infectious diseases. As a result, they are potentially more susceptible to the effects of these conditions at older ages. This study examines this conjecture by comparing obesity, diabetes, and hypertension in older adults born in the beginning portion of the 1930s–1960s across different mortality regimes using a subset of harmonized cross national data from seven low and middle income countries (RELATE, n=16,836). Using birthplace and height as indicators of early life conditions, results show (1) higher prevalence of obesity and diabetes and higher likelihood of obesity, diabetes and hypertension in middle income countries but, (2) no convincing evidence to indicate stronger effects of early life conditions on health in these countries. However, shorter adults living in urban areas were more likely to be obese indicating the overall importance of early life conditions and the potential negative impact of urban exposures during adulthood. Obesity results may foreshadow the health of future cohorts born in the later portion of the 1930s–1960s as they reach older ages (60+). PMID:26266970

  13. Oral health disparity in older adults: dental decay and tooth loss.

    PubMed

    Friedman, Paula K; Kaufman, Laura B; Karpas, Steven L

    2014-10-01

    Progress has been made in reducing dental caries and edentulism in older adults, but disparities continue to exist related to race, ethnicity, socioeconomic level, and sex. Lack of training in treating medically complex patients, economic factors including absence of coverage for oral health services in Medicare and as a required service for adults in Medicaid, and attitudinal issues on the part of patients, caregivers, and providers contribute to barriers to care for older adults. In addition to the impact of oral health on overall health, oral health impacts quality of life and social and employment opportunities.

  14. Oral health status of older adults in Kentucky: results from the Kentucky Elder Oral Health Survey.

    PubMed

    Bush, Heather M; Dickens, Noel E; Henry, Robert G; Durham, Lisa; Sallee, Nancy; Skelton, Judith; Stein, Pam S; Cecil, James C

    2010-01-01

    The purpose of the Kentucky Elder Oral Health Survey (KEOHS) was to assess the oral health status of Kentuckians 65 and older. The KEOHS consisted of a self-administered questionnaire and a clinical examination. Recruitment occurred from May 2002 through March 2005 of persons aged 65 and older (n = 1,386) whose functional ability was classified by residential setting. Independent elders living in their own homes were designated as "well-elders," those who lived in skilled nursing facilities and who were functionally dependent were designated as "nursing home elders," and those older adults who were considered frail were designated as "homebound elders." Significant associations were found between the functional ability of the elders and demographic characteristics. While elders who were homebound reported the highest rate of barriers to care, dental insurance, affordability, and transportation were consistently reported as barriers for all groups of elders. This study has established the baseline oral health status of older adults in Kentucky and the data show differences that exist for various community living situations.

  15. On the Validity of the Rapid Estimate of Adult Literacy in Medicine (REALM) Scale as a Measure of Health Literacy

    PubMed Central

    Dumenci, Levent; Matsuyama, Robin K.; Kuhn, Laura; Perera, Robert A.; Siminoff, Laura A.

    2013-01-01

    Originally developed to measure the literacy level of patients, the Rapid Estimate of Adult Literacy in Medicine (REALM) scale is one of the most widely used instruments to measure the construct of health literacy. This article critically examines the validity of the REALM as a measure of health literacy. Logical analysis of content coverage led to the conclusion that scores on the REALM should not be used to make inferences about a person's level of health literacy. Rather, the REALM should be used to make inferences about the ability of a person to read and pronounce health related terms. Evidence from an analysis of a sample of 1,037 respondents to the REALM with a cancer diagnosis supports the quality of the REALM as a measure of reading and pronunciation ability. Other uses of the REALM in health literacy research are discussed. PMID:23935770

  16. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    PubMed

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC. PMID:25116081

  17. Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

    PubMed Central

    Vives, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan

    2013-01-01

    Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent's sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making. PMID:23431322

  18. Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications.

    PubMed

    Dashti, Hassan S; Scheer, Frank Ajl; Jacques, Paul F; Lamon-Fava, Stefania; Ordovás, José M

    2015-11-01

    Links between short sleep duration and obesity, type 2 diabetes, hypertension, and cardiovascular disease may be mediated through changes in dietary intake. This review provides an overview of recent epidemiologic studies on the relations between habitual short sleep duration and dietary intake in adults from 16 cross-sectional studies. The studies have observed consistent associations between short sleep duration and higher total energy intake and higher total fat intake, and limited evidence for lower fruit intake, and lower quality diets. Evidence also suggests that short sleepers may have irregular eating behavior deviating from the traditional 3 meals/d to fewer main meals and more frequent, smaller, energy-dense, and highly palatable snacks at night. Although the impact of short sleep duration on dietary intake tends to be small, if chronic, it may contribute to an increased risk of obesity and related chronic disease. Mechanisms mediating the associations between sleep duration and dietary intake are likely to be multifactorial and include differences in the appetite-related hormones leptin and ghrelin, hedonic pathways, extended hours for intake, and altered time of intake. Taking into account these epidemiologic relations and the evidence for causal relations between sleep loss and metabolism and cardiovascular function, health promotion strategies should emphasize improved sleep as an additional factor in health and weight management. Moreover, future sleep interventions in controlled studies and sleep extension trials in chronic short sleepers are imperative for establishing whether there is a causal relation between short sleep duration and changes in dietary intake.

  19. Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications.

    PubMed

    Dashti, Hassan S; Scheer, Frank Ajl; Jacques, Paul F; Lamon-Fava, Stefania; Ordovás, José M

    2015-11-01

    Links between short sleep duration and obesity, type 2 diabetes, hypertension, and cardiovascular disease may be mediated through changes in dietary intake. This review provides an overview of recent epidemiologic studies on the relations between habitual short sleep duration and dietary intake in adults from 16 cross-sectional studies. The studies have observed consistent associations between short sleep duration and higher total energy intake and higher total fat intake, and limited evidence for lower fruit intake, and lower quality diets. Evidence also suggests that short sleepers may have irregular eating behavior deviating from the traditional 3 meals/d to fewer main meals and more frequent, smaller, energy-dense, and highly palatable snacks at night. Although the impact of short sleep duration on dietary intake tends to be small, if chronic, it may contribute to an increased risk of obesity and related chronic disease. Mechanisms mediating the associations between sleep duration and dietary intake are likely to be multifactorial and include differences in the appetite-related hormones leptin and ghrelin, hedonic pathways, extended hours for intake, and altered time of intake. Taking into account these epidemiologic relations and the evidence for causal relations between sleep loss and metabolism and cardiovascular function, health promotion strategies should emphasize improved sleep as an additional factor in health and weight management. Moreover, future sleep interventions in controlled studies and sleep extension trials in chronic short sleepers are imperative for establishing whether there is a causal relation between short sleep duration and changes in dietary intake. PMID:26567190

  20. Poverty indicators and mental health functioning among adults living with HIV in Delhi, India.

    PubMed

    Kang, Ezer; Delzell, Darcie A P; McNamara, Paul E; Cuffey, Joel; Cherian, Anil; Matthew, Saira

    2016-01-01

    Poor mental health functioning among persons living with HIV (PLHIV) has gained considerable attention particularly in low-income countries that disproportionately carry the global HIV/AIDS burden. Fewer studies, however, have examined the relationship between poverty indicators and mental health among PHLIV in India. Based on this cross-sectional study of 196 HIV-seropositive adults who received medical services at Shalom AIDS Project in Delhi, India, structural equation modeling and mediation analysis were employed to estimate the associations between poverty indices (household asset index, food security, unemployment, water treatment, sanitation), HIV-health factors (illness in the past 3 months, co-morbid medical conditions), and psychological distress. In the final model, ownership of fewer household assets was associated with higher levels of food insecurity, which in turn was associated with higher psychological distress. Also, the household asset index, food insecurity, and unemployment had a larger effect on psychological distress than new opportunistic infections. These findings build on increasing evidence that support concerted efforts to design, evaluate, and refine HIV mental health interventions that are mainstreamed with livelihood programming in high poverty regions in India.

  1. Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health.

    PubMed

    Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Chatterji, Somnath

    2016-06-01

    This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum. PMID:26895999

  2. Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health.

    PubMed

    Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Chatterji, Somnath

    2016-06-01

    This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum.

  3. Gender Differences in Health Literacy Among Korean Adults: Do Women Have a Higher Level of Health Literacy Than Men?

    PubMed

    Lee, Hee Yun; Lee, Jiwoo; Kim, Nam Keol

    2015-09-01

    The role of gender in determining the level of health literacy in Korean adults is unclear. This study aimed to investigate the level of health literacy in Korean adults and identify factors associated with health literacy by gender. This study employed a cross-sectional survey design with a convenient sample of 585 community-dwelling Korean adults age19 years and older. Health literacy was measured by using eight items selected from Chew et al.'s 16-question self-reported health literacy measure. In accordance with Andersen's health behavior model, predisposing, enabling, and need factors were included in the multiple regression model. Women indicated a higher level of health literacy than men in understanding medical forms, directions on medication bottles, and written information offered by health care providers. Additionally, for Korean women, a higher level of health literacy was associated with attaining a higher education level and having a consistent place to receive care. Unmarried men and men who had higher self-rated health reported a higher level of health literacy compared with their counterparts. Lower level of depression and higher monthly income were significantly linked to a higher level of health literacy in both men and women. This study has established the importance of gender differences in health literacy and suggests gender-specific intervention may be warranted to reduce the existing gap in health literacy in both Korean men and women. Future research should replicate this study to confirm whether or not our finding is an international phenomenon.

  4. Health and Beyond… Strategies for a Better India: Incorporating Evidence to Strengthen Health Policy

    PubMed Central

    Bhaumik, Soumyadeep

    2014-01-01

    India plans to roll-out universal health coverage in spite of having one of the lowest governments spending on health in the world. A scenario such as this means that health policy decisions particularly with respect to priority setting and resource allocation are often difficult and riddled with difficult choices. Moreover, a variety of decisions and determinants beyond the barriers of the health system has to be taken into account in a pluralistic and diverse nation like India during the healthy policy making process. The review provides a brief overview on the current policy making scenario, where often decisions are not based on latest research evidence, but on placating powerful activist groups and is more problem oriented rather than being solution oriented. Various opportunities which exist in order to incorporate evidence in order to inform health policy are discussed. The article highlights the need to develop a transparent, inclusive and independent mechanism to prospectively appraise all available evidence and help inform policy-making based on predetermined criteria and to as evaluate the impact of policy decisions thereby helping in knowledge creation, translation as well as its implementation. PMID:25657936

  5. Egalitarianism and altruism in health: some evidence of their relationship

    PubMed Central

    2014-01-01

    Background Egalitarianism and altruism are two ways in which people may have attitudes that go beyond the narrowly defined selfish preferences. The theoretical constructs of egalitarianism and altruism are different from each other, yet there may be connections between the two. This paper explores the empirical relationship between egalitarianism and altruism, in the context of health. Methods We define altruism as individual behaviour that aims to benefit another individual in need; and egalitarianism as a characteristic of a social welfare function, or a meta-level preference. Furthermore, we specify a model that explains the propensity of an individual to be egalitarian in terms of altruism and other background characteristics. Individuals who prefer a hypothetical policy that reduces socioeconomic inequalities in health outcomes over another that does not are regarded ‘egalitarian’ in the health domain. On the other hand, ‘altruism’ in the health context is captured by whether or not the same respondents are (or have been) regular blood donors, provided they are medically able to donate. Probit models are specified to estimate the relationship between egalitarianism and altruism, thus defined. A representative sample of the Spanish population was interviewed for the purpose (n = 417 valid cases). Results Overall, 75% of respondents are found to be egalitarians, whilst 35% are found to be altruists. We find that, once controlled for background characteristics, there is a statistically significant empirical relationship between egalitarianism and altruism in the health context. On average, the probability of an altruist individual supporting egalitarianism is 10% higher than for a non-altruist person. Regarding the other control variables, those living in high per capita income regions have a lower propensity and those who are politically left wing have a higher propensity to be an egalitarian. We do not find evidence of a relationship between

  6. Identifying Family History and Substance Use Associations for Adult Epilepsy from the Electronic Health Record.

    PubMed

    Wang, Yan; Chen, Elizabeth S; Leppik, Ilo; Pakhomov, Serguei; Sarkar, Indra Neil; Melton, Genevieve B

    2016-01-01

    Epilepsy is a prevalent chronic neurological disorder afflicting about 50 million people worldwide. There is evidence of a strong relationship between familial risk factors and epilepsy, as well as associations with substance use. The goal of this study was to explore the interactions between familial risk factors and substance use based on structured data from the family and social history modules of an electronic health record system for adult epilepsy patients. A total of 8,957patients with 38,802 family history entries and 8,822 substance use entries were gathered and mined for associations at different levels of granularity for three age groupings (>18, 18-64, and ≥65 years old). Our results demonstrate the value of an association rule mining approach to validate knowledge of familial risk factors. The preliminary findings also suggest that substance use does not demonstrate significant association between social and familial risk factors for epilepsy. PMID:27570679

  7. Identifying Family History and Substance Use Associations for Adult Epilepsy from the Electronic Health Record

    PubMed Central

    Wang, Yan; Chen, Elizabeth S.; Leppik, Ilo; Pakhomov, Serguei; Sarkar, Indra Neil; Melton, Genevieve B.

    2016-01-01

    Epilepsy is a prevalent chronic neurological disorder afflicting about 50 million people worldwide. There is evidence of a strong relationship between familial risk factors and epilepsy, as well as associations with substance use. The goal of this study was to explore the interactions between familial risk factors and substance use based on structured data from the family and social history modules of an electronic health record system for adult epilepsy patients. A total of 8,957patients with 38,802 family history entries and 8,822 substance use entries were gathered and mined for associations at different levels of granularity for three age groupings (>18, 18-64, and ≥65 years old). Our results demonstrate the value of an association rule mining approach to validate knowledge of familial risk factors. The preliminary findings also suggest that substance use does not demonstrate significant association between social and familial risk factors for epilepsy. PMID:27570679

  8. Polyunsaturated fatty acids and their relation with bone and muscle health in adults.

    PubMed

    Mangano, Kelsey M; Sahni, Shivani; Kerstetter, Jane E; Kenny, Anne M; Hannan, Marian T

    2013-09-01

    Age-related bone and muscle loss are major public health problems. Investigational therapies to reduce these losses include anti-inflammatory dietary supplementations, such as polyunsaturated fatty acids (PUFA). Surprisingly, this topic has received little attention in the osteoporosis community. Recent research highlights the role of PUFA in inflammatory regulation of bone remodeling via cellular pathways. Emerging research suggests significant roles for PUFA in reducing bone and muscle loss with aging; however, findings are conflicted for PUFA and fracture risk. Limited studies suggest a relation between higher omega-3 FA and better muscle/bone in older adults. This review highlights new research since 2008 and synthesizes our current understanding of PUFA in relation to bone and muscle. Across study designs, evidence indicates that PUFA has positive effects upon bone. As data are sparse, future clinical trials and prospective studies are important to determine the long term benefits of PUFA supplementation upon bone and muscle outcomes. PMID:23857286

  9. Polyunsaturated fatty acids and their relation with bone and muscle health in adults

    PubMed Central

    Mangano, Kelsey M; Sahni, Shivani; Kerstetter, Jane E; Kenny, Anne M; Hannan, Marian T

    2013-01-01

    Age-related bone and muscle loss are major public health problems. Investigational therapies to reduce these losses include anti-inflammatory dietary supplementations, such as polyunsaturated fatty acids (PUFA). Surprisingly, this topic has received little attention in the osteoporosis community. Recent research highlights the role of PUFA in inflammatory regulation of bone remodeling via cellular pathways. Emerging research suggests significant roles for PUFA in reducing bone and muscle loss with aging; however, findings are conflicted for PUFA and fracture risk. Limited studies suggest a relation between higher omega-3 FA and better muscle/bone in older adults. This review highlights new research since 2008 and synthesizes our current understanding of PUFA in relation to bone and muscle. Across study designs, evidence indicates that PUFA has positive effects upon bone. As data are sparse, future clinical trials and prospective studies are important to determine the long term benefits of PUFA supplementation upon bone and muscle outcomes. PMID:23857286

  10. Unmet Health Care Needs of People with Disabilities: Population Level Evidence

    ERIC Educational Resources Information Center

    McColl, Mary Ann; Jarzynowska, Anna; Shortt, S. E. D.

    2010-01-01

    The present study examined population level data on unmet needs for adults with physical, sensory and cognitive disabilities, using the National Population Health Survey. The study revealed that disabled adults (aged 20-64) reported more than three times as many unmet health care needs as their non-disabled counterparts. Even after controlling for…

  11. Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey

    PubMed Central

    Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

    2016-01-01

    Background: The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. Aims: To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Study Design: Cross-sectional study. Methods: This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households – 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Results: Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16–1.51), unemployment (1.36; 1.18–1.56), single status (1.34; 1.23–1.45), and Wealth Index middle class (1.20; 1.08–1.32) or poor (1.33; 1.21–1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59–0.89). Single (1.50; 1.26–1.78), unemployed (1.39; 1.07–1.80) and inactive respondents (1.42; 1.10–1.83) had a higher odds of chronic anxiety or depression than married

  12. e-Health Technologies for Adult Hearing Screening

    PubMed Central

    Stenfelt, S.; Janssen, T.; Schirkonyer, V.; Grandori, F.

    2011-01-01

    The development of hearing diagnosis methods and hearing screening methods are not isolated phenomena: they are intimately related to changes in the cultural background and to advances in fields of medicine and engineering. In the recent years, there has been a rapid evolution in the development of fast, easy and reliable techniques for low-cost hearing screening initiatives. Since adults and elderly people typically experience a reduced hearing ability in challenging listening situations [e.g., in background noise, in reverberation, or with competing speech (Pichora-Fuller & Souza, 2003)], these newly developed screening tests mainly rely on the recognition of speech stimuli in noise, so that the real experienced listening difficulties can be effectively targeted (Killion & Niquette, 2000). New tests based on the recognition of speech in noise are being developed on portable, battery-operated devices (see, for example, Paglialonga et al., 2011), or distributed diffusely using information and communication technologies. The evolutions of e-Health and telemedicine have shifted focus from patients coming to the hearing clinic for hearing health evaluation towards the possibility of evaluating the hearing status remotely at home. So far, two ways of distributing the hearing test have primarily been used: ordinary telephone networks (excluding mobile networks) and the internet. When using the telephone network for hearing screening, the predominantly test is a speech-in-noise test often referred to as the digit triplet test where the subjects hearing status is evaluated as the speech-to-noise threshold for spoken digits. This test is today available in some ten countries in Europe, North America and Australia. The use of internet as testing platform allows several different types of hearing assessment tests such as questionnaires, different types of speech in noise tests, temporal gap detection, sound localization (minimum audible angle), and spectral (un)masking tests

  13. Developing a personal health record for community-dwelling older adults and clinicians: technology and content.

    PubMed

    Monsen, Karen A; Westra, Bonnie L; Paitich, Nadine; Ekstrom, Dawn; Mehle, Susan C; Kaeding, Maggie; Abdo, Sajeda; Natarajan, Gowtham; Ruddarraju, Uday Kumar Raju

    2012-07-01

    To empower older consumers and improve health outcomes, a consumer-friendly personal health record (PHR) is needed. The purpose of this article was to evaluate PHR technology and content for older community-dwelling consumers. Specific aims were to: (a) develop a secure, web-based application for a PHR to enable interoperable exchanges of data between consumers and clinicians; (b) develop structured, evidence-based shared care plan content for the PHR using an interface terminology standard; and (c) validate the shared care plans with consumers. An interoperable web-based form was developed. The standardized PHR content was developed by expert panel consensus using the Omaha System problem list and care plans, and validated by consumer interviews. Evidence-based shared care plans for 21 problems common among community-dwelling older adults were developed and encoded with Omaha System terms for data capture in the PHR. An additional problem, Neighborhood-workplace safety, was identified by consumers and will be added to the care plans.

  14. Oral health-related quality of life in Swedish young adults

    PubMed Central

    Johansson, Gunvi; Östberg, Anna-Lena

    2015-01-01

    The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21–29 years, were interviewed. The findings from the interviews were summarized under the theme “Young adults reflected on their OHRQoL in a time perspective” consisting of three categories: “Past experiences, Present situation, and Future prospects.” The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up. PMID:26066517

  15. "More Universal for Some than Others": Canada's Health Care System and the Role of Adult Education

    ERIC Educational Resources Information Center

    Quigley, B. Allan; Coady, Maureen; Gregoire, Helene; Folinsbee, Sue; Kraglund-Gauthier, Wendy

    2009-01-01

    Health and health care in Canada is a story of high ideals, complex policy agreements, moments of raging public controversy, and the creation of a national health system that is the envy of many other nations. Despite its many health care achievements, evidence is mounting that good health is far from being universally accessible to all Canadians.…

  16. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

    PubMed Central

    2014-01-01

    Background The rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants. Methodology Both quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed. Results Twenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited. Discussion The review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings. PMID:25177360

  17. The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon.

    PubMed

    Undurraga, Eduardo A; Behrman, Jere R; Leonard, William R; Godoy, Ricardo A

    2016-01-01

    Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. PMID:26706403

  18. The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon.

    PubMed

    Undurraga, Eduardo A; Behrman, Jere R; Leonard, William R; Godoy, Ricardo A

    2016-01-01

    Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health.

  19. Designing, Implementing, and Evaluating Mobile Health Technologies for Managing Chronic Conditions in Older Adults: A Scoping Review

    PubMed Central

    Harris, Lauren; Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; Ibrahim, Sarah; Gafni, Amiram; Isaacs, Sandra

    2016-01-01

    Background The current landscape of a rapidly aging population accompanied by multiple chronic conditions presents numerous challenges to optimally support the complex needs of this group. Mobile health (mHealth) technologies have shown promise in supporting older persons to manage chronic conditions; however, there remains a dearth of evidence-informed guidance to develop such innovations. Objectives The purpose of this study was to conduct a scoping review of current practices and recommendations for designing, implementing, and evaluating mHealth technologies to support the management of chronic conditions in community-dwelling older adults. Methods A 5-stage scoping review methodology was used to map the relevant literature published between January 2005 and March 2015 as follows: (1) identified the research question, (2) identified relevant studies, (3) selected relevant studies for review, (4) charted data from selected literature, and (5) summarized and reported results. Electronic searches were conducted in 5 databases. In addition, hand searches of reference lists and a key journal were completed. Inclusion criteria were research and nonresearch papers focused on mHealth technologies designed for use by community-living older adults with at least one chronic condition, or health care providers or informal caregivers providing care in the home and community setting. Two reviewers independently identified articles for review and extracted data. Results We identified 42 articles that met the inclusion criteria. Of these, described innovations focused on older adults with specific chronic conditions (n=17), chronic conditions in general (n=6), or older adults in general or those receiving homecare services (n=18). Most of the mHealth solutions described were designed for use by both patients and health care providers or health care providers only. Thematic categories identified included the following: (1) practices and considerations when designing mHealth

  20. Families, Friends, and the Neighborhood of Older Adults: Evidence from Public Housing in Singapore

    PubMed Central

    Wu, Treena; Chan, Angelique

    2012-01-01

    Introduction. This empirical paper examines how the Housing Development Board (HDB) public housing neighborhood influences older urban Singaporeans' social interactions and ameliorates social isolation. Methods. Using 4,542 observations of noninstitutionalized urban adults aged 60 and above, ordered logistic regressions are run to determine the predictors of isolation while controlling for physical health and demographics. Results. 87% of older Singaporeans reside in public housing apartments while 13% reside in private market housing. The main predictor of social isolation is living alone and the second main predictor is coresidence with adult children. The relationship between coresidence with adult children and isolation is mediated when controlling for older adult functional limitations. The public apartment neighborhood and daily participation in public neighborhood events have substantial effects on reducing the risk of isolation. Older adult contact with friends alleviates isolation more than contact with non-coresiding relatives. Conclusion. Findings suggest that the public neighborhood-built environment in Singapore plays a positive role in the social interactions of the elderly. Knowledge of the factors that decrease the risk of social isolation will have implications for studying morbidity and mortality among the elderly. PMID:22162809

  1. Health Risks and Changes in Self-Efficacy Following Community Health Screening of Adults with Serious Mental Illnesses

    PubMed Central

    Cook, Judith A.; Razzano, Lisa A.; Swarbrick, Margaret A.; Jonikas, Jessica A.; Yost, Chantelle; Burke, Larisa; Steigman, Pamela J.; Santos, Alberto

    2015-01-01

    Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre- to post-screening increases in participants’ self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care. PMID:25875181

  2. Health risks and changes in self-efficacy following community health screening of adults with serious mental illnesses.

    PubMed

    Cook, Judith A; Razzano, Lisa A; Swarbrick, Margaret A; Jonikas, Jessica A; Yost, Chantelle; Burke, Larisa; Steigman, Pamela J; Santos, Alberto

    2015-01-01

    Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre- to post-screening increases in participants' self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care. PMID:25875181

  3. Evidence and ethics in public health: the experience of SARS in Canada.

    PubMed

    Upshur, Ross E G

    2012-01-01

    Making decisions on the basis of evidence is a central tenet of all health-care disciplines, including public health. However, it is not entirely clear what it means to base decisions on evidence; debates on evidence-based approaches often lack a clear understanding of the nature of evidence and obscure the normative underpinnings of evidence. Public health decision making requires an acceptance of limitations such as the availability of funding for research to provide complete evidence for any given decision, the ethical constraints on the creation of certain types of evidence and the ongoing dilemma between the need to take action and the need to gather more information. Using the example of the SARS outbreak in Canada, the inter-relationships between evidence and ethics are explored. I outline a set of critical questions for the global public health community to discuss regarding the nature of the relationship between evidence-based public health practice and ethics.

  4. Personal factors predictive of health-related lifestyles of community-dwelling older adults.

    PubMed

    Peralta-Catipon, Terry; Hwang, Jengliang Eric

    2011-01-01

    We explored personal factors that can predict health-related lifestyles of community-dwelling older adults. A convenience sample of 253 older adults was recruited to complete the Health Enhancement Lifestyle Profile (HELP), a comprehensive measure of health-promoting behaviors. Data were analyzed through univariate correlational/comparative statistics followed by stepwise multiple regression analysis to determine significant predictor variables for different aspects of health-related lifestyle. Personal health conditions, including the number of chronic diseases or impairments and self-rated health, were two strong predictors for the HELP (R2 = .571, p < .0001). Demographic characteristics, including age, gender, race, education, and employment status, also demonstrated varied degrees of capability for predicting the different HELP scales (e.g., Exercise, Diet, Leisure). When developing individualized plans for older adults in community settings, occupational therapists should consider the clients' strengths and vulnerabilities potentially derived from personal health factors and demographic attributes to yield more effective lifestyle interventions.

  5. The Impact of Medicaid Expansion on Oral Health Equity for Older Adults: A Systems Perspective

    PubMed Central

    Metcalf, Sara S.; Birenz, Shirley S.; Kunzel, Carol; Wang, Hua; Schrimshaw, Eric W.; Marshall, Stephen E.; Northridge, Mary E.

    2015-01-01

    This paper uses a collaborative, interdisciplinary systems science inquiry to explore implications of Medicaid expansion on achieving oral health equity for older adults. Through an iterative modeling process oriented toward the experiences of both patients and oral health care providers, complex feedback mechanisms for promoting oral health equity are articulated that acknowledge the potential for stigma as well as disparities in oral health care accessibility. Multiple factors mediate the impact of Medicaid expansion on oral health equity. PMID:26457047

  6. The Impact of Medicaid Expansion on Oral Health Equity for Older Adults: A Systems Perspective.

    PubMed

    Northridge, Mary E; Metcalf, Sara S; Birenz, Shirley S; Kunzel, Carol; Wang, Hua; Schrimshaw, Eric W; Marshall, Stephen E

    2015-07-01

    This paper uses a collaborative, interdisciplinary systems science inquiry to explore implications of Medicaid expansion on achieving oral health equity for older adults. Through an iterative modeling process oriented toward the experiences of both patients and oral health care providers, complex feedback mechanisms for promoting oral health equity are articulated that acknowledge the potential for stigma as well as disparities in oral health care accessibility. Multiple factors mediate the impact of Medicaid expansion on oral health equity. PMID:26457047

  7. The Impact of Medicaid Expansion on Oral Health Equity for Older Adults: A Systems Perspective.

    PubMed

    Northridge, Mary E; Metcalf, Sara S; Birenz, Shirley S; Kunzel, Carol; Wang, Hua; Schrimshaw, Eric W; Marshall, Stephen E

    2015-07-01

    This paper uses a collaborative, interdisciplinary systems science inquiry to explore implications of Medicaid expansion on achieving oral health equity for older adults. Through an iterative modeling process oriented toward the experiences of both patients and oral health care providers, complex feedback mechanisms for promoting oral health equity are articulated that acknowledge the potential for stigma as well as disparities in oral health care accessibility. Multiple factors mediate the impact of Medicaid expansion on oral health equity.

  8. Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

    PubMed Central

    McMorrow, Stacey; Zuckerman, Stephen

    2014-01-01

    Objective To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data Sources Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008). Study Design We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. Data Collection We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Principal Findings Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Conclusions Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. PMID:24344818

  9. Health Insurance Status and Psychological Distress among US Adults Aged 18-64 Years.

    PubMed

    Ward, Brian W; Martinez, Michael E

    2015-10-01

    The purpose of this research was to examine the relationship between psychological distress and aspects of health insurance status, including lack of coverage, types of coverage and disruption in coverage, among US adults. Data from the 2001-2010 National Health Interview Survey were used to conduct analyses representative of the US adult population aged 18-64 years. Multivariate analyses regressed psychological distress on health insurance status while controlling for covariates. Adults with private or no health insurance coverage had lower levels of psychological distress than those with public/other coverage. Adults who recently (≤1 year) experienced a change in health insurance status had higher levels of distress than those who had not recently experienced a change. An interaction effect indicated that the relationship between recent change in health insurance status and distress was not dependent on whether an adult had private versus public/other coverage. However, for adults who had not experienced a change in status in the past year, the average absolute level of distress is higher among those with no coverage versus private coverage. Although significant relationships between psychological distress and health insurance status were identified, their strength was modest, with other demographic and health condition covariates also being potential sources of distress. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  10. Weight maintenance from young adult weight predicts better health outcomes

    PubMed Central

    Votruba, Susanne B; Thearle, Marie S; Piaggi, Paolo; Knowler, William C; Hanson, Robert L; Krakoff, Jonathan

    2014-01-01

    Objective Defining groups of individuals within a larger population with similar patterns of weight change over time may provide insight into influences of weight stability or gain. Methods Latent class growth modeling was used to define subgroups of weight change in adult members of the Gila River Indian Community participating in at least 4 non-diabetic health exams including OGTTs (N=1157, 762F/395M; 78.4±19.0 kg). In a separate study, 152 individuals had 24-hr EE measured in a respiratory chamber. Results Eight groups with baseline weights of 54.6±7.3 (n=124), 64.2±7.7 (n=267), 73.6±7.8 (n=298), 86.1±10.2 (n=194), 95.5±6.7 (n=90), 97.9±10.4 (n=92), 110.9±11.9 (n=61), and 122.1±13.6 (n=31) kg (P<0.001) were delineated. Group 5, (initial weight=95.5±6.7 kg) maintained a comparatively stable weight over time (+3.3±10.3 kg, +3.8±11.2% of initial weight; median follow-up time: 13.1 years). All other groups gained weight over time (+29.9±21.1% of initial weight; median follow-up time: 16.3 years). Higher starting weight defined weight gain in most groups, but higher 2hr glucose predicted membership in the lower weight trajectories. The weight stable group had higher rates of impaired glucose regulation at baseline and higher 24-hr EE. Conclusions Weight in young adulthood defined weight gain trajectory underscoring the importance of intervening early to prevent weight gain. PMID:25131650

  11. Cardiometabolic risk factors predict cerebrovascular health in older adults: results from the Brain in Motion study.

    PubMed

    Tyndall, Amanda V; Argourd, Laurie; Sajobi, Tolulope T; Davenport, Margie H; Forbes, Scott C; Gill, Stephanie J; Parboosingh, Jillian S; Anderson, Todd J; Wilson, Ben J; Smith, Eric E; Hogan, David B; Hill, Michael D; Poulin, Marc J

    2016-04-01

    Aging and physical inactivity are associated with an increased risk of developing metabolic syndrome (MetS). With the rising prevalence of MetS, it is important to determine the extent to which it affects cerebrovascular health. The primary purpose of this report is to examine the impact of MetS on cerebrovascular health (resting cerebral blood flow (CBF) peak velocity (V¯P), cerebrovascular conductance (CVC), and CBF responses to hypercapnia) in healthy older adults with normal cognition. A secondary goal was to examine the influence of apolipoprotein E (APOE) ε4 expression on these indices. In a sample of 258 healthy men and women older than 53 years, 29.1% met criteria for MetS. MetS, sex, and age were found to be significant predictors of CVC, and V¯P, MetS, and APOE status were significant predictors of V¯P-reactivity, and CVC-reactivity was best predicted by MetS status. After controlling for these factors, participants with MetS demonstrated lower cerebrovascular measures (CVC, V¯P, CVC-reactivity, and V¯P-reactivity) compared to participants without MetS. APOE ε4 carriers had higher V¯P-reactivity than noncarriers. These results provide evidence that cardiometabolic and vascular risk factors clustered together as the MetS predict measures of cerebrovascular health indices in older adults. Higher V¯P-reactivity in APOE ε4 carriers suggests vascular compensation for deleterious effects of this known risk allele for Alzheimer's disease and stroke. PMID:27117804

  12. Cardiometabolic risk factors predict cerebrovascular health in older adults: results from the Brain in Motion study.

    PubMed

    Tyndall, Amanda V; Argourd, Laurie; Sajobi, Tolulope T; Davenport, Margie H; Forbes, Scott C; Gill, Stephanie J; Parboosingh, Jillian S; Anderson, Todd J; Wilson, Ben J; Smith, Eric E; Hogan, David B; Hill, Michael D; Poulin, Marc J

    2016-04-01

    Aging and physical inactivity are associated with an increased risk of developing metabolic syndrome (MetS). With the rising prevalence of MetS, it is important to determine the extent to which it affects cerebrovascular health. The primary purpose of this report is to examine the impact of MetS on cerebrovascular health (resting cerebral blood flow (CBF) peak velocity (V¯P), cerebrovascular conductance (CVC), and CBF responses to hypercapnia) in healthy older adults with normal cognition. A secondary goal was to examine the influence of apolipoprotein E (APOE) ε4 expression on these indices. In a sample of 258 healthy men and women older than 53 years, 29.1% met criteria for MetS. MetS, sex, and age were found to be significant predictors of CVC, and V¯P, MetS, and APOE status were significant predictors of V¯P-reactivity, and CVC-reactivity was best predicted by MetS status. After controlling for these factors, participants with MetS demonstrated lower cerebrovascular measures (CVC, V¯P, CVC-reactivity, and V¯P-reactivity) compared to participants without MetS. APOE ε4 carriers had higher V¯P-reactivity than noncarriers. These results provide evidence that cardiometabolic and vascular risk factors clustered together as the MetS predict measures of cerebrovascular health indices in older adults. Higher V¯P-reactivity in APOE ε4 carriers suggests vascular compensation for deleterious effects of this known risk allele for Alzheimer's disease and stroke.

  13. [Developmental origins of adult health and disease: an important concept for social inequalities in health].

    PubMed

    Charles, M-A

    2013-08-01

    According to the theory of the developmental origins of adult health and disease, development in utero and in the first years of life are critical phases during which susceptibility to many chronic diseases is set. Diseases eventually occur only if the environment and lifestyle in later life is favorable. Exposure to chemicals (environmental or drug), to infectious agents, unbalanced nutrition, or psychosocial stress prenatally or in the first months/years of life are all factors which have been shown to impact long-term health of individuals. The consequences, however, are not limited to health. A demonstrative example was provided by the study of the influenza epidemic of 1918-1919 in the United States. Nationwide, it was estimated that the loss of income over a lifetime for individuals exposed during fetal life to this epidemic amounted to 14 billion dollars. This example demonstrates that an exposure during fetal life, which is not socially differentiated, may affect the social situation of individuals in adulthood. In many situations, it is much more difficult to separate the specific effect of a given exposure from the overall effect of the social environment. Indeed, it has been shown that socioeconomic status in childhood is associated with increased risk of mortality in adulthood, even after accounting for the socioeconomic status and risky behaviors in adulthood. Among the explanations, the theory of developmental origins of health credits of biological plausibility the model of critical periods early in which the individual is particularly vulnerable to certain exposures. Thus, ensuring the best conditions for the biological, physical, emotional and cognitive development of children in early life will enable them to reach their potential in terms of health and socioeconomic return to society. Investment in this period also brings the hope of reducing the perpetuation of social inequalities and health from generation to generation.

  14. Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers

    PubMed Central

    Nam, Gina E.; Zhang, Yingying; McFadden, Molly; Wright, Jennifer; Spraker-Perlman, Holly; Kinney, Anita Y.; Oeffinger, Kevin C.; Kirchhoff, Anne C.

    2016-01-01

    Purpose Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population. Methods We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors. Results A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20–39: 27 vs. 14.3%, respectively; currently aged 40–64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR)=1.64, 95 % confidence interval (CI) 1.43–1.90; males, RR=2.62, 95 % CI 1.71–4.02). Poor social/emotional support was associated with smoking (RR= 1.26, 95 % CI 1.07–1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR= 1.12, 95 % CI 1.01–1.23) and female (RR=1.12, 95 % CI 1.05–1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR=1.26–1.91, all p<0.01) than survivors 5–10 years from diagnosis. Conclusions Unhealthy lifestyle behaviors are common in survivors of AYA cancer. Implications for Cancer Survivors AYA survivors require health behavior support. PMID:26248766

  15. Does social status predict adult smoking and obesity? Results from the 2000 Mexican National Health Survey

    PubMed Central

    Buttenheim, A.M.; Wong, R.; Goldman, N.; Pebley, A.R.

    2009-01-01

    Socioeconomic status is generally associated with better health, but recent evidence suggests that this ‘social gradient’ in health is far from universal. This study examines whether social gradients in smoking and obesity in Mexico—a country in the midst of rapid socioeconomic change—conform to or diverge from results for richer countries. Using a nationally-representative sample of 39 129 Mexican adults, we calculate the odds of smoking and of being obese by educational attainment and by household wealth. We conclude that socioeconomic determinants of smoking and obesity in Mexico are complex, with some flat gradients and some strong positive or negative gradients. Higher social status (education and assets) is associated with more smoking and less obesity for urban women. Higher status rural women also smoke more, but obesity for these women has a non-linear relationship to education. For urban men, higher asset levels (but not education) are associated with obesity, whereas education is protective of smoking. Higher status rural men with more assets are more likely to smoke and be obese. As household wealth, education, and urbanisation continue to increase in Mexico, these patterns suggest potential targets for public health intervention now and in the future. PMID:19367478

  16. Getting the Message out about Cognitive Health: A Cross-Cultural Comparison of Older Adults' Media Awareness and Communication Needs on How to Maintain a Healthy Brain

    ERIC Educational Resources Information Center

    Friedman, Daniela B.; Laditka, James N.; Hunter, Rebecca; Ivey, Susan L.; Wu, Bei; Laditka, Sarah B.; Tseng, Winston; Corwin, Sara J.; Liu, Rui; Mathews, Anna E.

    2009-01-01

    Purpose: Evidence suggests that physical activity and healthy diets may help to maintain cognitive function, reducing risks of developing Alzheimer's disease and vascular dementia. Using a cross-cultural focus, we describe older adults' awareness about cognitive health, and their ideas about how to inform and motivate others to engage in…

  17. Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?

    ERIC Educational Resources Information Center

    Krahn, Gloria L.; Fox, Michael H.

    2014-01-01

    Background: Recent attention to health of people with intellectual disabilities has used a health disparities framework. Building on historical context, the paper summarizes what is known about health disparities from reports and research and provides direction on what to do to reduce these disparities among adults with intellectual disabilities.…

  18. Perceived Discrimination, Perceived Stress, and Mental and Physical Health among Mexican-Origin Adults

    ERIC Educational Resources Information Center

    Flores, Elena; Tschann, Jeanne M.; Dimas, Juanita M.; Bachen, Elizabeth A.; Pasch, Lauri A.; de Groat, Cynthia L.

    2008-01-01

    This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when…

  19. Cost Estimation of a Health-Check Intervention for Adults with Intellectual Disabilities in the UK

    ERIC Educational Resources Information Center

    Romeo, R.; Knapp, M.; Morrison, J.; Melville, C.; Allan, L.; Finlayson, J.; Cooper, S.-A.

    2009-01-01

    Background: High rates of health needs among adults with intellectual disabilities flag the need for information about the economic consequences of strategies to identify and address unmet needs. Health-check interventions are one such strategy, and have been demonstrated to effect health gains over the following 12-month period. However, little…

  20. Self-Regulation, Self-Efficacy and Health Behavior Change in Older Adults.

    ERIC Educational Resources Information Center

    Purdie, Nola; McCrindle, Andrea

    2002-01-01

    Presents an overview of self-regulation models: theory of planned behavior, protection motivation theory, health belief model, action control theory, transtheoretical model of behavior change, health action process, and precaution adoption process. Applies models to health behavior change in older adults with cardiovascular disease or diabetes.…

  1. Suicide Ideation in Older Adults: Relationship to Mental Health Problems and Service Use

    ERIC Educational Resources Information Center

    Corna, Laurie M.; Cairney, John; Streiner, David L.

    2010-01-01

    Purpose: To assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Design and Methods: We use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of…

  2. Development of a Scale to Measure Adults' Perceptions of Health: Preliminary Findings

    ERIC Educational Resources Information Center

    Diamond, James J.; Becker, Julie A.; Arenson, Christine A.; Chambers, Christopher V.; Rosenthal, Michael P.

    2007-01-01

    Given the national agenda on chronic disease self-management, the goal of the project described in this brief report was to develop a scale that measured adult perceptions about health but did not focus on a specific condition. The Perception of Health Scale (PHS) is based on earlier work that used the Health Belief Model as a focus. The 15-item…

  3. Health Worry, Physical Activity Participation, and Walking Difficulty among Older Adults: A Mediation Analysis

    ERIC Educational Resources Information Center

    Li, Kin-Kit; Cardinal, Bradley J.; Vuchinich, Samuel

    2009-01-01

    This study examined the effect of health worry (i.e., cognitive aspect of anxiety resulting from concern for health) on walking difficulty in a nationally representative sample (N = 7,527) of older adults (M age = 76.83 years). The study further tested whether physical activity mediates the effect of health worry on walking difficulty in a 6-year…

  4. Health Learning and Adult Education: In Search of a Theory of Practice

    ERIC Educational Resources Information Center

    Schecter, Sandra R.; Lynch, Jacqueline

    2011-01-01

    Fifty-five percent of Canadians aged 16 to 64 years lack the skills necessary to read and appropriately interpret health information in textual format. This critical review of research explores issues related to adults' health and health literacy learning in an effort to illuminate why this unacceptable condition persists. The authors also explore…

  5. Transitions and Loss: Illuminating Parameters of Young Adults' Mental Health

    ERIC Educational Resources Information Center

    Rowling, Louise; Weber, Zita; Scanlon, Lesley

    2005-01-01

    Different disciplinary groups are increasingly questioning current conceptualisations of young adults' educational, social and personal lives after compulsory schooling. New perspectives are being advanced on the life trajectories of choice and complexity now experienced by school leavers. A consistent theme is the changed nature of young adults'…

  6. Optimizing Health Care for Adults with Spina Bifida

    ERIC Educational Resources Information Center

    Webb, Thomas S.

    2010-01-01

    Survival into adulthood for individuals with spina bifida has significantly improved over the last 40 years with the majority of patients now living as adults. Despite this growing population of adult patients who have increased medical needs compared to the general population, including spina bifida (SB)-specific care, age-related secondary…

  7. Comparing Young Adults to Older Adults in E-Cigarette Perceptions and Motivations for Use: Implications for Health Communication

    ERIC Educational Resources Information Center

    Cooper, Maria; Harrell, Melissa B.; Perry, Cheryl L.

    2016-01-01

    Purpose: Use of electronic cigarettes ("e-cigarettes" is rapidly rising, and is especially prevalent among young adults. A better understanding of e-cigarette perceptions and motivations for use is needed to inform health communication and educational efforts. This study aims to explore these aspects of use with a focus on comparing…

  8. The effect of a severe health shock on work behavior: Evidence from different health care regimes.

    PubMed

    Datta Gupta, Nabanita; Kleinjans, Kristin J; Larsen, Mona

    2015-07-01

    In this paper, we use the policy variation of two different types of health insurance in the US and in Denmark - employer-provided and universal insurance combined with substantial differences in expected and actual medical out-of-pocket expenditures - to explore the effect of new severe health shocks on the labor force participation of older workers. Our results not only provide insight into how relative disease risk affects labor force participation at older ages, but also into how different types of health care and health insurance systems affect individual decisions of labor force participation. Although employer-tied health insurance and greater out-of-pocket medical expenditures give US Americans greater incentives to continue to work, we find only small differences in the work response between the two countries. We provide compelling evidence that our somewhat counterintuitive finding is the result of differential mortality and baseline health differences coupled with distinct treatment regimes under the respective health care systems. PMID:25982868

  9. Evidence of heterogeneity within bovine satellite cells isolated from young and adult animals.

    PubMed

    Li, J; Gonzalez, J M; Walker, D K; Hersom, M J; Ealy, A D; Johnson, S E

    2011-06-01

    Satellite cells are a heterogeneous population of myogenic precursors responsible for muscle growth and repair in mammals. The objectives of the experiment were to examine the growth rates and degree of heterogeneity within bovine satellite cells (BSC) isolated from young and adult animals. The BSC were harvested from the semimembranosus of young (4.3 ± 0.5 d) and adult (estimated 24 to 27 mo) cattle and cultured en masse. Young animal BSC re-enter the cell cycle sooner and reach maximal 5-ethynyl-2'-deoxyuridine (EdU) incorporation earlier (P < 0.05) than adult contemporaries. Adult BSC contain fewer (P < 0.05) MyoD and myogenin immunopositive nuclei than BSC isolated from young animals after 3, 4, and 5 d in culture. These results indicate that BSC from young animals activate, proliferate, and differentiate sooner than isolates from adult animals. Lineage heterogeneity within BSC was examined using antibodies specific for Pax7 and Myf5, lineage markers of satellite cells, and myoblasts. Immunocytochemistry revealed the majority of Pax7-expressing BSC also express Myf5; a minor population (~5%) fails to exhibit Myf5 immunoreactivity. The percentage of Pax7:Myf5 BSC from young animals decreases sooner (P < 0.05) in culture than adult BSC, indicating a more rapid rate of muscle fiber formation. A subpopulation immunopositive for Myf5 only was identified in both ages of BSC isolates. The growth kinetics and heterogeneity of young BSC was further evaluated by clonal analysis. Single cell clones were established and analyzed after 10 d. Colonies segregated into 2 groups based upon population doubling time. Immunostaining of the slow-growing colonies (population doubling time ≥ 3 d) revealed that a portion exhibited asymmetric distribution of the lineage markers Pax7 and Myf5, similar to self-renewable mouse muscle stem cells. In summary, these results offer insight into the heterogeneity of BSC and provide evidence for subtle differences between rodent and bovine

  10. NICE CG178 Psychosis and Schizophrenia in Adults: Treatment and Management - an evidence-based guideline?

    PubMed

    Taylor, Mark; Perera, Udayanga

    2015-05-01

    National Institute for Health and Care Excellence (NICE) clinical guideline (CG)178 was published in 2014. NICE guidelines occupy an important international position. We argue that CG178 overemphasises the use of cognitive-behavioural therapy for schizophrenia and those 'at risk' of psychosis, with recommendations that do not always reflect the evidence base. The CG178 recommendations on medications are limited.

  11. Health impact of "reduced yield" cigarettes: a critical assessment of the epidemiological evidence

    PubMed Central

    Thun, M.; Burns, D.

    2001-01-01

    Cigarettes with lower machine measured "tar" and nicotine yields have been marketed as "safer" than high tar products over the last four decades, but there is conflicting evidence about the impact of these products on the disease burden caused by smoking. This paper critically examines the epidemiological evidence relevant to the health consequences of "reduced yield" cigarettes. Some epidemiological studies have found attenuated risk of lung cancer but not other diseases, among people who smoke "reduced yield" cigarettes compared to smokers of unfiltered, high yield products. These studies probably overestimate the magnitude of any association with lung cancer by over adjusting for the number of cigarettes smoked per day (one aspect of compensatory smoking), and by not fully considering other differences between smokers of "high yield" and "low yield" cigarettes. Selected cohort studies in the USA and UK show that lung cancer risk continued to increase among older smokers from the 1950s to the 1980s, despite the widespread adoption of lower yield cigarettes. The change to filter tip products did not prevent a progressive increase in lung cancer risk among male smokers who began smoking during and after the second world war compared to the first world war era smokers. National trends in vital statistics data show declining lung cancer death rates in young adults, especially males, in many countries, but the extent to which this is attributable to "reduced yield" cigarettes remains unclear. No studies have adequately assessed whether health claims used to market "reduced yield" cigarettes delay cessation among smokers who might otherwise quit, or increase initiation among non-smokers. There is no convincing evidence that past changes in cigarette design have resulted in an important health benefit to either smokers or the whole population. Tobacco control policies should not allow changes in cigarette design to subvert or distract from interventions proven to reduce

  12. Tobacco plain packaging: Evidence based policy or public health advocacy?

    PubMed

    McKeganey, Neil; Russell, Christopher

    2015-06-01

    In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters.

  13. Governance in Health – The Need for Exchange and Evidence

    PubMed Central

    Chanturidze, Tata; Obermann, Konrad

    2016-01-01

    Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i) the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii) the finding that operational complexities may hinder well–designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the "evidence-based governance" concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate. PMID:27694665

  14. Governance in Health – The Need for Exchange and Evidence

    PubMed Central

    Chanturidze, Tata; Obermann, Konrad

    2016-01-01

    Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i) the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii) the finding that operational complexities may hinder well–designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the "evidence-based governance" concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate.

  15. Tobacco plain packaging: Evidence based policy or public health advocacy?

    PubMed

    McKeganey, Neil; Russell, Christopher

    2015-06-01

    In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters. PMID:26041731

  16. Complexity and indeterminism of evidence-based public health: an analytical framework.

    PubMed

    Attena, Francesco

    2014-08-01

    Improving the evidence in public health is an important goal for the health promotion community. With better evidence, health professionals can make better decisions to achieve effectiveness in their interventions. The relative failure of such evidence in public health is well-known, and it is due to several factors. Briefly, from an epistemological point of view, it is not easy to develop evidence-based public health because public health interventions are highly complex and indeterminate. This paper proposes an analytical explanation of the complexity and indeterminacy of public health interventions in terms of 12 points. Public health interventions are considered as a causal chain constituted by three elements (intervention, risk factor, and disease) and two levels of evaluation (risk factor and disease). Public health interventions thus differ from clinical interventions, which comprise two causal elements and one level of evaluation. From the two levels of evaluation, we suggest a classification of evidence into four typologies: evidence of both relations; evidence of the second (disease) but not of the first (risk factor) relation; evidence of the first but not of the second relation; and no evidence of either relation. In addition, a grading of indeterminacy of public health interventions is introduced. This theoretical point of view could be useful for public health professionals to better define and classify the public health interventions before acting.

  17. Systemwide Initiative Documents Robust Health Screening for Adults With Intellectual Disability.

    PubMed

    Brown, Marisa; Jacobstein, Diane; Yoon, Irene Seyoung; Anthony, Bruno; Bullock, Kim

    2016-10-01

    It is well documented that adults with intellectual disability (ID) experience higher rates of a series of health conditions compared to their peers without disability. These health conditions include cardiovascular disease, obesity, diabetes, gastrointestinal disorders, and psychiatric and behavioral disorders. With life expectancy approximating the general population, adults with ID are also now experiencing health conditions related to aging, further increasing their risk for diminished function and well-being. This increased morbidity poses new challenges in geriatric healthcare planning for this population. Relatively simple health prevention practices, such as the implementation of a health screening tool, can substantially increase disease detection and clinical activities directed toward improved health outcomes for people with ID. This study examines data collected from the District of Columbia Developmental Disabilities Administration's (DC DDA's) health screening component of its Health and Wellness Standards. Findings are presented, along with recommendations and implications for improving preventive health screening practices in the ID population. PMID:27673736

  18. Future Directions in the Study of Health Behavior among Older Adults.

    PubMed

    Ziegelmann, Jochen P; Knoll, Nina

    2015-01-01

    The study of health behaviors and fostering health-behavior change is an important endeavor even in old age. The aim of this viewpoint article is threefold. First, we use a broad perspective for the definition of health behaviors to capture all relevant aspects of health-behavior change in older adults. Particularly, we suggest a distinction between proximal (e.g., physical activity) and distal health behaviors (e.g., social participation). Second, we recommend a stronger orientation towards processes in order to study health behaviors and the design of health-behavior change interventions. Third, we review the advantages of a developmental perspective in health psychology. Future directions in the study of health behavior among older adults are discussed. PMID:25660128

  19. Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

    PubMed

    Barrows, Jennifer L; Fleury, Julie

    2016-06-01

    The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. PMID:26689218

  20. Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing

    PubMed Central

    2013-01-01

    Background Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana. Methods This work was based on the World Health Organization’s multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons. Results Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country

  1. The impact of childhood sickness on adult socioeconomic outcomes: Evidence from late 19th century America

    PubMed Central

    Warren, John Robert; Knies, Laurie; Haas, Steven; Hernandez, Elaine M.

    2013-01-01

    We use family fixed-effects models to estimate the impact of childhood health on adult literacy, labor force outcomes, and marital status among pairs of white brothers observed as children in the 1880 U.S. Census and then as adults in the 1900–1930 Censuses. Given our focus on the 19th century, we observed a wider array of infectious, chronic, and traumatic health problems than is observed using data that are more recent; our results thus provide some insights into circumstances in modern developing countries where similar health problems are more frequently observed. Compared to their healthy siblings, sick brothers were less likely to be located (and thus more likely to be dead) 20–50 years after their 1880 enumeration. Sick brothers were also less likely to be literate, to have ever been married, and to have reported an occupation. However, among those with occupations, sick and healthy brothers tended to do similar kinds of work. We discuss the implications of our results for research on the impact of childhood health on socioeconomic outcomes in developed and developing countries. PMID:22809795

  2. What Are Young Adults Saying About Mental Health? An Analysis of Internet Blogs

    PubMed Central

    Westra, Henny A; Eastwood, John D; Barnes, Kirsten L

    2012-01-01

    Background Despite the high prevalence of mental health concerns, few young adults access treatment. While much research has focused on understanding the barriers to service access, few studies have explored unbiased accounts of the experiences of young adults with mental health concerns. It is through hearing these experiences and gaining an in-depth understanding of what is being said by young adults that improvements can be made to interventions focused on increasing access to care. Objective To move beyond past research by using an innovative qualitative research method of analyzing the blogs of young adults (18–25 years of age) with mental health concerns to understand their experiences. Methods We used an enhanced Internet search vehicle, DEVONagent, to extract Internet blogs using primary keywords related to mental health. Blogs (N = 8) were selected based on age of authors (18–25 years), gender, relevance to mental health, and recency of the entries. Blogs excerpts were analyzed using a combination of grounded theory and consensual qualitative research methods. Results Two core categories emerged from the qualitative analysis of the bloggers accounts: I am powerless (intrapersonal) and I am utterly alone (interpersonal). Overall, the young adult bloggers expressed significant feelings of powerlessness as a result of their mental health concerns and simultaneously felt a profound sense of loneliness, alienation, and lack of connection with others. Conclusions The present study suggests that one reason young adults do not seek care might be that they view the mental health system negatively and feel disconnected from these services. To decrease young adults’ sense of powerlessness and isolation, efforts should focus on creating and developing resources and services that allow young adults to feel connected and empowered. Through an understanding of the experiences of young adults with mental health problems, and their experiences of and attitudes toward

  3. Adult attention deficit hyperactivity symptoms and psychosis: Epidemiological evidence from a population survey in England.

    PubMed

    Marwaha, Steven; Thompson, Andrew; Bebbington, Paul; Singh, Swaran P; Freeman, Daniel; Winsper, Catherine; Broome, Matthew R

    2015-09-30

    Despite both having some shared features, evidence linking psychosis and adult attention deficit hyperactivity disorder (ADHD) is sparse and inconsistent. Hypotheses tested were (1) adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis (2) links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs. PMID:26235475

  4. Stable isotope evidence of meat eating and hunting specialization in adult male chimpanzees

    PubMed Central

    Fahy, Geraldine E.; Richards, Michael; Riedel, Julia; Hublin, Jean-Jacques; Boesch, Christophe

    2013-01-01

    Observations of hunting and meat eating in our closest living relatives, chimpanzees (Pan troglodytes), suggest that among primates, regular inclusion of meat in the diet is not a characteristic unique to Homo. Wild chimpanzees are known to consume vertebrate meat, but its actual dietary contribution is, depending on the study population, often either unknown or minimal. Constraints on continual direct observation throughout the entire hunting season mean that behavioral observations are limited in their ability to accurately quantify meat consumption. Here we present direct stable isotope evidence supporting behavioral observations of frequent meat eating among wild adult male chimpanzees (Pan troglodytes verus) in Taï National Park, Côte d’Ivoire. Meat eating among some of the male chimpanzees is significant enough to result in a marked isotope signal detectable on a short-term basis in their hair keratin and long-term in their bone collagen. Although both adult males and females and juveniles derive their dietary protein largely from daily fruit and seasonal nut consumption, our data indicate that some adult males also derive a large amount of dietary protein from hunted meat. Our results reinforce behavioral observations of male-dominated hunting and meat eating in adult Taï chimpanzees, suggesting that sex differences in food acquisition and consumption may have persisted throughout hominin evolution, rather than being a recent development in the human lineage. PMID:23530185

  5. Adult attention deficit hyperactivity symptoms and psychosis: Epidemiological evidence from a population survey in England.

    PubMed

    Marwaha, Steven; Thompson, Andrew; Bebbington, Paul; Singh, Swaran P; Freeman, Daniel; Winsper, Catherine; Broome, Matthew R

    2015-09-30

    Despite both having some shared features, evidence linking psychosis and adult attention deficit hyperactivity disorder (ADHD) is sparse and inconsistent. Hypotheses tested were (1) adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis (2) links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs.

  6. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    PubMed

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  7. Educational Success and Adult Health: Findings from the Chicago Longitudinal Study

    PubMed Central

    Topitzes, James; Godes, Olga; Mersky, Joshua P.; Ceglarek, Sudi; Reynolds, Arthur J.

    2013-01-01

    Growing evidence indicates that education is associated with health, yet we lack knowledge about the specific educational experiences influencing health trajectories. This study examines the role school factors play in the emergence of poor young adult health outcomes for a low-income, minority sample. The following research questions are addressed. First, what are the education-based predictors of daily tobacco smoking, frequent substance use, depression, and no health insurance coverage? Second, do later-occurring school factors explain the association between earlier school measures and the outcomes and, if so, what pathways account for this mediation effect? Data derived from the Chicago Longitudinal Study, an investigation of a cohort of 1,539 individuals, born around 1980, who attended kindergarten programs in the Chicago Public Schools. Participants were followed prospectively from early childhood through age 24, and study measures were created from various data sources and multiple assessment waves. Findings from probit hierarchical regressions with controls for early sociodemographic covariates indicated that elementary school socioemotional classroom adjustment and high school completion were significantly and negatively associated with all four study outcomes. Participation in Chicago Child Parent Center preschool program predicted lower rates of both daily tobacco smoking and no health insurance coverage (p<.05). Middle school reading achievement was inversely related to depression (p<.01), while middle school frustration tolerance was inversely associated with daily tobacco smoking and frequent drug use (p<.05). Also, negatively linked to frequent drug use was a high school measure of students’ expectation to attend college (p<.01). In nearly all cases, later-occurring school factors fully mediated significant associations between earlier ones and the outcomes. Patterns of mediation were explored along with implications of results. PMID:19172395

  8. Essential Public Health Services’ Accessibility and its Determinants among Adults with Chronic Diseases in China

    PubMed Central

    Tian, Miaomiao; Wang, Heng; Tong, Xuetao; Zhu, Kun; Zhang, Xiaojuan; Chen, Xi

    2015-01-01

    Background Along with three years implementation of health reform in China, this study aimed at providing the up-to-date evidence about the accessibility of essential public health services (EPHS) among adults with chronic diseases (CDs) in both urban and rural areas, as well as determinants in access to EPHS. Methods The data were collected from a cross-sectional survey conducted in 2013, which used a multistage stratified random sampling method to select 54 urban communities and 54 rural villages. Hypertension patients and diabetes patients were the target population who are the main beneficiaries of EPHS. Single factor analysis of influencing factors on difference access to EPHS was performed by Chi-Square analysis. Logistic regression analysis was used to determine the predictors of effective management and effective control. Results Patients with hypertension or diabetes were predominantly middle-aged or older persons and had a mean age of 65.26 year. People with CDs in China have a higher basic accessibility rate in EPHS with more than 90% of them having experience in receiving EPHS. And those who are willing to receive services from doctors have the most positive influence on effective management and control in blood pressure or blood glucose. But unsatisfied quality and equity of EPHS still exist in primary health system. 90% of participants could receive EPHS, but just 44% of them could control their diseases effectively. And participants from cities had the higher rates in effective management (urban: rural = 57%: 50.6%) and effective control (urban: rural = 39.5%: 27.8%). Conclusion People with CDs have a high level in geography and economic accessibility to EPHS, but the effectiveness of health management also needs to be improved, especially for those living in rural areas. Our study highlights the continuing need for improving ability to provide EPHS and the equality among regions. Meanwhile, strengthen health education and promotion for patients with

  9. An Efficacy Trial of "Steps to Your Health", a Health Promotion Programme for Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    McDermott, Suzanne; Whitner, Wendy; Thomas-Koger, Marlo; Mann, Joshua R.; Clarkson, John; Barnes, Timothy L.; Bao, Haikun; Meriwether, Rebecca A

    2012-01-01

    Objective: Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities (ID), randomized efficacy trials of such interventions are lacking. Design: A randomized active control intervention trial. Setting: The participants attended the health promotion classes in local…

  10. Health Insurance: The Facts You Need. Student Workbook. Health Promotion for Adult Literacy Students: An Empowering Approach.

    ERIC Educational Resources Information Center

    Hudson River Center for Program Development, Glenmont, NY.

    This workbook was developed to help adult literacy students learn about health insurance. It contains information sheets, student worksheets, and answers to the worksheets. The information sheets are coordinated with an available audiotape. Some of the topics covered in the workbook are the following: understanding health insurance choices;…

  11. Limited health literacy and decline in executive function in older adults.

    PubMed

    Sequeira, Shwetha S; Eggermont, Laura H P; Silliman, Rebecca A; Bickmore, Timothy W; Henault, Lori E; Winter, Michael R; Nelson, Kerrie; Paasche-Orlow, Michael K

    2013-01-01

    Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective cohort in the setting of a randomized controlled trial to promote walking in older adults. Participants were community-dwelling older adults (65 years of age or older) who scored 2 or more on the Mini-Cog, without depression (score of less than 15 on the 9-item Patient Health Questionnaire), and who completed baseline and 12-month evaluations (n = 226). Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Executive function measured at baseline and 12 months using the Trail Making Test (TMT), Controlled Oral Word Association Test, and Category Fluency. The associations between health literacy and 12-month decline in each test of executive function were modeled using multivariate linear regression. Health literacy was found to be limited in 37% of participants. Limited health literacy was associated with reduced performance on all 3 executive function tests. In fully adjusted models, limited health literacy was associated with greater 12-month decline in performance on the TMT than higher health literacy (p = .01). In conclusion, older adults with limited health literacy are at risk for more rapid decline in scores on the TMT, a measure of executive function.

  12. "That was grown folks' business": narrative reflection and response in older adults' family health history communication.

    PubMed

    Yamasaki, Jill; Hovick, Shelly R

    2015-01-01

    Given the importance of family health history and the pivotal role of older adults in communicating it, this study examines how African American older adults (a) characterize their understandings of health-related conditions in their family histories and (b) rationalize their motivations and constraints for sharing this information with current family members. Using narrative theory as a framework, we illustrate how the participants reflect on prior health-related experiences within the family to respond to moral and practical calls for communicating family health information to current relatives. Specifically, our analysis highlights how storied family secrets--as constructed by 28 participants in group and individual interviews--reveal and inform shifting cultural and generational practices that shape the lived health behaviors and communication of older adults at greater risk for health disparities.

  13. Food Insecurity and Health Care Utilization Among Older Adults in the United States.

    PubMed

    Bhargava, Vibha; Lee, Jung Sun

    2016-01-01

    This study examined the relationships between food insecurity and utilization of four health services among older Americans: office visits, inpatient hospital nights, emergency department visits, and home health care. Nationally representative data from the 2011 and 2012 National Health Interview Survey were used (N = 13,589). Nearly 83.0% of the sample had two or more office visits, 17.0% reported at least one hospital night, 23.0% had at least one emergency room visit, and 8.1% used home health care during the past 12 months. Adjusting for confounders, food-insecure older adults had higher odds of using more office visits, inpatient hospital nights, and emergency department visits than food-secure older adults, but similar odds of home health care utilization. The findings of this study suggest that programs and policies aimed at reducing food insecurity among older adults may have a potential to reduce utilization of health care services.

  14. The Impact of Health Checks for People with Intellectual Disabilities: A Systematic Review of Evidence

    ERIC Educational Resources Information Center

    Robertson, J.; Roberts, H.; Emerson, E.; Turner, S.; Greig, R.

    2011-01-01

    Background: Health checks for people with intellectual disabilities (ID) have been recommended as one component of health policy responses to the poorer health of people with ID. This review summarises evidence on the impact of health checks on the health and well-being of people with ID. Methods: Electronic literature searches and email contacts…

  15. Perspectives on Health Care of Adults with Developmental Disabilities

    ERIC Educational Resources Information Center

    Parish, Susan L.; Moss, Kathryn; Richman, Erica L.

    2008-01-01

    A focus group study was conducted with individuals with developmental disabilities to understand their perspectives on their health status, health promotion behaviors, and health care services they receive. The majority of participants reported good to excellent health, and all had some form of medical insurance. However, participants reported…

  16. [Special Report: Adult Education and Primary Health Care.

    ERIC Educational Resources Information Center

    Vijayendra, T.; And Others

    1982-01-01

    A series of five case studies examines (1) literacy, health, and conscientization in the Mandar region of India; (2) the training of community health workers in Indonesia; (3) the Chinese strategy combining health, political will, and participation; (4) British community-based health education programs, and (5) participatory methodology for…

  17. Masked Morphological Priming in German-Speaking Adults and Children: Evidence from Response Time Distributions

    PubMed Central

    Hasenäcker, Jana; Beyersmann, Elisabeth; Schroeder, Sascha

    2016-01-01

    In this study, we looked at masked morphological priming effects in German children and adults beyond mean response times by taking into account response time distributions. We conducted an experiment comparing suffixed word primes (kleidchen-KLEID), suffixed nonword primes (kleidtum-KLEID), nonsuffixed nonword primes (kleidekt-KLEID), and unrelated controls (träumerei-KLEID). The pattern of priming in adults showed facilitation from suffixed words, suffixed nonwords, and nonsuffixed nonwords relative to unrelated controls, and from both suffixed conditions relative to nonsuffixed nonwords, thus providing evidence for morpho-orthographic and embedded stem priming. Children also showed facilitation from real suffixed words, suffixed nonwords, and nonsuffixed nonwords compared to unrelated words, but no difference between the suffixed and nonsuffixed conditions, thus suggesting that German elementary school children do not make use of morpho-orthographic segmentation. Interestingly, for all priming effects, a shift of the response time distribution was observed. Consequences for theories of morphological processing are discussed. PMID:27445899

  18. The current age of youthful melancholia. Evidence for increase in depression among adolescents and young adults.

    PubMed

    Klerman, G L

    1988-01-01

    The possibility of a rise in rates of depression among adolescents and young adults was first reported in the 1970s. Particular note was taken of the emergence of childhood depression and the increase in suicide attempts and death among adolescents and young adults. Data from large-sample family studies and community epidemiological surveys have been reviewed and reanalysed, using life-table statistical methodology. Evidence for secular trends are presented, and the problems of disentangling period and cohort effect are discussed. It appears that the 'baby boomers' - those born in the years after World War II - have had increased rates of depression and other related illnesses, including drug abuse and alcoholism. The theoretical aspects of this are discussed, particularly for gene-environment interactions.

  19. Masked Morphological Priming in German-Speaking Adults and Children: Evidence from Response Time Distributions.

    PubMed

    Hasenäcker, Jana; Beyersmann, Elisabeth; Schroeder, Sascha

    2016-01-01

    In this study, we looked at masked morphological priming effects in German children and adults beyond mean response times by taking into account response time distributions. We conducted an experiment comparing suffixed word primes (kleidchen-KLEID), suffixed nonword primes (kleidtum-KLEID), nonsuffixed nonword primes (kleidekt-KLEID), and unrelated controls (träumerei-KLEID). The pattern of priming in adults showed facilitation from suffixed words, suffixed nonwords, and nonsuffixed nonwords relative to unrelated controls, and from both suffixed conditions relative to nonsuffixed nonwords, thus providing evidence for morpho-orthographic and embedded stem priming. Children also showed facilitation from real suffixed words, suffixed nonwords, and nonsuffixed nonwords compared to unrelated words, but no difference between the suffixed and nonsuffixed conditions, thus suggesting that German elementary school children do not make use of morpho-orthographic segmentation. Interestingly, for all priming effects, a shift of the response time distribution was observed. Consequences for theories of morphological processing are discussed. PMID:27445899

  20. Elder mistreatment and physical health among older adults: the South Carolina Elder Mistreatment Study.

    PubMed

    Cisler, Josh M; Amstadter, Ananda B; Begle, Angela M; Hernandez, Melba; Acierno, Ron

    2010-08-01

    Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among older adults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among older adults residing in South Carolina. Older adults aged 60 and above (N = 902) participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors. PMID:20690195

  1. Popular Education for Adult Literacy and Health Development in Indigenous Australia

    ERIC Educational Resources Information Center

    Boughton, Bob

    2009-01-01

    The focus of this paper is adult literacy, and the impact this has on Aboriginal and Torres Strait Islander individual and community health. It directs attention to those Aboriginal and Torres Strait Islander young people and adults who have not benefited from the formal school education system, and who, as a consequence, have very low levels of…

  2. The Contribution of Adult Learning to Health and Social Capital. Wider Benefits of Learning Research Report.

    ERIC Educational Resources Information Center

    Feinstein, Leon; Hammond, Cathie; Woods, Laura; Preston, John; Bynner, John

    Researchers investigated effects of adult learning (AL) on a range of measures of health and social capital and cohesion. Data from the National Child Development Study relating to almost 10,000 adults born in Britain in 1958 were used, with focus on changes in their lives between age 33 in 1991 and 42 in 2000. Findings indicated AL played an…

  3. The Prevalence and Incidence of Mental Ill-Health in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Mantry, D.; Cooper, S. -A.; Smiley, E.; Morrison, J.; Allan, L.; Williamson, A.; Finlayson, J.; Jackson, A.

    2008-01-01

    Background: While there is considerable literature on adults with Down syndrome who have dementia, there is little published on the epidemiology of other types of mental ill-health in this population. Method: Longitudinal cohort study of adults with Down syndrome who received detailed psychiatric assessment (n = 186 at the first time point; n =…

  4. Health Literacy and Social Capital: What Role for Adult Literacy Partnerships and Pedagogy?

    ERIC Educational Resources Information Center

    Black, Stephen; Balatti, Jo; Falk, Ian

    2013-01-01

    This paper makes the case for adult literacy (including numeracy) practitioners to play a greater role in health literacy initiatives in Australia. The paper draws on data from a national research project that investigated adult literacy partnerships and pedagogy viewed from a social capital perspective. The primary purpose of the project was to…

  5. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

    ERIC Educational Resources Information Center

    Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

    2014-01-01

    Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

  6. Transformation through Health Teaching for Adults with Intellectual and Developmental Disabilities: A Qualitative Study

    ERIC Educational Resources Information Center

    Focht-New, Ginny

    2012-01-01

    Adults with intellectual and developmental disabilities have medical conditions similar to those among the general population but with more complex presentation, a extended life expectancy, and increased risk of morbidity and mortality. These adults' health education has been inadequate. In this qualitative study, the author describes the…

  7. Mental Health Problems in Adults with Down Syndrome and Their Association with Life Circumstances

    ERIC Educational Resources Information Center

    Mallardo, Mariarosa; Cuskelly, Monica; White, Paul; Jobling, Anne

    2014-01-01

    This study focused on current life circumstances, previous life events, and engagement with productive and enjoyable activities. It examined the association of these variables with mental health problems and mood in a cohort of young adults with Down syndrome. Participants were 49 adults with Down syndrome (age range 20-31 years) and their…

  8. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    ERIC Educational Resources Information Center

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  9. Use of health systems evidence by policymakers in eastern mediterranean countries: views, practices, and contextual influences

    PubMed Central

    2012-01-01

    Background Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers’ views and practices regarding the use of health systems evidence in health policymaking in 10 eastern Mediterranean countries, including factors that influence health policymaking and barriers and facilitators to the use of evidence. Methods This study utilized a survey adapted and customized from a similar tool developed in Canada. Health policymakers from 10 countries (Algeria, Bahrain, Jordan, Lebanon Oman, Pakistan, Palestine, Sudan, Tunisia, and Yemen) were surveyed. Descriptive and bi-variate analyses were performed for quantitative questions and thematic analysis was done for qualitative questions. Results A total of 237 policymakers completed the survey (56.3% response rate). Governing parties, limited funding for the health sector and donor organizations exerted a strong influence on policymaking processes. Most (88.5%) policymakers reported requesting evidence and 43.1% reported collaborating with researchers. Overall, 40.1% reported that research evidence is not delivered at the right time. Lack of an explicit budget for evidence-informed health policymaking (55.3%), lack of an administrative structure for supporting evidence-informed health policymaking processes (52.6%), and limited value given to research (35.9%) all limited the use of research evidence. Barriers to the use of evidence included lack of research targeting health policy, lack of funding and investments, and political forces. Facilitators included availability of health research and research institutions, qualified researchers, research funding, and easy access to information. Conclusions Health policymakers in several countries recognize the importance of using health systems evidence. Study findings are important in light of changes unfolding

  10. Functional decline over two years in older Spanish adults: Evidence from SHARE

    PubMed Central

    Rodríguez López, Santiago; Montero, Pilar; Carmenate, Margarita; Avendano, Mauricio

    2013-01-01

    Aim To evaluate the social, educational, health and behavioral predictors of physical functional decline in older Spanish adults. Methods Two-year longitudinal study based on 699 community-dwelling Spanish adults over 65 year-old participating in the Survey of Health, Ageing and Retirement of Europe (SHARE). Several predictors of a combined measure of functional disability were examined using logistic regressions. Results A decline in function was experienced by 166 individuals. Functional decline in men was associated with increased number of chronic diseases (OR= 2.25, 95%CI 1.21–4.19) and depressive symptoms (OR= 5.05, 95%CI 2.42–10.54) over a two-year period, while among women it was associated with decreased numeracy score (OR= 1.88, 95%CI 1.05–3.34). Conclusions Longitudinal changes in predictors are strongly associated with longitudinal changes in function between baseline and a two-year follow-up, most clearly among men. A decrease in cognitive functioning and increased depressive symptoms are associated with a decline in physical functioning and can serve as useful clinical predictors to prevent disability in older Spanish adults. PMID:23844926

  11. Falls among Older Adults: Public Health Impact and Prevention Strategies.

    ERIC Educational Resources Information Center

    Stevens, Judy A.

    2003-01-01

    Provides an overview of the epidemiology of falls among older adults, describes current prevention strategies, and highlights key areas that need to be addressed, including risk assessments, exercise, and environmental changes. (Contains 50 references.) (JOW)

  12. A Public Health Approach to Addressing Arthritis in Older Adults: The Most Common Cause of Disability

    PubMed Central

    Helmick, Charles G.; Brady, Teresa J.

    2012-01-01

    Arthritis is highly prevalent and is the leading cause of disability among older adults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of older adults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions. PMID:22390506

  13. [Influence of child nutrition on health status during adult years].

    PubMed

    Ksiazyk, J

    2000-01-01

    The problem of safety of child's nutrition should be considered from the moment of his conception because intrauterine growth may be related to the diseases in adult life: atherosclerosis and coronary heart disease. Strict vegetarian diets are not appropriate for children. The task of proper nutrition in childhood is to prevent adult life diseases and to promote potentially highest quality of life and development of cognitive and intellectual functions, and proper growth. The role of microelements - iron and zinc - is also discussed.

  14. Is It Really Worse to Have Public Health Insurance than to Have No Insurance at All? Health Insurance and Adult Health in the United States

    ERIC Educational Resources Information Center

    Quesnel-Vallee, Amelie

    2004-01-01

    Using prospective cohort data from the 1979 National Longitudinal Survey of Youth, this study examines the extent to which health insurance coverage and the source of that coverage affect adult health. While previous research has shown that privately insured nonelderly individuals enjoy better health outcomes than their uninsured counterparts, the…

  15. Anxiety symptomatology and perceived health in African American adults: Moderating role of emotion regulation

    PubMed Central

    Carter, Sierra E.; Walker, Rheeda L.

    2014-01-01

    Though emotional health has been theoretically and empirically linked to physical health, the anxiety-physical health association in particular is not well understood for African American adults. This study examined anxiety as a specific correlate of perceived health in addition to testing the potential moderating role of emotion regulation, an index of how and when individuals modulate emotions, in the association for anxiety to perceived health. Study participants were 151 community-based African American adults who completed measures of anxiety symptomatology and emotion regulation in addition to responding to a self-report question of perceived health. Results showed that higher levels of anxiety symptomatology were associated with poorer health ratings for those who reported more limited access to emotion regulation strategies but not those who reported having more emotion regulation strategies. The findings suggest that anxiety-related distress and health problems may be interrelated when emotion regulation strategies are limited. PMID:25045943

  16. Linguistic adaptation and psychometric evaluation of original Oral Health Literacy-Adult Questionnaire (OHL-AQ)

    PubMed Central

    VYAS*, SHALEEN; NAGARAJAPPA, SANDESH; DASAR, PRALHAD L; MISHRA, PRASHANT

    2016-01-01

    Introduction: Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013), consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. Methods: The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire - Hindi Version using the World Health Organization recommended translation back-translation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015) and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and test-retest reliability were assessed using Cronbach’s alpha and Intra-class correlation coefficient (ICC), respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and p<0.05 was considered as the significance level. Results: The mean OHL-AQ-H score was 13.58±2.82. ICC and Cronbach’s alpha for Oral Health Literacy Adult Questionnaire - Hindi Version were 0.94 and 0

  17. Happiness, Mental Health, and Socio-Demographic Associations Among a National Cohort of Thai Adults.

    PubMed

    Yiengprugsawan, Vasoontara; Somboonsook, Boonchai; Seubsman, Sam-Ang; Sleigh, Adrian C

    2012-12-01

    Research on happiness has been of interest in many parts of the world. Here we provide evidence from developing countries; this is the first analysis of happiness among a cohort of Thai distance learning adults residing throughout the country (n = 60,569 in 2009). To measure happiness, we tested use of the short format Thai Mental Health Indicators (TMHI), correlating each domain with two direct measures of happiness and life satisfaction. Several TMHI domains correlated strongly with happiness. We found the mental state and the social support domains moderately or strongly correlated with happiness by either measure (correlation coefficients 0.24-0.56). The other two TMHI domains (mental capacity and mental quality) were not correlated with happiness. Analysis of socio-demographic attributes and happiness revealed little effect of age and sex but marital status (divorced or widowed), low household income, and no paid work all had strong adverse effects. Our findings provide Thai benchmarks for measuring happiness and associated socio-demographic attributes. We also provide evidence that the TMHI can measure happiness in the Thai population. Furthermore, the results among Thai cohort members can be monitored over time and could be useful for comparison with other Southeast Asian countries.

  18. A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK

    PubMed Central

    Twomey, Conal D; Baldwin, David S; Hopfe, Maren; Cieza, Alarcos

    2015-01-01

    Objectives To identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors. Design A narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014. Setting The majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys. Participants Included were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia. Primary outcome A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and ‘total HSU’. Results Taking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU. Conclusions The findings can inform decisions about which variables might be used to derive mental health clusters in ‘payment by results’ systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health

  19. Prevalence of anemia and associated factors in older adults: evidence from the SABE Study

    PubMed Central

    Corona, Ligiana Pires; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lucia

    2014-01-01

    OBJECTIVE To assess the prevalence of anemia and associated factors in older adults. METHODS The prevalence and factors associated with anemia in older adults were studied on the basis of the results of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Welfare and Aging) study. A group of 1,256 individuals were interviewed during the third wave of the SABE study performed in Sao Paulo, SP, in 2010. The study included 60.4% females; the mean age of the participants was 70.4 years, and their average education was 5.3 years. The dependent variable was the presence of anemia (hemoglobin levels: 12 g/dL in women and 13 g/dL in men). Descriptive analysis and hierarchical logistic regression were performed. The independent variables were as follows: a) demographics: gender, age, and education and b) clinical characteristics: self-reported chronic diseases, presence of cognitive decline and depression symptoms, and body mass index. RESULTS The prevalence of anemia was 7.7% and was found to be higher in oldest adults. There was no difference between genders, although the hemoglobin distribution curve in women showed a displacement toward lower values in comparison with the distribution curve in men. Advanced age (OR = 1.07; 95%CI 0.57;1.64; p < 0.001), presence of diabetes (OR = 2.30; 95%CI 1.33;4.00; p = 0.003), cancer (OR = 2.72; 95%CI 1.2;6.11; p = 0.016), and presence of depression symptoms (OR = 1.75; 95%CI 1.06;2.88; p = 0.028) remained significant even after multiple analyses. CONCLUSIONS The prevalence of anemia in older adults was 7.7% and was mainly associated with advanced age and presence of chronic diseases. Thus, anemia can be an important marker in the investigation of health in older adults because it can be easily diagnosed and markedly affects the quality of life of older adults. PMID:25372162

  20. Aging expectations are associated with physical activity and health among older adults of low socioeconomic status.

    PubMed

    Dogra, Shilpa; Al-Sahab, Ban; Manson, James; Tamim, Hala

    2015-04-01

    The purpose of the current study was to determine whether aging expectations (AE) are associated with physical activity participation and health among older adults of low socioeconomic status (SES). A cross-sectional analysis of a sample of 170 older adults (mean age 70.9 years) was conducted. Data on AE, physical activity, and health were collected using the 12 item Expectations Regarding Aging instrument, the Healthy Physical Activity Participation Questionnaire, and the Short Form-36, respectively. Adjusted linear regression models showed significant associations between AE and social functioning, energy/vitality, mental health, and self-rated general health, as well as physical activity. These results suggest that AE may help to better explain the established association between low SES, low physical activity uptake, and poor health outcomes among older adults.