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Sample records for adult health evidence

  1. Health maintenance in older adults: combining evidence and individual preferences.

    PubMed

    Gestuvo, Maria Kristina

    2012-01-01

    There is increasing interest in maintaining health and delaying disability for older adults as this population segment expands. And instead of focusing on a traditional disease-specific approach to health maintenance, there is an ongoing shift to a patient-centered approach, and defining outcomes based on the older adults' goals. In this approach, their goals and preferences are central, and other factors such as their health status and prognosis help determine which goals may be realistic. These subjective goals and objective characteristics are then balanced with the risks, benefits, and harms of established evidence-driven health-maintenance recommendations. Hence, older adults share their goals and preferences with clinicians; while clinicians share information on risks, benefits, harms, and uncertainties of existing health-maintenance recommendations, and help guide the older adult through how existing evidence can respond to their health goals and preferences. In this article, the concept of patient-centered care in the context of health maintenance for older adults is discussed; and health maintenance recommendations for older adults are reviewed.

  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. Elderly parent health and the migration decisions of adult children: evidence from rural China.

    PubMed

    Giles, John; Mu, Ren

    2007-05-01

    Recent research has shown that participation in migrant labor markets has led to substantial increases in income for families in rural China. This article addresses the question of how participation is affected by elderly parent health. We find that younger adults are less likely to work as migrants when a parent is ill. Poor health of an elderly parent has less impact on the probability of employment as a migrant when an adult child has siblings who may be available to provide care. We also highlight the potential importance of including information on nonresident family members when studying how parent illness and elder care requirements influence the labor supply decisions of adult children.

  4. Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials

    PubMed Central

    Marcum, Zachary A.; Murray, Michael D.

    2017-01-01

    Background Poor medication adherence is a major public health problem in older adults often resulting in negative health outcomes. Objective The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. Methods Articles that assessed medication adherence interventions and related health outcomes in elderly individuals were identified through searches of MEDLINE (1970–June 2016), the Cochrane Database of Systematic Reviews (through to June 2016), and Google Scholar. Across the 12 included studies, interventions were grouped into three main categories: behavioral/educational (n = 3), pharmacist-led (n = 7), and reminder/simplification (n = 2). Results Among the behavioral/educational intervention studies, two showed improvements in both adherence and related health outcomes, whereas one found no changes in adherence or health outcomes. Among the pharmacist-led studies, three showed improvements in both adherence and related health outcomes, while three reported no changes in adherence or health outcomes. One found an improvement in adherence but not health outcomes. Among the reminder/simplification studies, both studies reported improvements in adherence without a significant impact on related health outcomes. Conclusion This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature. Future patient-centered and multidisciplinary interventions should be developed and tested using evidence-based principles to improve medication adherence and health outcomes in older adults. PMID:28074410

  5. 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.

  6. The health benefits of network growth: new evidence from a national survey of older adults.

    PubMed

    Cornwell, Benjamin; Laumann, Edward O

    2015-01-01

    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.

  7. Area social fragmentation, social support for individuals and psychosocial health in young adults: evidence from a national survey in England.

    PubMed

    Fagg, James; Curtis, Sarah; Stansfeld, Stephen A; Cattell, Vicky; Tupuola, Ann-Marie; Arephin, Muna

    2008-01-01

    This paper uses national survey data for young adults in England to explore empirically the relationships between social fragmentation in communities (measured for geographical areas), social support experienced by individuals from their immediate social circle, and psychosocial health of young adults. After reviewing previous research about these associations, we adopted an empirical approach to these questions, which was innovative in using data on area social fragmentation from a different source to the survey data on individuals. Also, we have examined the relevance for mental health of interactions between individual social support and area social fragmentation, as well as their independent associations with health. To test these ideas empirically, we present a statistical analysis, using survey data from the national Health Survey for England on young people aged 16-24 years, linked to a geographical indicator of social fragmentation, derived from the population census and with a measure of material poverty. The outcome variable was distress measured by the General Health Questionnaire (GHQ). In a logistic regression model that controls for grouping of individuals within areas we included data on individuals' sex, ethnic group, employment status, social class and educational level. Controlling for these indicators, we demonstrate that risk of individual distress (indicated by GHQ score of 3+) was significantly and positively associated with area social fragmentation and there was a significant association with social support received within the individual's immediate social circle, which was negative ('protective'). An index of material poverty in one's area of residence did not predict individual distress. There was no evidence that social support was more 'protective' in areas of greatest social fragmentation. We also note that while being in employment was associated with better mental health in this sample, higher educational level was associated with

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

    PubMed

    Hunter, Lori M; Twine, Wayne; Johnson, Aaron

    2011-01-01

    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.

  9. 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

  10. Adult non-communicable disease mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites

    PubMed Central

    Streatfield, P. Kim; Khan, Wasif A.; Bhuiya, Abbas; Hanifi, Syed M.A.; Alam, Nurul; Bagagnan, Cheik H.; Sié, Ali; Zabré, Pascal; Lankoandé, Bruno; Rossier, Clementine; Soura, Abdramane B.; Bonfoh, Bassirou; Kone, Siaka; Ngoran, Eliezer K.; Utzinger, Juerg; Haile, Fisaha; Melaku, Yohannes A.; Weldearegawi, Berhe; Gomez, Pierre; Jasseh, Momodou; Ansah, Patrick; Debpuur, Cornelius; Oduro, Abraham; Wak, George; Adjei, Alexander; Gyapong, Margaret; Sarpong, Doris; Kant, Shashi; Misra, Puneet; Rai, Sanjay K.; Juvekar, Sanjay; Lele, Pallavi; Bauni, Evasius; Mochamah, George; Ndila, Carolyne; Williams, Thomas N.; Laserson, Kayla F.; Nyaguara, Amek; Odhiambo, Frank O.; Phillips-Howard, Penelope; Ezeh, Alex; Kyobutungi, Catherine; Oti, Samuel; Crampin, Amelia; Nyirenda, Moffat; Price, Alison; Delaunay, Valérie; Diallo, Aldiouma; Douillot, Laetitia; Sokhna, Cheikh; Gómez-Olivé, F. Xavier; Kahn, Kathleen; Tollman, Stephen M.; Herbst, Kobus; Mossong, Joël; Chuc, Nguyen T.K.; Bangha, Martin; Sankoh, Osman A.; Byass, Peter

    2014-01-01

    Background Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among much older people, who have survived other hazards, is inevitable. The INDEPTH Network collects detailed individual data within defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. Objective To describe patterns of adult NCD mortality from INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories, with separate consideration of premature (15–64 years) and older (65+ years) NCD mortality. Design All adult deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. Results A total of 80,726 adult (over 15 years) deaths were documented over 7,423,497 person-years of observation. NCDs were attributed as the cause for 35.6% of these deaths. Slightly less than half of adult NCD deaths occurred in the 15–64 age group. Detailed results are presented by age and sex for leading causes of NCD mortality. Per-site rates of NCD mortality were significantly correlated with rates of HIV/AIDS-related mortality. Conclusions These findings present important evidence on the distribution of NCD mortality

  11. Birth weight and adult health in historical perspective: evidence from a New Zealand cohort, 1907-1922.

    PubMed

    Roberts, Evan; Wood, Pamela

    2014-04-01

    We provide new historical evidence on the developmental origins of health and disease in a cohort of boys born between 1907 and 1922 in Wellington, New Zealand. Using a dataset of 1523 birth records that include birth weight and length we find 852 (58%) of the adult cohort in World War II records measuring stature, body mass and blood pressure. On average, the boys weighed 3.5 kg at birth, similar to Australian and American babies of the era, and nearly identical to full-term New Zealand babies in the 1990s. Using OLS regression models we estimate the effect of birth weight on adult stature and systolic blood pressure. We find an increase in birth weight of 1 kg is associated with an increase in stature of 2.6 cm (95% confidence interval [CI] 1.6 cm-3.6 cm), and a decrease in systolic blood pressure of 2.1 mm/Hg (95% CI - 5.00 to 0.67). This is the earliest cohort by fifty years for whom the fetal origins hypothesis has been examined in early adulthood. Our estimates of the effect of birth weight on blood pressure are towards the upper end of the range of published estimates in modern cohorts.

  12. 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

  13. 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…

  14. The Effect of Education on Adult Health and Mortality: Evidence from Britain. NBER Working Paper No. 16013

    ERIC Educational Resources Information Center

    Clark, Damon; Royer, Heather

    2010-01-01

    There is a strong, positive and well-documented correlation between education and health outcomes. There is much less evidence on the extent to which this correlation reflects the causal effect of education on health--the parameter of interest for policy. In this paper we attempt to overcome the difficulties associated with estimating the causal…

  15. 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 adults…

  16. Continuity of care from child and adolescent to adult mental health services: evidence from a regional survey in Northern Italy.

    PubMed

    Stagi, Paolo; Galeotti, Simona; Mimmi, Stefano; Starace, Fabrizio; Castagnini, Augusto C

    2015-12-01

    To examine clinical and demographic factors associated with continuity of care from child-adolescent (CAMHS) to adult mental health services (AMHS), we undertook a record-linkage study to the Adult Mental Health Information System including all those 16 years old and over who were listed between 2010 and 2013 in the Child and Adolescent Neuropsychiatry Information System in Emilia-Romagna, an Italian region of nearly 4.5 million residents. From a cohort of 8239 adolescents attending CAMHS (population at risk about 144,000), 821 (19.4 %) moved to AMHS, excluding cases with specific developmental disorders, whose conditions were not managed by adult psychiatrists, and those with mental retardation who attended usually social services. Young people referred for treatment to AMHS were more likely to receive a discharge diagnosis of schizophrenia and related disorders (Odds Ratio [OR] 3.92; 95 % confidence interval [CI] 2.17-7.08), personality disorders (OR 2.69; 95 % CI 1.89-3.83), and pervasive developmental disorders (OR 2.13; 95 % CI 1.51-2.99). Further factors predicting transfer to AMHS were not living with parents, inpatient psychiatric admission, and being on medication in the previous 24 months. These findings suggest that a relatively small number of adolescents moved to AMHS and are likely to reflect the configuration of local mental health services and alternative care available, mainly for those with less-severe mental disorders.

  17. 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.

  18. Epidemiology of multimorbidity within the Brazilian adult general population: Evidence from the 2013 National Health Survey (PNS 2013)

    PubMed Central

    de Azevedo-Marques, João Mazzoncini; Coxon, Domenica; Santos, Jair Lício Ferreira

    2017-01-01

    Middle-income countries are facing a growing challenge of adequate health care provision for people with multimorbidity. The objectives of this study were to explore the distribution of multimorbidity and to identify patterns of multimorbidity in the Brazilian general adult population. Data from 60202 adults, aged ≥18 years that completed the individual questionnaire of the National Health Survey 2013 (Portuguese: “Pesquisa Nacional de Saúde”–“PNS”) was used. We defined multimorbidity as the presence of two or more chronic conditions, including self-reported diagnoses and responses to the 9-item Patient Health Questionnaire for depression. Multivariate Poisson regression analyses were used to explore relationship between multimorbidity and demographic factors. Exploratory tetrachoric factor analysis was performed to identify multimorbidity patterns. 24.2% (95% CI 23.5–24.9) of the study population were multimorbid, with prevalence rate ratios being significantly higher in women, older people and those with lowest educational level. Multimorbidity occurred earlier in women than in men, with half of the women and men aged 55–59 years and 65–69 years, respectively, were multimorbid. The absolute number of people with multimorbidity was approximately 2.5-fold higher in people younger than 65 years than older counterparts (9920 vs 3945). Prevalence rate ratios of any mental health disorder significantly increased with the number of physical conditions. 46.7% of the persons were assigned to at least one of three identified patterns of multimorbidity, including: “cardio-metabolic”, “musculoskeletal-mental” and “respiratory” disorders. Multimorbidity in Brazil is as common as in more affluent countries. Women in Brazil develop diseases at younger ages than men. Our findings can inform a national action plan to prevent multimorbidity, reduce its burden and align health-care services more closely with patients’ needs. PMID:28182778

  19. Implementation of a Positive Development, Evidence-Supported Practice for Emerging Adults with Serious Mental Health Conditions: The Transition to Independence Process (TIP) Model.

    PubMed

    Dresser, Karyn; Clark, Hewitt B; Deschênes, Nicole

    2015-04-01

    Transition into adulthood represents a particularly challenging period for youth and young adults with serious mental health conditions and related needs. The Transition to Independence Process (TIP) model is based on a positive development approach and has been demonstrated to be an evidence-supported practice for preparing emerging adults in their movement into employment/career, education, living situation, personal effectiveness/well-being, and community-life functioning--and to be responsive to their families. This article describes the TIP model from a positive youth development framework, its empirical underpinnings, and the fidelity and outcome tracking tools that have been developed for use with transition sites for implementation and sustainability. A research study on the fidelity tools showed their reliability and validity and a second study presents progress and outcome findings for youth and young adults at a new TIP model site. The implications of the TIP model and these findings are discussed.

  20. Social rank and adult male nutritional status: evidence of the social gradient in health from a foraging-farming society.

    PubMed

    Reyes-García, Victoria; McDade, Thomas W; Molina, Jose Luis; Leonard, William R; Tanner, Susan N; Huanca, Tomas; Godoy, Ricardo

    2008-12-01

    Research with humans and non-human primate species has found an association between social rank and individual health. Among humans, a robust literature in industrial societies has shown that each step down the rank hierarchy is associated with increased morbidity and mortality. Here, we present supportive evidence for the social gradient in health drawing on data from 289 men (18+ years of age) from a society of foragers-farmers in the Bolivian Amazon (Tsimane'). We use a measure of social rank that captures the locally perceived position of a man in the hierarchy of important people in a village. In multivariate regression analysis we found a positive and statistically significant association between social rank and three standard indicators of nutritional status: body mass index (BMI), mid-arm circumference, and the sum of four skinfolds. Results persisted after controlling for material and psychosocial pathways that have been shown to mediate the association between individual socioeconomic status and health in industrial societies. Future research should explore locally-relevant psychosocial factors that may mediate the association between social status and health in non-industrial societies.

  1. Examining evidence based resistance plus balance training in community-dwelling older adults with complex health care needs: Trial protocol for the Muscling Up Against Disability project.

    PubMed

    Keogh, Justin W L; Henwood, Tim; Gardiner, Paul; Tuckett, Anthony; Hodgkinson, Brent; Rouse, Kevin

    Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs. Using a modified stepped-wedge design, 248 community-dwelling adults 65 years and older with some level of government support aged care have been randomised into the study. Those randomised to exercise undertake six months of twice weekly machine-based, moderate to high intensity, supervised PRBT, followed by a six month unsupervised, unsupported follow-up. Controls spend six months undertaking usual activities, before entering the PRBT and follow-up phases. Data are collected at baseline and after each of the six month phases. Measures include level of and change in health and care needs, body composition, muscle capacity, falls, sleep, quality of life, nutritional and mental health status. In addition, acceptance and engagement is determined through telephone and focus group interviews complementing a multi-model health cost benefit evaluation. It is hypothesised this study will demonstrate the feasibility and efficacy of PRBT in improving primary and secondary health outcomes for older adults with aged care needs, and will support the value of this modality of exercise as an integral evidence-based service model of care.

  2. 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…

  3. Older Adults and Mental Health

    MedlinePlus

    ... and Resources Clinical Trials Share Older Adults and Mental Health Overview It’s just as important for an older ... this helpline, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), to receive immediate counseling. Calling ...

  4. 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…

  5. 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.

  6. 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.

  7. Health Literacy and Older Adults

    PubMed Central

    Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole

    2016-01-01

    Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488

  8. Food Insecurity among Young Adults with Intellectual and Developmental Disabilities in the United States: Evidence from the National Health Interview Survey

    ERIC Educational Resources Information Center

    Brucker, Debra L.; Nord, Derek

    2016-01-01

    People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may…

  9. Adult height, nutrition, and population health

    PubMed Central

    Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

    2016-01-01

    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. PMID:26928678

  10. 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.

  11. 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

  12. Examining longer-term effects of parental death in adolescents and young adults: Evidence from the national longitudinal survey of adolescent to adult health.

    PubMed

    Feigelman, William; Rosen, Zohn; Joiner, Thomas; Silva, Caroline; Mueller, Anna S

    2017-03-01

    Using longitudinal data spanning a 7-year period, we investigated the behavioral and psycho-social effects resulting from a parent's death during early childhood or teenage years on adolescent and early adulthood functioning. Findings confirmed previous work demonstrating various behavioral problems and social-psychological adjustment deficits during adolescence. Results suggested that most detrimental adjustment behaviors among parentally bereaved youth fade as they entered into young adulthood. Yet, premature school withdrawals and diminished interests in college attendance at Wave 1 left many of these young adults with diminished academic accomplishments, lingering economic disadvantages and for females a hesitancy to marry as their lives progressed into adulthood.

  13. 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…

  14. 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…

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Lay Meanings of Health among Rural Older Adults in Appalachia

    ERIC Educational Resources Information Center

    Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly

    2011-01-01

    Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…

  1. 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…

  2. 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…

  3. 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…

  4. 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.

  5. 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.

  6. 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…

  7. Virginia Adult Education Health Literacy Toolkit.

    ERIC Educational Resources Information Center

    Singleton, Kate, Comp.

    This toolkit is a resource to help adult education instructors and administrators better understand the problem of health literacy as it affects their learners. It is designed to support creative approaches to helping learners increase their health literacy as they engage in sound, productive adult literacy instruction. Information resources are…

  8. Domestic violence and mental health in older adults.

    PubMed

    Knight, Lucy; Hester, Marianne

    2016-10-01

    Domestic violence affects every age group and is present throughout the life span, but, while the mental health impact of domestic violence is clearly established in working age adults, less is known about the nature and impact of domestic violence among older adults. This review, therefore, aimed to synthesize findings on the prevalence, nature, and impact of domestic violence among older adults, and its identification and management. Electronic searches were conducted of Medline, PsycINFO, Cinahl, and Embase to identify studies reporting on the mental health and domestic violence in older adults. Findings suggested that, although prevalence figures are variable, the likely lifetime prevalence for women over the age of 65 is between 20-30%. Physical abuse is suggested to decrease with age, but rates of emotional abuse appear to be stable over the lifespan. Among older adults, domestic violence is strongly associated with physical and mental health problems, and the scarce research comparing the impact of domestic violence across the age cohorts suggests that the physical health of older victims may be more severely affected than younger victims. In contrast, there is evidence that older victims may experience less psychological distress in response to domestic violence than younger victims. Internationally, evidence on the management of domestic violence in older adults is sparse. Findings suggest, however, that identification of domestic violence is poor among older adults, and there are very limited options for onwards referral and support.

  9. 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

  10. Adult Reformulations of Child Errors as Negative Evidence.

    ERIC Educational Resources Information Center

    Chouinard, Michelle M.; Clark, Eve V.

    2003-01-01

    Examined whether there was negative evidence in adult reformulations of erroneous child utterances, and if so, whether children made use of that evidence. Findings show that adults reformulate erroneous utterances often enough for learning to occur. Children can detect differences between their own utterance and the adult reformulation and make…

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. Health Care Transition Experiences of Young Adults With Cerebral Palsy.

    PubMed

    Carroll, Ellen McLaughlin

    2015-01-01

    Health care transition (HCT) describes the purposeful, planned movement of adolescents from child to adult-orientated care. The purpose of this qualitative study is to uncover the meaning of transition to adult-centered care as experienced by young adults with cerebral palsy (YA-CP) through the research question: What are the lived experiences of young adults with cerebral palsy transitioning from pediatric to adult healthcare? Six females and 3 males, aged 19-25 years of age, who identified as carrying the diagnosis of cerebral palsy without cognitive impairment, were interviewed. Giorgi's (1985) method for analysis of phenomenology was the framework for the study and guided the phenomenological reduction. The meaning of the lived experiences of YA-CPs transition to adult health care is expert novices with evidence and experience-based expectations, negotiating new systems interdependently and accepting less than was expected. More information and support is needed for the YA-CP during transition to ensure a well-organized move to appropriate adult-oriented health care that is considerate of the lifelong impact of the disorder. The nurses' role as advocate, mentor and guide can optimize the individual's response to the transition process.

  16. 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.

  17. 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…

  18. 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…

  19. Health Tips for Older Adults

    MedlinePlus

    ... held weights, like soup cans, to improve your strength. The Go4Life campaign, sponsored by the National Institute on Aging (NIA), offers easy-to-use materials on health and aging. Try their tips on ...

  20. 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

  1. Optimizing Tailored Health Promotion for Older Adults

    PubMed Central

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

    2016-01-01

    Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

  2. 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.

  3. 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.

  4. 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

  5. Childhood abuse, adult health, and health care utilization: results from a representative community sample.

    PubMed

    Chartier, M J; Walker, J R; Naimark, B

    2007-05-01

    The long-term consequences of childhood abuse on adult mental health have been a major focus of research. Much less attention has been directed to its effects on physical health outcomes. By use of data from the Ontario Health Survey (n = 9,953), the association between retrospective reports of childhood physical and sexual abuse and adult health and health care utilization was examined in men and women. The population health survey was conducted from November 1990 to March 1991 in the Canadian province of Ontario. An association of moderate strength was found between childhood abuse and multiple health problems, poor or fair self-rated health, pain that interferes with activities, disability due to physical health problems, and frequent emergency room and health professional visits but not frequent general practitioner visits. These effects were more pronounced in females and younger respondents. The strength of the associations reported here with odds ratios of 1.3-2.2 was lower than that found between childhood abuse and adult mental health, with odds ratios of 1.9-3.4. Given the growing evidence of the long-term effects of childhood abuse, greater efforts are clearly needed in developing more effective strategies for the prevention and treatment of child abuse.

  6. Mobile health technology evaluation: the mHealth evidence workshop.

    PubMed

    Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-08-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research.

  7. 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…

  8. 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.

  9. Understanding evidence-based public health policy.

    PubMed

    Brownson, Ross C; Chriqui, Jamie F; Stamatakis, Katherine A

    2009-09-01

    Public health policy has a profound impact on health status. Missing from the literature is a clear articulation of the definition of evidence-based policy and approaches to move the field forward. Policy-relevant evidence includes both quantitative (e.g., epidemiological) and qualitative information (e.g., narrative accounts). We describe 3 key domains of evidence-based policy: (1) process, to understand approaches to enhance the likelihood of policy adoption; (2) content, to identify specific policy elements that are likely to be effective; and (3) outcomes, to document the potential impact of policy. Actions to further evidence-based policy include preparing and communicating data more effectively, using existing analytic tools more effectively, conducting policy surveillance, and tracking outcomes with different types of evidence.

  10. Stability and Change in Health, Functional Abilities, and Behavior Problems among Adults with and without Down Syndrome

    ERIC Educational Resources Information Center

    Esbensen, Anna J.; Seltzer, Marsha Mailick; Krauss, Marty Wyngaarden

    2008-01-01

    Changes in health, functional abilities, and behavior problems among 150 adults with Down syndrome and 240 adults with mental retardation due to other causes were examined with seven assessments over a 9-year period. Adults were primarily younger than 40, the age at which declines begin to be evident in individuals with Down syndrome. Adults with…

  11. Quick Guide to Health Literacy and Older Adults

    MedlinePlus

    ... to content Office of Disease Prevention and Health Promotion Quick Guide to Health Literacy and Older Adults ... CONTACT US Office of Disease Prevention and Health Promotion U.S. Department of Health and Human Services

  12. Sexual health and older adults: suggestions for social science research.

    PubMed

    Hinchliff, Sharron

    2016-11-01

    The body of evidence on older adults' sexual health is beginning to grow. However, it remains an under-researched area particularly within the social sciences. This viewpoint outlines four considerations for those who carry out social science research in this area: 1. defining the age category "older adults"; 2. being clear about the types of sex under research; 3. capturing a range of diverse voices; and 4. considering the use of qualitative research methods to explore the topic in depth. These suggestions are aimed at helping researchers to avoid some of the pitfalls of research in this area, as well as improving the evidence base in order to advance recognition of the issues and drive change in service provision.

  13. 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.

  14. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  15. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  16. 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

  17. Broader health coverage is good for the nation's health: evidence from country level panel data.

    PubMed

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries.

  18. Broader health coverage is good for the nation's health: evidence from country level panel data

    PubMed Central

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries. PMID:25598588

  19. Health and social care management for older adults with multimorbidity: a multiperspective approach.

    PubMed

    Meranius, Martina Summer; Josefsson, Karin

    2017-03-01

    Multimorbidity, a condition common among older adults, may be regarded as a failure of a complex system. The aim of this study was to describe the core components in health and social care management for older adults with multimorbidity. A cross-sectional design included two methods: individual interviews and group discussions. A total of 105 participants included older adults with multimorbidity and their relatives, care staff and healthcare policymakers. Data were analysed using content analysis. The results show that seven core components comprise a multiperspective view of health and social care management for older adults with multimorbidity: political steering, leadership, cooperation, competence, support for relatives, availability and continuity. Steps should be taken to ensure that every older adult with multimorbidity has a treatment plan according to a multiperspective view to prevent fragmentation of their health care. This study provides relevant evidence developing a multiperspective model of health and social care management for older adults with multimorbidity.

  20. 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…

  1. Procedures for identifying evidence-based psychological treatments for older adults.

    PubMed

    Yon, Adriana; Scogin, Forrest

    2007-03-01

    The authors describe the methods used to identify evidence-based psychological treatments for older adults in this contribution to the special section. Coding teams were assembled to review the literature on several problems relevant to mental health and aging. These teams used the manual developed by the Committee on Science and Practice of the Society for Clinical Psychology (Division 12) of the American Psychological Association that provided definitions of key constructs used in coding. The authors provide an overview of the process followed by the review teams and of some of the issues that emerged to illustrate the steps involved in the coding procedure. Identifying evidence-based treatments is a fundamental aspect of promoting evidence-based practice with older adults; such practice is advocated by most health care disciplines, including psychology.

  2. 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.

  3. 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

  4. Evidence in the development of health policy.

    PubMed

    Macintyre, Sally

    2012-03-01

    For over a century and a half, reformers, researchers and politicians have complained that social and public health policy is not based on evidence. Linear models of knowledge transfer gaps are consistently shown to be poor predictors of research uptake. Public health research, in particular, involves more elements than the linear biomedical model of translation into healthcare products or interventions. Policy makers certainly need to be more sophisticated in understanding and commissioning different types of research and acting on it. However, researchers also need to be much more sophisticated and less naive in understanding how research does and does not influence policy, and how to go about helping policy makers to interpret the jigsaw of evidence, and its relevance and usability.

  5. The Early Determinants of Adult Health Study.

    PubMed

    Susser, E; Buka, S; Schaefer, C A; Andrews, H; Cirillo, P M; Factor-Litvak, P; Gillman, M; Goldstein, J M; Henry, P Ivey; Lumey, L H; McKeague, I W; Michels, K B; Terry, M B; Cohn, B A

    2011-01-01

    This issue of the Journal features collaborative follow-up studies of two unique pregnancy cohorts recruited during 1959-1966 in the United States. Here we introduce the Early Determinants of Adult Health (EDAH) study. EDAH was designed to compare health outcomes in midlife (age 40s) for same-sex siblings discordant on birthweight for gestational age. A sufficient sample of discordant siblings could only be obtained by combining these two cohorts in a single follow-up study. All of the subsequent six papers are either based upon the EDAH sample or are related to it in various ways. For example, three papers report results from studies that significantly extended the 'core' EDAH sample to address specific questions. We first present the overall design of and rationale for the EDAH study. Then we offer a synopsis of past work with the two cohorts to provide a context for both EDAH and the related studies. Next, we describe the recruitment and assessment procedures for the core EDAH sample. This includes the process of sampling and recruitment of potential participants; a comparison of those who were assessed and not assessed based on archived data; the methods used in the adult follow-up assessment; and the characteristics at follow-up of those who were assessed. We provide online supplementary tables with much further detail. Finally, we note further work in progress on EDAH and related studies, and draw attention to the broader implications of this endeavor.

  6. The Early Determinants of Adult Health Study

    PubMed Central

    Susser, E.; Buka, S.; Schaefer, C. A.; Andrews, H.; Cirillo, P. M.; Factor-Litvak, P.; Gillman, M.; Goldstein, J. M.; Henry, P. Ivey; Lumey, L. H.; McKeague, I. W.; Michels, K. B.; Terry, M. B.; Cohn, B. A.

    2014-01-01

    This issue of the Journal features collaborative follow-up studies of two unique pregnancy cohorts recruited during 1959–1966 in the United States. Here we introduce the Early Determinants of Adult Health (EDAH) study. EDAH was designed to compare health outcomes in midlife (age 40s) for same-sex siblings discordant on birthweight for gestational age. A sufficient sample of discordant siblings could only be obtained by combining these two cohorts in a single follow-up study. All of the subsequent six papers are either based upon the EDAH sample or are related to it in various ways. For example, three papers report results from studies that significantly extended the ‘core’ EDAH sample to address specific questions. We first present the overall design of and rationale for the EDAH study. Then we offer a synopsis of past work with the two cohorts to provide a context for both EDAH and the related studies. Next, we describe the recruitment and assessment procedures for the core EDAH sample. This includes the process of sampling and recruitment of potential participants; a comparison of those who were assessed and not assessed based on archived data; the methods used in the adult follow-up assessment; and the characteristics at follow-up of those who were assessed. We provide online supplementary tables with much further detail. Finally, we note further work in progress on EDAH and related studies, and draw attention to the broader implications of this endeavor. PMID:25126404

  7. 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.

  8. Health claim evidence requirements in Japan.

    PubMed

    Yamada, Kazuhiko; Sato-Mito, Natsuko; Nagata, Junichi; Umegaki, Keizo

    2008-06-01

    In the early 1980s the Japanese scientific academy defined a functional food as a food having a tertiary or physiologically active function. The current Japanese "Food with Health Claims" include 2 categories. For the first category, "Food with Nutrient Function Claims," the label may be freely used if a product satisfies the standard for the minimum and maximum levels per daily portion usually consumed. The second category is defined as "Food for Specified Health Uses" (FOSHU). FOSHU foods are those that contain dietary ingredients that have beneficial effects on the physiological functions of the human body, maintain and promote health, and improve health-related conditions. Health claims on these foods correspond to the category of "other" function claims of the Codex Alimentarius. However, claims of disease-risk reduction are not currently allowed under FOSHU with an exception for calcium and folic acid. Manufacturers can emphasize the characteristics of their products and promote sales by labeling or claims. Therefore, the labeling should be clear and correct and avoid any chance of misinterpretation. The labeling of health claims on foods should always be based on scientific evidence. Any manufacturer who applies to the government for approval under the FOSHU code for its product must tabulate both published available publications and internal reports on the effectiveness of the product and/or its ingredients and provide a summary of each available publication or report. The tabulation must include in vitro metabolic and biochemical studies, in vivo studies, and randomized controlled trials on Japanese people. The overall philosophy of the Ministry is to maintain and improve the health status of people and to prevent chronic noncommunicable diseases through an approach that involves a well-balanced diet as well as through the use of "health foods" including "Food with Health Claims."

  9. 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…

  10. Social, Economic, and Health Disparities Among LGBT Older Adults

    PubMed Central

    Emlet, Charles A.

    2016-01-01

    LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery. PMID:28366981

  11. Infant Nutrition and Later Health: A Review of Current Evidence

    PubMed Central

    Robinson, Siân; Fall, Caroline

    2012-01-01

    There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet. PMID:23016121

  12. 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…

  13. 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.

  14. Stability and change in health, functional abilities, and behavior problems among adults with and without Down syndrome.

    PubMed

    Esbensen, Anna J; Seltzer, Marsha Mailick; Krauss, Marty Wyngaarden

    2008-07-01

    Changes in health, functional abilities, and behavior problems among 150 adults with Down syndrome and 240 adults with mental retardation due to other causes were examined with seven assessments over a 9-year period. Adults were primarily younger than 40, the age at which declines begin to be evident in individuals with Down syndrome. Adults with Down syndrome were advantaged in their functional abilities and lack of behavior problems, comparable in health, and exhibited comparable rates of change on these measures as adults with mental retardation due to other causes. Placement out of the parental home and parental death were predictors of change in health, functional abilities, and behavior problems.

  15. 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

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

    MedlinePlus

    ... High Blood Pressure Managing Multiple Health Problems Nutrition Osteoporosis Stroke Related Documents PDF Living With Multiple Health Problems: What Older Adults Should Know Download Join our e-newsletter! Resources ...

  17. Adult reformulations of child errors as negative evidence.

    PubMed

    Chouinard, Michelle M; Clark, Eve V

    2003-08-01

    Parents frequently check up on what their children mean. They often do this by reformulating with a side sequence or an embedded correction what they think their children said. These reformulations effectively provide children with the conventional form for that meaning. Since the child's utterance and the adult reformulation differ while the intended meanings are the same, children infer that adults are offering a correction. In this way, reformulations identify the locus of any error, and hence the error itself. Analyses of longitudinal data from five children between 2;0 and 4;0 (three acquiring English and two acquiring French) show that (a) adults reformulate their children's erroneous utterances and do so significantly more often than they replay or repeat error-free utterances; (b) their rates of reformulation are similar across error-types (phonological, morphological, lexical, and syntactic) in both languages; (c) they reformulate significantly more often to younger children, who make more errors. Evidence that children attend to reformulations comes from four measures: (a) their explicit repeats of corrected elements in their next turn; (b) their acknowledgements (yeah or uh-huh) as a preface to their next turn; (c) repeats of any new information included in the reformulation; and (d) their explicit rejections of reformulations where the adult has misunderstood. Adult reformulations, then, offer children an important source of information about how to correct errors in the course of acquisition.

  18. 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…

  19. 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…

  20. 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…

  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. Summary of the epidemiological evidence relating snus to health.

    PubMed

    Lee, Peter N

    2011-03-01

    Interest in snus (Swedish-type moist snuff) as a smoking alternative has increased. This wide-ranging review summarizes evidence relating snus to health and to initiation and cessation of smoking. Meta-analyses are included. After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97, 95% CI 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites, or with heart disease (1.01, 0.91-1.12) or stroke (1.05, 0.95-1.15). No clear associations are evident in never smokers, any possible risk from snus being much less than from smoking. "Snuff-dipper's lesion" does not predict oral cancer. Snus users have increased weight, but diabetes and chronic hypertension seem unaffected. Notwithstanding unconfirmed reports of associations with reduced birthweight, and some other conditions, the evidence provides scant support for any major adverse health effect of snus. Although some claims that snus reduces initiation or encourages quitting are unsoundly based, snus seems not to increase initiation, as indicated by few smokers using snus before starting and current snus use being unassociated with smoking in adults (the association in children probably being due to uncontrolled confounding), and there are no reports that snus discourages quitting.

  3. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  4. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  5. 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:…

  6. Evidence of health benefits of canola oil

    PubMed Central

    Lin, Lin; Allemekinders, Hanja; Dansby, Angela; Campbell, Lisa; Durance-Tod, Shaunda; Berger, Alvin; Jones, Peter JH

    2013-01-01

    Canola oil-based diets have been shown to reduce plasma cholesterol levels in comparison with diets containing higher levels of saturated fatty acids. Consumption of canola oil also influences biological functions that affect various other biomarkers of disease risk. Previous reviews have focused on the health effects of individual components of canola oil. Here, the objective is to address the health effects of intact canola oil, as this has immediate practical implications for consumers, nutritionists, and others deciding which oil to consume or recommend. A literature search was conducted to examine the effects of canola oil consumption on coronary heart disease, insulin sensitivity, lipid peroxidation, inflammation, energy metabolism, and cancer cell growth. Data reveal substantial reductions in total cholesterol and low-density lipoprotein cholesterol, as well as other positive actions, including increased tocopherol levels and improved insulin sensitivity, compared with consumption of other dietary fat sources. In summary, growing scientific evidence supports the use of canola oil, beyond its beneficial actions on circulating lipid levels, as a health-promoting component of the diet. PMID:23731447

  7. Evidence of health benefits of canola oil.

    PubMed

    Lin, Lin; Allemekinders, Hanja; Dansby, Angela; Campbell, Lisa; Durance-Tod, Shaunda; Berger, Alvin; Jones, Peter J H

    2013-06-01

    Canola oil-based diets have been shown to reduce plasma cholesterol levels in comparison with diets containing higher levels of saturated fatty acids. Consumption of canola oil also influences biological functions that affect various other biomarkers of disease risk. Previous reviews have focused on the health effects of individual components of canola oil. Here, the objective is to address the health effects of intact canola oil, as this has immediate practical implications for consumers, nutritionists, and others deciding which oil to consume or recommend. A literature search was conducted to examine the effects of canola oil consumption on coronary heart disease, insulin sensitivity, lipid peroxidation, inflammation, energy metabolism, and cancer cell growth. Data reveal substantial reductions in total cholesterol and low-density lipoprotein cholesterol, as well as other positive actions, including increased tocopherol levels and improved insulin sensitivity, compared with consumption of other dietary fat sources. In summary, growing scientific evidence supports the use of canola oil, beyond its beneficial actions on circulating lipid levels, as a health-promoting component of the diet.

  8. 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

  9. 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.

  10. Older adults in health education research: some recommendations.

    PubMed

    Connell, C M

    1999-06-01

    A review of articles published in two health education journals is provided to examine the extent to which older adults were included in published research. The review suggests that older adults were included in about 15% of the research articles published in Health Education and Behavior and Health Education Research. Of the articles that include older adults, age differences in study processes and outcomes are rarely examined, and very few studies advance specific hypotheses based on a theoretical or conceptual model of aging or older adulthood. Several recommendations for health education research are suggested.

  11. Homophily and health behavior in social networks of older adults.

    PubMed

    Flatt, Jason D; Agimi, Yll; Albert, Steve M

    2012-01-01

    A common network phenomenon, homophily, involves developing relationships with others who are similar to you. The intent of this study was to determine if older adults' health behaviors were shared within social networks. We interviewed older adults from low-income senior housing (egos) on egocentric social network characteristics and key health behaviors for themselves and for named social ties (alters). Findings suggest strong effects for homophily, especially for those who smoked and were physically inactive. Public health interventions for older adults should consider the influence that social relationships have on personal health behaviors. Network-based interventions may be required.

  12. 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.

  13. Evidence for epithelial-mesenchymal transitions in adult liver cells.

    PubMed

    Sicklick, Jason K; Choi, Steve S; Bustamante, Marcia; McCall, Shannon J; Pérez, Elizabeth Hernández; Huang, Jiawen; Li, Yin-Xiong; Rojkind, Marcos; Diehl, Anna Mae

    2006-10-01

    Both myofibroblastic hepatic stellate cells (HSC) and hepatic epithelial progenitors accumulate in damaged livers. In some injured organs, the ability to distinguish between fibroblastic and epithelial cells is sometimes difficult because cells undergo epithelial-mesenchymal transitions (EMT). During EMT, cells coexpress epithelial and mesenchymal cell markers. To determine whether EMT occurs in adult liver cells, we analyzed the expression profile of primary HSC, two HSC lines, and hepatic epithelial progenitors. As expected, all HSC expressed HSC markers. Surprisingly, these markers were also expressed by epithelial progenitors. In addition, one HSC line expressed typical epithelial progenitor mRNAs, and these epithelial markers were inducible in the second HSC line. In normal and damaged livers, small ductular-type cells stained positive for an HSC marker. In conclusion, HSC and hepatic epithelial progenitors both coexpress epithelial and mesenchymal markers, providing evidence that EMT occurs in adult liver cells.

  14. 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.

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

    PubMed

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

    2016-03-14

    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

  16. [Evidence-based guidelines for physical activity of adult Canadians].

    PubMed

    Warburton, Darren E R; Katzmarzyk, Peter T; Rhodes, Ryan E; Shephard, Roy J

    2007-01-01

    This review of the literature provides an update on the scientific biological and psychosocial bases for Canada's Physical Activity Guide for Health Active Living, with particular reference to the effect of physical activity on the health of adults aged 20-55 years. Existing physical activity guidelines for adults from around the world are summarized briefly and compared to the Canadian guidelines. The descriptive epidemiology of physical activity and inactivity in Canada is presented, and the strength of the relationship between physical activity and specific health outcomes is evaluated, with particular emphasis on minimal and optimal physical activity requirements. Finally, areas requiring further investigation are highlighted. Summarizing the findings, Canadian and most international physical activity guidelines advocate moderate-intensity physical activity on most days of the week. Physical activity appears to reduce the risk for over 25 chronic conditions, in particular coronary heart disease, stroke, hypertension, breast cancer, colon cancer, type 2 diabetes, and osteoporosis. Current literature suggests that if the entire Canadian population followed current physical activity guidelines, approximately one-third of deaths related to coronary heart disease, one quarter of deaths related to stroke and osteoporosis, 20% of deaths related to colon cancer, hypertension, and type 2 diabetes, and 14% of deaths related to breast cancer could be prevented. It also appears that the prevention of weight gain and the maintenance of weight loss require greater physical activity levels than current recommendations.

  17. Comprehension of Health-related Written Materials by Older Adults

    PubMed Central

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

    2008-01-01

    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 with low verbal ability or older than 77 years of age had difficulty understanding texts high in text cohesion but low in Flesch Reading Ease. These results imply that writers must increase Flesch Reading Ease without disrupting text cohesion to ensure comprehension of health-related texts. PMID:19543546

  18. 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.

  19. 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…

  20. 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...

  1. 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…

  2. 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…

  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. 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.

  5. Health and social care costs for young adults with epilepsy in the UK.

    PubMed

    Beecham, Jennifer; Snell, Tom; Perkins, Margaret; Knapp, Martin

    2010-09-01

    Maintaining contact with services will help improve clinical and social outcomes as children with epilepsy move into their adult lives. This study has collated evidence on the extent to which young adults with epilepsy are supported by health and social care services posttransition, and the costs of such support. UK prevalence and service use data were taken from policy and research literature, as well as national data sets and reports. Costs were attached to these data to arrive at agency and overall total costs. There are approximately 42,000 young adults (18-25 years) with epilepsy costing the UK health and social care budgets 715.3 pound million per annum, on average 17,000 found per young adult with epilepsy. A further 61 pound million falls to the social security budget. Most young adults with epilepsy will rarely use these services, but those with additional health needs have high and often long-term support needs, including supported accommodation and personal care. Current resources used by these young adults are summarised but deficits in service availability can mean long waiting times and sub-optimal treatment. Young adults also want more support to help them take advantage of education and employment opportunities and more information about managing the impacts of epilepsy on their lives. Improving services will cost money, but has the potential to lead to better outcomes for young adults.

  6. Older Adults with PTSD: Brief State of Research and Evidence-Based Psychotherapy Case Illustration.

    PubMed

    Cook, Joan M; McCarthy, Elissa; Thorp, Steven R

    2017-01-04

    Although lifetime exposure to potentially traumatic events among older adults is fairly high, rates of full-blown post-traumatic stress disorder (PTSD) are estimated at about 4.5%, a rate lower than that for middle-aged and young adults. Nevertheless, PTSD seems to be an under-recognized and under-treated condition in older adults. Assessment and treatment can be challenging in this population for various reasons, including potential cognitive or sensory decline and comorbid mental and physical disorders. This article provides highlights of the empirical research on PTSD in late life, including information on its effects on cognition and physical health. The bulk of this piece is spent on reviewing the theory, description of, and efficacy for an evidence-based psychotherapy, Prolonged Exposure (PE), for PTSD. A detailed successful application of PE with an older veteran with severe, chronic PTSD in the Department of Veterans Affairs Health Care System is presented. Evidence-based psychotherapy for PTSD can be safely and effectively used with older individuals.

  7. 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.

  8. 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,…

  9. 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

  10. Economic evaluation for protein and energy supplementation in adults: opportunities to strengthen the evidence.

    PubMed

    Milte, R K; Ratcliffe, J; Miller, M D; Crotty, M

    2013-12-01

    Malnutrition is a costly problem for health care systems internationally. Malnourished individuals require longer hospital stays and more intensive nursing care than adequately nourished individuals and have been estimated to cost an additional £7.3 billion in health care expenditures in the United Kingdom alone. However, treatments for malnutrition have rarely been considered from an economic perspective. The aim of this systematic review was to identify the cost effectiveness of using protein and energy supplementation as a widely used intervention to treat adults with and at risk of malnutrition. Papers were identified that included economic evaluations of protein or energy supplementation for the treatment or prevention of malnutrition in adults. While the variety of outcome measures reported for cost-effectiveness studies made synthesis of results challenging, cost-benefit studies indicated that the savings for the health system could be substantial due to reduced lengths of hospital stay and less intensive use of health services after discharge. In summary, the available economic evidence indicates that protein and energy supplementation in treatment or prevention of malnutrition provides an opportunity to improve patient wellbeing and lower health system costs.

  11. 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…

  12. Adult Competency Instructional Guide Based on Adult Performance Level Studies. Career Education for Adults. Consumer Economics Module. Health Module.

    ERIC Educational Resources Information Center

    Auburn Univ., AL. Dept. of Vocational and Adult Education.

    Developed at Auburn University, Alabama, and based on Adult Performance Level (APL) research conducted at the University of Texas, the two teaching modules for adult career education in this curriculum guide are for the health and for the consumer economics curriculum areas. Focus is on development of basic skills in communication, problem…

  13. Current evidence for automatic Theory of Mind processing in adults.

    PubMed

    Schneider, Dana; Slaughter, Virginia P; Dux, Paul E

    2017-05-01

    Theory of Mind (ToM) is thought to play a key role in social information processing as it refers to the ability of individuals to represent the mental states of others (e.g., intentions, desires, beliefs). A provocative hypothesis has been put forward which espouses the existence of two ToM systems: one that is implicit and involves the automatic analysis of the belief states of others and another that is not automatic and is involved in explicitly reasoning about others' mental states. Recently, Phillips et al. (2015) have suggested that there is limited evidence for automatic ToM processing, after identifying a confound in a previous high-profile paper supporting the existence of this cognitive operation in infants and adults (Kovács, Téglás, & Endress, 2010). Here, we take a broader view of the literature and find, contrary to the conclusions of Phillips et al., that there is a substantial body of literature which demonstrates that adult humans are able to engage in unconscious and unintentional, and thus automatic, analyses of others' mental states. However, whether this ability is best described under a one, two or multiple systems ToM account remains to be determined.

  14. 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…

  15. 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…

  16. Urban health: evidence, challenges, and directions.

    PubMed

    Galea, Sandro; Vlahov, David

    2005-01-01

    Urbanization is one of the most important demographic shifts worldwide during the past century and represents a substantial change from how most of the world's population has lived for the past several thousand years. The study of urban health considers how characteristics of the urban environment may affect population health. This paper reviews the empirical research assessing urban living's impact on population health and our rationale for considering the study of urban health as a distinct field of inquiry. The key factors affecting health in cities can be considered within three broad themes: the physical environment, the social environment, and access to health and social services. The methodologic and conceptual challenges facing the study of urban health, arising both from the limitations of the research to date and from the complexities inherent in assessing the relations among complex urban systems, disease causation, and health are discussed.

  17. 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

  18. 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

  19. Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

    PubMed Central

    Friedman, Esther M.; Montez, Jennifer Karas; Sheehan, Connor McDevitt; Guenewald, Tara L.; Seeman, Teresa E.

    2015-01-01

    Objective Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. Results The best-fitting specification of quantity of events was a linear measure reflecting a dose–response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women’s risk of heart disease. Discussion Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures. PMID:25903978

  20. Auditory Training: Evidence for Neural Plasticity in Older Adults

    PubMed Central

    Anderson, Samira; Kraus, Nina

    2014-01-01

    Improvements in digital amplification, cochlear implants, and other innovations have extended the potential for improving hearing function; yet, there remains a need for further hearing improvement in challenging listening situations, such as when trying to understand speech in noise or when listening to music. Here, we review evidence from animal and human models of plasticity in the brain’s ability to process speech and other meaningful stimuli. We considered studies targeting populations of younger through older adults, emphasizing studies that have employed randomized controlled designs and have made connections between neural and behavioral changes. Overall results indicate that the brain remains malleable through older adulthood, provided that treatment algorithms have been modified to allow for changes in learning with age. Improvements in speech-in-noise perception and cognition function accompany neural changes in auditory processing. The training-related improvements noted across studies support the need to consider auditory training strategies in the management of individuals who express concerns about hearing in difficult listening situations. Given evidence from studies engaging the brain’s reward centers, future research should consider how these centers can be naturally activated during training. PMID:25485037

  1. The Adults' Health & Developmental Program: Descriptive and Evaluative Data.

    ERIC Educational Resources Information Center

    Leviton, Dan; Santa Maria, Laine

    1979-01-01

    Describes the intergenerational Adults' Health and Developmental Program. A survey conducted at the end of the AHDP found that over 80 percent of the sample perceived improvement in personal health, well-being, body image, physical efficiency, intellectual stimulation, and staff-member intimacy. Results are discussed in terms of ongoing sequential…

  2. Health Education in the Field of Adult Education

    ERIC Educational Resources Information Center

    Wallace, J. MacDonald

    1974-01-01

    The real demand for health education lies in learning about stress and tension, facing up to anxiety, and understanding one's own behavior, according to the author, who has taught psychological aspects of health successfully to adults for several years, with neuromuscular relaxation techniques the matirx unifying and integrating his course. (AJ)

  3. Poverty and mental health: how do low-income adults and children fare in psychotherapy?

    PubMed

    Santiago, Catherine DeCarlo; Kaltman, Stacey; Miranda, Jeanne

    2013-02-01

    Poverty is associated with an increased risk for psychological problems. Even with this increased risk for mental health problems and need for care, many low-income adults and families do not receive treatment because of logistical, attitudinal, and systemic barriers. Despite significant barriers to obtaining care, research suggests that low-income individuals show significant benefit from evidence-based mental healthcare. In this article, we review the link between poverty and mental health, common barriers to obtaining mental health services, and treatment studies that have been conducted with low-income groups. Finally, we discuss the implications of the research reviewed and offer recommendations for clinicians working with low-income children or adults, highlighting the importance of evidence-based care, extensive outreach, and empathic respect.

  4. Pathways to health risk exposure in adult film performers.

    PubMed

    Grudzen, Corita R; Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2009-01-01

    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.

  5. 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

  6. Health literacy in adult education: a natural partnership for health equity.

    PubMed

    Chervin, Cara; Clift, Joseph; Woods, Lakeesha; Krause, Elizabeth; Lee, Kien

    2012-11-01

    Incorporating health literacy in adult education instruction is a promising approach to increasing the health equity of people who face racial/ethnic health disparities. Six adult education centers throughout a small Northeast state received 1-year Health Literacy Project grants from a local foundation to increase their capacity to teach health literacy through Study Circles. The evaluation of the project assessed changes in adult learners' skills needed to navigate health systems, manage chronic diseases, and engage in preventive behavior; learners' self-efficacy; and how the education centers increased their capacity to teach health literacy skills to adult learners of color. Quantitative and qualitative data indicated that students' knowledge about health issues and self-efficacy increased significantly as a result of the health literacy instruction. All six centers improved their capacity to teach health literacy. By the end of the Health Literacy Project, almost three quarters of classes included health literacy instruction. Almost half of the Study Circle teachers continued to attend professional development activities for health literacy and share their knowledge with other teachers. Each center also developed partnerships with health care providers and created an infrastructure to continue to teach health literacy. Implications of the identified strengths and challenges on future efforts to increase health literacy and equity are considered.

  7. 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.

  8. 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

  9. Youth with special health care needs: transition to adult health care services.

    PubMed

    Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

    2013-12-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

  10. 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

  11. 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…

  12. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  13. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  14. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  15. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  16. 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…

  17. Examining health information-seeking behaviors of older adults.

    PubMed

    Chaudhuri, Shomir; Le, Thai; White, Cathy; Thompson, Hilaire; Demiris, George

    2013-11-01

    This study aims to examine which resources older adults utilize for their health information needs, how trustworthy and reliable they find these resources, and the difficulties they face in obtaining health-related information. A 41-item survey designed to understand the information-seeking characteristics of older adults was developed and distributed to retirement communities. Some items were taken from the Health Information National Trends Survey. Of 1520 surveys, 403 were returned completed (26.6%). Respondents' mean age was 77.65 years. Average scores indicated respondents trusted particular sources of health information in the following order (highest to lowest): health care providers, pharmacists, friends and relatives, retirement community staff, newspapers, the Internet, television, and the radio. In conclusion, older adults have a greater amount of trust in a person with whom they are able to actively discuss their health as opposed to a nonliving source, which they have to access or manipulate, such as the Internet. Efforts must be made to help older adults better navigate and utilize the Internet and recognize dependable online sources so that they may increase their trust in its use, thereby increasing satisfaction with their own ability to seek and use sources of health information.

  18. Integrating mental health parity for homebound older adults under the medicare home health care benefit.

    PubMed

    Davitt, Joan K; Gellis, Zvi D

    2011-04-01

    Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.

  19. Religion and health-promoting behaviors among emerging adults.

    PubMed

    Horton, Shalonda E B

    2015-02-01

    Studies suggest we capitalize upon religion's health benefits to prevent obesity. The purpose of this qualitative descriptive study was to determine how emerging adults used religion to manage their health. Two focus groups were conducted among White and African American participants. Content analysis of the data revealed categories about their attitudes regarding parental and religious influences, religion's influence on behavior, negative health effects of religion, barriers, obesity prevention, and health promotion programs. Society sends out "easy" solutions for unhealthy behaviors, but we should focus on healthy behavior benefits, remove barriers, and consider religion's part in health promotion (obesity prevention).

  20. 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

  1. 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

  2. Health reform in Massachusetts increased adult dental care use, particularly among the poor.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2013-09-01

    States frequently expand or limit dental benefits for adults covered by Medicaid. As part of statewide health reform in 2006, Massachusetts expanded dental benefits to all adults ages 19-64 whose annual income was at or below 100 percent of the federal poverty level. We examined the impact of this reform and found that it led to an increase in dental care use among the Massachusetts adult population, driven by gains among poor adults. Compared to the prereform period, dental care use increased by 2.9 percentage points among all nonelderly adults in Massachusetts, relative to all nonelderly adults in eight control states. For poor Massachusetts adults, the effect was larger-an eleven-percentage-point increase in dental care use above the increase among the state's nonpoor residents. The Massachusetts experience provides evidence that providing dental benefits to poor adults through Medicaid can improve dental care access and use. Our results imply that the lack of expanded dental coverage for low-income adults under the Affordable Care Act is a missed opportunity to improve access to oral care.

  3. Women's oral health: growing evidence for enhancing perspectives.

    PubMed

    Halpern, Leslie R; Kaste, Linda M; Briggs, Charlotte; DiPietro, Luisa A; Erwin, Katherine; Frantsve-Hawley, Julie; Gordon, Sara; Heaton, Brenda; Henshaw, Michelle M; Joskow, Renée; Reisine, Susan T; Sinkford, Jeanne C

    2013-04-01

    Women's health, including oral health, is an evolving science with foundation knowledge from many disciplines. Key milestones, particularly in the last decade, provide a roadmap towards the necessary inclusion of gender into dental practice. Such focus is especially important for the evolving role of oral health care providers as primary health care providers. Continued progress of the vibrant incorporation of evidence-based women's oral health into the standard practice of oral health care is encouraged. This expanded preface provides an introduction to this DCNA issue, a brief history and timeline of major women's oral health events, and resources for further consideration.

  4. Health Promotion Board-Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community.

    PubMed

    Shyamala, Thilagaratnam; Wong, Sweet Fun; Andiappan, Akila; Au Eong, Kah Guan; Bakshi, Anu Birla; Boey, Debbie; Chong, Tsung Wei; Eng, Hui Ping; Ismail, Noor Hafizah; Lau, Tang Ching; Lim, Wei-Yen; Lim, Hsin Wei Wendy; Seong, Lydia; Wong, Wei Chin; Yap, Kai Zhen; Yudah, Sri

    2015-05-01

    The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  5. Public mental health care utilization by older adults.

    PubMed

    Karlin, Bradley E; Norris, Margaret P

    2006-11-01

    The present study examined the extent to which older adults began public mental health treatment throughout Texas in 1999, the types of services they used, and how they compared on demographic and clinical variables to younger consumers. Notwithstanding recent policy and related developments, older adults were found to use public mental health services at substantially low rates, as in past decades. Significantly, older consumers tended to be relatively healthy and independent. Among younger and, even more so, older consumers, there were relatively high proportions of rural residents and minorities, groups previously found to be unlikely to utilize private mental health services. Overall, the findings urge that greater attention be devoted to public mental health outreach and service delivery with the elderly, and raise the question of what role the public mental health system should have in nursing homes and other long-term care settings.

  6. 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.

  7. Use of Complementary Therapies for Health Promotion Among Older Adults

    PubMed Central

    Arcury, Thomas A.; Nguyen, Ha T.; Sandberg, Joanne C.; Neiberg, Rebecca H.; Altizer, Kathryn P.; Bell, Ronny A.; Grzywacz, Joseph G.; Lang, Wei; Quandt, Sara A.

    2014-01-01

    This article describes the types of complementary therapies used by older adults for health promotion, and delineates the predisposing, enabling, and need factors associated with their use. One-hundred ninety-five African American and White participants (age 65+) completed a baseline interview and up to six sets of three daily follow-up interviews at monthly intervals. Complementary therapies for health promotion included home remedies, specific foods or beverages, herbs, supplements, vitamins, over-the-counter (OTC) medicine, prayer, exercise, and being active. Although gender, ethnicity, education, and trust in doctors were associated with the use of complementary therapies for health promotion, health information seeking was the predisposing factor most often associated. The enabling factors were also associated with their use. Health information seeking, which reflects a wellness lifestyle, had the most consistent associations with complementary therapy use for health promotion. This health self-management for health promotion may have positive effects on future medical expenditures. PMID:24652893

  8. Use of Complementary Therapies for Health Promotion Among Older Adults.

    PubMed

    Arcury, Thomas A; Nguyen, Ha T; Sandberg, Joanne C; Neiberg, Rebecca H; Altizer, Kathryn P; Bell, Ronny A; Grzywacz, Joseph G; Lang, Wei; Quandt, Sara A

    2015-08-01

    This article describes the types of complementary therapies used by older adults for health promotion, and delineates the predisposing, enabling, and need factors associated with their use. One-hundred ninety-five African American and White participants (age 65+) completed a baseline interview and up to six sets of three daily follow-up interviews at monthly intervals. Complementary therapies for health promotion included home remedies, specific foods or beverages, herbs, supplements, vitamins, over-the-counter (OTC) medicine, prayer, exercise, and being active. Although gender, ethnicity, education, and trust in doctors were associated with the use of complementary therapies for health promotion, health information seeking was the predisposing factor most often associated. The enabling factors were also associated with their use. Health information seeking, which reflects a wellness lifestyle, had the most consistent associations with complementary therapy use for health promotion. This health self-management for health promotion may have positive effects on future medical expenditures.

  9. Use of Tobacco Cessation Treatments Among Young Adult Smokers: 2005 National Health Interview Survey

    PubMed Central

    Curry, Susan J.; Sporer, Amy K.; Pugach, Oksana; Campbell, Richard T.; Emery, Sherry

    2007-01-01

    Objectives. We compared use of smoking cessation treatments and factors associated with treatment use among young adult smokers and other adult smokers. Methods. We used data from the 2005 National Health Interview Survey core and cancer control supplement. The sample consisted of 6511 current smokers, of whom 759 were aged 18–24 years. Our analyses were weighted to account for differential sampling probabilities and nonresponse rates. We compared continuous measures using the t test; logistic regression was used to obtain odds ratios and confidence intervals. Multiple logistic regression was used to identify correlates of treatment use. Results. Behavioral treatment use was infrequent among all smokers (4%–5%). Young adult smokers were less likely than other smokers to use pharmacotherapy (18% vs 32%). Correlates of pharmacotherapy use for young adult smokers were receiving advice from a health care provider, heavier smoking, and higher educational attainment. Compared with other smokers, young adult smokers were less likely to have received advice to quit from a health care provider (49% vs 60%). Conclusions. Evidence-based tobacco cessation treatments are underused by young adult smokers. PMID:17600243

  10. Middle-Aged and Older Adult Health Care Selection.

    PubMed

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L

    2017-04-01

    This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the "outshopping theory," where respondents select services in larger regional economic centers rather than local "mom and pop" providers, now extends to older adult health care selection.

  11. 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.

  12. Health literacy of Dutch adults: a cross sectional survey

    PubMed Central

    2013-01-01

    Background Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socio-economic disparities in health. This paper is part of the European Health Literacy Survey (HLS-EU). It aims to add to the body of theoretical knowledge about health literacy by measuring perceived difficulties with health information in various domains of health, looking at a number of competences. The definition and measure of health literacy is still topic of debate and hardly any instruments are available that are applicable for the general population. The objectives were to obtain an initial measure of health literacy in a sample of the general population in the Netherlands and to relate this measure to education, income, perceived social status, age, and sex. Methods The HLS-EU questionnaire was administered face-to-face in a sample of 925 Dutch adults, during July 2011. Perceived difficulties with the health literacy competences for accessing, understanding, appraising and applying information were measured within the domains of healthcare, disease prevention and health promotion. Multiple linear regression analyses were applied to explore the associations between health literacy competences and education, income, perceived social status, age, and sex. Results Perceived difficulties with health information and their association with demographic and socio-economic variables vary according to the competence and health domain addressed. Having a low level of education or a low perceived social status or being male were consistently found to be significantly related to relatively low health literacy scores, mainly for accessing and understanding health information. Conclusions Perceived difficulties with health information vary between competences and domains of

  13. The Obama health care plan: what it means for mental health care of older adults.

    PubMed

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  14. 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

  15. 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.

  16. 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

  17. 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

    2013-10-16

    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.

  18. Understanding nutritional health in older adults. A pilot study.

    PubMed

    Callen, Bonnie

    2004-01-01

    A pilot study of adults ages 65 and older admitted to an acute care setting was conducted to compare nutritional risk as measured by hospital dieticians with two Nutrition Screening Initiative tools, the DETERMINE Your Nutritional Health Checklist and the Level I Screen, and to elicit from patients their own perceptions of nutritional health. Ten community-living older adults were interviewed. Although all 10 were at nutritional risk as measured by both hospital assessment and nutritional risk screening tools, none of these patients believed themselves to be at risk. One conclusion of this pilot is that interventions and education need to be tailored to the perceptions of targeted individuals.

  19. 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.

  20. Comparative risk judgements for oral health hazards among Norwegian adults: a cross sectional study.

    PubMed

    Astrøm, Anne

    2002-08-20

    BACKGROUND: This study identified optimistic biases in health and oral health hazards, and explored whether comparative risk judgements for oral health hazards vary systematically with socio-economic characteristics and self-reported risk experience. METHODS: A simple random sample of 1,190 residents born in 1972 was drawn from the population resident in three counties of Norway. A total of 735 adults (51% women) completed postal questionnaires at home. RESULTS: Mean ratings of comparative risk judgements differed significantly (p < 0.001) from the mid point of the scales. T-values ranged from -13.1 and -12.1 for the perceived risk of being divorced and loosing all teeth to -8.2 and -7.8 (p < 0.001) for having gum disease and toothdecay. Multivariate analyses using General Linear Models, GLM, revealed gender differences in comparative risk judgements for gum disease, whereas social position varied systematically with risk judgements for tooth decay, gum disease and air pollution. The odds ratios for being comparatively optimistic with respect to having gum disease were 2.9, 1.9, 1.8 and 1.5 if being satisfied with dentition, having a favourable view of health situation, and having high and low involvement with health enhancing and health detrimental behaviour, respectively. CONCLUSION: Optimism in comparative judgements for health and oral health hazards was evident in young Norwegian adults. When judging their comparative susceptibility for oral health hazards, they consider personal health situation and risk behaviour experience.

  1. Comparative risk judgements for oral health hazards among Norwegian adults: a cross sectional study

    PubMed Central

    Åstrøm, Anne Nordrehaug

    2002-01-01

    Background This study identified optimistic biases in health and oral health hazards, and explored whether comparative risk judgements for oral health hazards vary systematically with socio-economic characteristics and self-reported risk experience. Methods A simple random sample of 1,190 residents born in 1972 was drawn from the population resident in three counties of Norway. A total of 735 adults (51% women) completed postal questionnaires at home. Results Mean ratings of comparative risk judgements differed significantly (p < 0.001) from the mid point of the scales. T-values ranged from -13.1 and -12.1 for the perceived risk of being divorced and loosing all teeth to -8.2 and -7.8 (p < 0.001) for having gum disease and toothdecay. Multivariate analyses using General Linear Models, GLM, revealed gender differences in comparative risk judgements for gum disease, whereas social position varied systematically with risk judgements for tooth decay, gum disease and air pollution. The odds ratios for being comparatively optimistic with respect to having gum disease were 2.9, 1.9, 1.8 and 1.5 if being satisfied with dentition, having a favourable view of health situation, and having high and low involvement with health enhancing and health detrimental behaviour, respectively. Conclusion Optimism in comparative judgements for health and oral health hazards was evident in young Norwegian adults. When judging their comparative susceptibility for oral health hazards, they consider personal health situation and risk behaviour experience. PMID:12186656

  2. 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.

  3. 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.

  4. The Effect of Parental Divorce on the Health of Adult Children.

    PubMed

    Thomas, Jason R; Högnäs, Robin S

    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.

  5. Is quality of life poorer for older adults with HIV/AIDS? International evidence using the WHOQOL-HIV.

    PubMed

    Skevington, S M

    2012-01-01

    Increasingly older adults are being diagnosed with HIV/AIDS. In 2002, UNAIDS indicated that 13 aspects of quality of life (QoL) were poorer for older adults, but only sparse, inconsistent cross-cultural evidence is available. This statement was investigated using a reliable, valid measure (the WHOQOL-HIV) distributed in nine cultures (eight countries). HIV positive and well adults (n = 2089) were assessed across 30 QoL facets; 403 were 40+ years. It was confirmed that sleep, fatigue and sex-life were poorer areas of QoL for older HIV adults than younger. Furthermore, they could be misinterpreted as normal ageing signs. Moreover, older people reported greater dependency on medication. However, older HIV adults had better QoL than expected on 11 dimensions; negative feelings, social inclusion, and several environmental and spiritual facets. This highlights the extent of poor QoL in younger adults. After accounting for culture and gender, overall QoL and health in older HIV adults was explained by eight facets comprising 61.3% of the variance. Social relationships were paramount, especially personal relationships (41%), but support and sex-life also. Energy, negative feelings, cognitions, financial resources and HIV symptoms also contributed. Social interventions for ageing communities would improve well-being. This evidence could support global ageing and HIV policy.

  6. Health and agricultural productivity: Evidence from Zambia.

    PubMed

    Fink, Günther; Masiye, Felix

    2015-07-01

    We evaluate the productivity effects of investment in preventive health technology through a randomized controlled trial in rural Zambia. In the experiment, access to subsidized bed nets was randomly assigned at the community level; 516 farmers were followed over a one-year farming period. We find large positive effects of preventative health investment on productivity: among farmers provided with access to free nets, harvest value increased by US$ 76, corresponding to about 14.7% of the average output value. While only limited information was collected on farming inputs, shifts in the extensive and the intensive margins of labor supply appear to be the most likely mechanism underlying the productivity improvements observed.

  7. Families, resources, and adult health: where do sexual minorities fit?

    PubMed

    Denney, Justin T; Gorman, Bridget K; Barrera, Cristina B

    2013-03-01

    Extensive research documents the relevance of families and socioeconomic resources to health. This article extends that research to sexual minorities, using 12 years of the National Health Interview Survey (N = 460,459) to examine self-evaluations of health among male and female adults living in same-sex and different-sex relationships. Adjusting for socioeconomic status eliminates differences between same- and different-sex cohabitors so that they have similarly higher odds of poor health relative to married persons. Results by gender reveal that the cohabitation disadvantage for health is more pronounced for different-sex cohabiting women than for men, but little difference exists between same-sex cohabiting men and women. Finally, the presence of children in the home is more protective for women's than men's health, but those protections are specific to married women. In all, the results elucidate the importance of relationship type, gender, and the presence of children when evaluating health.

  8. 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…

  9. 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.

  10. Psychological treatments for mental disorders in adults: A review of the evidence of leading international organizations.

    PubMed

    Moriana, Juan Antonio; Gálvez-Lara, Mario; Corpas, Jorge

    2017-03-29

    Most mental health services throughout the world currently regard evidence-based psychological treatments as best practice for the treatment of mental disorders. The aim of this study was to analyze evidence-based treatments drawn from RCTs, reviews, meta-analyses, guides, and lists provided by the National Institute for Health and Care Excellence (NICE), Division 12 (Clinical Psychology) of the American Psychological Association (APA), Cochrane and the Australian Psychological Society (APS) in relation to mental disorders in adults. A total of 135 treatments were analyzed for 23 mental disorders and compared to determine the level of agreement among the organizations. The results indicate that, in most cases, there is little agreement among organizations and that there are several discrepancies within certain disorders. These results require reflection on the meaning attributed to evidence-based practice with regard to psychological treatments. The possible reasons for these differences are discussed. Based on these findings, proposals to unify the criteria that reconcile the realities of clinical practice with a scientific perspective were analyzed.

  11. Evidence that consumers are skeptical about evidence-based health care.

    PubMed

    Carman, Kristin L; Maurer, Maureen; Yegian, Jill Mathews; Dardess, Pamela; McGee, Jeanne; Evers, Mark; Marlo, Karen O

    2010-07-01

    We undertook focus groups, interviews, and an online survey with health care consumers as part of a recent project to assist purchasers in communicating more effectively about health care evidence and quality. Most of the consumers were ages 18-64; had health insurance through a current employer; and had taken part in making decisions about health insurance coverage for themselves, their spouse, or someone else. We found many of these consumers' beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as "medical evidence" or "quality guidelines." Most believed that more care meant higher-quality, better care. The gaps in knowledge and misconceptions point to serious challenges in engaging consumers in evidence-based decision making.

  12. Oral health of adults with serious mental illnesses: a review.

    PubMed

    Matevosyan, Naira Roland

    2010-12-01

    (A) To assess the prevalence of suboptimal oral health in adults with SMI in studies published in 1971-2009; (B) To describe approaches that promote oral health among adults with SMI. A total of 57 randomized, quasi-randomized, cross-section, and cohort studies from samples of 38-4,769 mental health consumers are identified through database, journal, and Internet searches (Cochrane, FASTSTATS, PUBMED, WHO.int). Selected studies are inclusive for the sample, reported statistical power, and external validity. Oral health adverse outcomes (xerostomia, sialorrhoea, dental caries, extracted teeth, malocclusion, periodontal disease, edentulous, oral cancer) are considered as measurable outcomes. This review suggests a substantial prevalence of suboptimal oral health (61%) among individuals with serious mental illnesses. The following outcomes are mostly met: xerostomia, gross caries, decayed teeth, and periodontal disease. Poor oral hygiene, higher intake of carbonates, poor perception of oral health self-needs, length of psychotropic treatment, and less access to dental care determine suboptimal oral health among this population. Further replication of this research should generate gender-wise ethnic cohorts, including detailed observations of environmental factors, and medical problems that contribute to suboptimal oral health. This review highlights the importance of bridging dental health education to psychiatric rehabilitation programs.

  13. 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:…

  14. More Evidence Ties Gum Health to Stroke Risk

    MedlinePlus

    ... 163755.html More Evidence Ties Gum Health to Stroke Risk Study shows increasing risk of brain blockage ... as people with healthy gums to suffer a stroke, new research suggests. It's not the first study ...

  15. Health Literacy and Education Predict Nutrient Quality of Diet of Socioeconomically Diverse, Urban Adults

    PubMed Central

    Kuczmarski, Marie F.; Adams, Erica L.; Cotugna, Nancy; Pohlig, Ryan T.; Beydoun, May A.; Zonderman, Alan B.; Evans, Michele K.

    2016-01-01

    Background Research has shown that health literacy may be a stronger predictor of health than age, employment status, education level, race, and income. Evidence supports a strong link between low health literacy and poor dietary management of chronic diseases. Objective The aim was to evaluate the relationship of micronutrient quality of diet, health numeracy and health literacy in White and African American adults randomly selected from 13 Baltimore neighborhoods. Design Cross-sectional analysis of Wave 3 (2009–2013) of the longitudinal Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study initiated in 2004. Main Outcome Measures Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Health numeracy was measured using the numeracy subscale of the Test of Functional Health Literacy in Adults (TOFHLA). Nutrient-based diet quality was measured using Mean Adequacy Ratio (MAR-S) scores calculated from 17 micronutrients from diet plus dietary supplement intake. Statistical Analyses The relationship of MAR-S scores to the health literacy measures were explored with multiple ordinary least square regression models, adjusting for a number of potential confounders. Results REALM but not numeracy was associated with MAR-S; significant covariates included age, current cigarette smoking status, and energy intake. The interactions of race and educational attainment, and REALM and educational attainment were significant, with the relationship between REALM and MAR-S becoming stronger as education level increased. Conclusion There is a synergistic relationship between health literacy and educational attainment in predicting nutrient-based diet quality. Education was a stronger predictor for Whites compared to African Americans emphasizing the need for health professionals to focus on both education and literacy when creating and providing diet and health-related interventions and resources. PMID:28154842

  16. 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

  17. Organizational justice and health; review of evidence.

    PubMed

    Elovainio, Marko; Heponiemi, Tarja; Sinervo, Timo; Magnavita, Nicola

    2010-01-01

    Organizational justice is a construct defining the quality of social interaction at work. Organizational justice can be divided into three categories: procedural justice (fairness of the decision-making procedures), distributive justice (fairness of outcomes) and relational justice (equity and fairness in the interpersonal treatment of employees by their supervisors). Organizational justice is related to employees' health and well-being. Low perceived justice has been shown to be associated with experienced stress reactions and related physiological and behavioral reactions, such as inflammation, sleeping problems, cardiovascular regulation and cognitive impairments, and with a high rate of work absenteeism. This paper is a review of the literature on organizational justice and its impact on workers' health.

  18. Health literacy and the social determinants of health: a qualitative model from adult learners.

    PubMed

    Rowlands, Gillian; Shaw, Adrienne; Jaswal, Sabrena; Smith, Sian; Harpham, Trudy

    2015-09-27

    Health literacy, 'the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health', is key to improving peoples' control over modifiable social determinants of health (SDH). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant 'health information' factors. Subsequently different learners put these together to develop a model of their 'Journey to health'. Twenty-seven participants were recruited; twenty from community health literacy courses and seven from an adult basic literacy and numeracy course. Participants described health as a 'journey' starting from an individual's family, ethnicity and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used to adapt negative external factors that might inhibit health-promotion. Our model is an iterative linear one moving from ethnicity, community and culture, through lifestyle, to health, with learning revisited in the context of different sources of support. It builds on existing models by highlighting the importance of SDH in the translation of new health knowledge into healthy behaviours, and the importance of health literacy in enabling people to overcome barriers to health.

  19. Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults.

    PubMed

    Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet

    2013-06-01

    Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups.

  20. 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…

  1. 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.

  2. Examining Reports of Mental Health in Adults with Williams Syndrome

    ERIC Educational Resources Information Center

    Stinton, Chris; Tomlinson, Katie; Estes, Zachary

    2012-01-01

    Prior research suggests that individuals with Williams syndrome (WS) have a disposition towards anxiety. Information regarding this is typically derived from parents and carers. The perspectives of the individuals with WS are rarely included in research of this nature. We examined the mental health of 19 adults with WS using explicit (psychiatric…

  3. 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…

  4. Health. Nevada Competency-Based Adult High School Diploma Project.

    ERIC Educational Resources Information Center

    Nevada Univ., Las Vegas. Coll. of Education.

    This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on health is divided into ten topics. The topics included are Nutrition, Reproduction, Menstruation, Contraception, Alcohol Abuse, Tobacco, Immunization, Disease, Accident Prevention, and…

  5. 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…

  6. 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…

  7. 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.

  8. 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.

  9. Promoting health equity in cities through evidence-based action.

    PubMed

    Kumaresan, Jacob; Prasad, Amit; Alwan, Ala; Ishikawa, Nobukatsu

    2010-09-01

    The impact of the urban setting on health and, in particular, health inequities has been widely documented. However, only a few countries have examined their inter- or intra-city health inequalities, and few do so regularly. Information that shows the gaps between cities or within the same city is a crucial requirement to trigger appropriate local actions to promote health equity. To generate relevant evidence and take appropriate actions to tackle health inequities, local authorities need a variety of tools. In order to facilitate a comprehensive understanding of health systems performance, these tools should: (1) adopt a multi-sectorial approach; (2) link evidence to actions; (3) be simple and user-friendly; and (4) be operationally feasible and sustainable. In this paper we have illustrated the use of one such tool, The World Health Organization's Urban HEART, which guides users through a process to identify health inequities, focusing on health determinants and then developing actions based on the evidence generated. In a time of increasing financial constraints, there is a pressing need to allocate scarce resources more efficiently. Tools are needed to guide policy makers in their planning process to identify best-practice interventions that promote health equity in their cities.

  10. Health promotion in young adults at a university in Korea

    PubMed Central

    Joh, Hee-Kyung; Kim, Hyun-Ji; Kim, Young-Oh; Lee, Jae-Young; Cho, BeLong; Lim, Chun Soo; Jung, Sung-Eun

    2017-01-01

    Abstract Young adulthood is a critical developmental period for establishing life-long health behaviors. However, too little attention has been paid to young adult health promotion. The purpose of this study was to describe the processes of development and implementation involved in a collaborative university-wide health promotion program and to evaluate the achievements of the program. A 3-day university-wide health promotion program was developed and implemented in the nation's largest public university in South Korea in September 2013. Its objectives were to heighten health awareness, to promote healthy behaviors, especially active lifestyle and healthy diet, and to disseminate health knowledge, skills, and access to health resources among young people. The program comprised 14 health lectures, 12 events, and 25 booths. To monitor and evaluate the program, a cross-sectional postevent survey was conducted. A convenience sample of 625 university members who participated in the program was used. The statistics were analyzed with a general linear model and paired t test. The program evaluation demonstrated that this university-wide program effectively provided opportunities for students to access health information, knowledge, skills, self-confidence, and available health services and resources. Participants positively evaluated most of the processes of the program activities and services. Participants’ overall evaluation score (83% rated “excellent” or “good”) and reparticipation intention (86%) were high. The majority of participants reported increased awareness of health (80%) and the need for a university health promotion program (87%) after the program. Most of the evaluation scores were similarly high for health lectures and booths/events. In conclusion, the university-wide health promotion program was effective in improving university members’ health awareness and providing opportunities for students to access various health information and

  11. 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

  12. 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…

  13. How Does Schooling Influence Maternal Health Practices? Evidence from Nepal

    ERIC Educational Resources Information Center

    Rowe, Meredith L.; Thapa, Bijaya Kumar; Levine, Robert; Levine, Sarah; Tuladhar, Sumon K.

    2005-01-01

    Women's schooling is associated with much of the world's improvement in child survival and maternal and child health since 1960. Evidence for these associations is widely interpreted as representing a causal influence of formal education on health. The relationships of variations in female school attendance at the levels of individuals,…

  14. 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…

  15. Personality, negative social exchanges, and physical health among bereaved adults

    PubMed Central

    Silva, Nicole M; Henrie, James A; Patrick, Julie Hicks

    2016-01-01

    While much research has investigated the association between personality and health, little research has done so using a bereaved sample. Additionally, little research has investigated how personality influences the frequency of negative social exchanges bereaved individuals receive. This study utilized a structural equation model to investigate the associations among age, gender, personality, negative social exchanges, length of bereavement, and self-reported physical health in a sample of bereaved adults. Results indicated that personality was associated with negative social exchanges and physical health. Therefore, these variables are important and should be studied further in this context. PMID:28070398

  16. 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

  17. Mental health, demographic, and risk behavior profiles of pregnant survivors of childhood and adult abuse.

    PubMed

    Seng, Julia S; Sperlich, Mickey; Low, Lisa Kane

    2008-01-01

    Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.

  18. Oral Health of Down Syndrome Adults in Bosnia and Herzegovina

    PubMed Central

    Porovic, Selma; Zukanovic, Amila; Juric, Hrvoje; Dinarevic, Senka Mesihovic

    2016-01-01

    Introduction: The objective of this study was to determine the oral health condition Down syndrome (DS) adults in Bosnia and Herzegovina, by analyzing oral health of Down syndrome individuals in two largest regions, Sarajevo and Tuzla Canton. Patients and Methods: Caries and oral health status of 33 Down syndrome adults aged 19-45 years were examined and assessed according WHO 1997 criteria. Results: The mean DMFT index is 15,96±8,08. The analysis of oral hygiene of Down syndrome children by using the debris index, is found that 42,4% have very good oral hygiene, 21,2% respondents have good oral hygiene, 27,3% are with poor oral hygiene, while the very poor hygiene have 9,1% subjects. The Value of CPI index is 0,82. PMID:28144195

  19. Explaining selected health behaviors in a national sample of Taiwanese adults.

    PubMed

    Tsai, Tzu-I; Lee, Shoou-Yih Daniel; Tsai, Yi-Wen

    2015-09-01

    Extant research provides little evidence about how health literacy, self-efficacy and health locus of control are related to each other in affecting health behaviors. The purposes of this study were to examine the associations among health literacy, self-efficacy and health locus of control and how the three factors are related to health behaviors using data from a national survey of Taiwanese adults. The analysis showed moderate correlations among health literacy, self-efficacy and locus of control, suggesting that they were independent, albeit correlated, factors. Moreover, we found in most cases that health literacy, self-efficacy and locus of control had independent associations with health behaviors. Of the three factors, self-efficacy had the most consistent and positive associations with health behaviors. Our findings suggest that efforts to promote and sustain health behaviors need to focus on improving individuals' emotional states and correcting their faulty self-beliefs and habits of thinking. Health education campaigns and enhancement of literacy skills alone may not achieve the desirable goal of behavioral change.

  20. 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

  1. Association of Returning to Work With Better Health in Working-Aged Adults: A Systematic Review

    PubMed Central

    Chambers, Lori; Wilson, Mike; Mustard, Cameron; Rourke, Sean B.; Bayoumi, Ahmed; Raboud, Janet; Lavis, John

    2012-01-01

    Objectives. We systematically reviewed the literature on the impact of returning to work on health among working-aged adults. Methods. We searched 6 electronic databases in 2005. We selected longitudinal studies that documented a transition from unemployment to employment and included a comparison group. Two reviewers independently appraised the retrieved literature for potential relevance and methodological quality. Results. Eighteen studies met our inclusion criteria, including 1 randomized controlled trial. Fifteen studies revealed a beneficial effect of returning to work on health, either demonstrating a significant improvement in health after reemployment or a significant decline in health attributed to continued unemployment. We also found evidence for health selection, suggesting that poor health interferes with people’s ability to go back to work. Some evidence suggested that earlier reemployment may be associated with better health. Conclusions. Beneficial health effects of returning to work have been documented in a variety of populations, times, and settings. Return-to-work programs may improve not only financial situations but also health. PMID:22390520

  2. Financing health services in Poland: new evidence on private expenditures.

    PubMed

    Chawla, M; Berman, P; Kawiorska, D

    1998-06-01

    This paper estimates total expenditure on health care in Poland in 1994 and provides new evidence on high levels of private spending on health care. The analysis shows that health care expenditures in Poland are higher than has usually been maintained, and are comparable with the prevailing levels in many other European countries. Private expenditure on health is a significant proportion of total expenditure on health, and in particular on financing outpatient care. Available evidence indicates that informal payments made by patients to physicians contribute as much as double of the physician's salary, and thus form an important source of earnings for physicians. This situation of high private expenditures on health care and informal payments to physicians is likely to be true of other transitional economies of Central and Eastern Europe as well. One policy implication that emerges is these transitional economies face a big challenge in managing existing resources, as opposed to finding new resources, in the health sector more effectively to meet the health care needs of their population. The paper highlights the need for better understanding of the current availability and distribution of resources in the health sector and their directions of flow, in both public and private sectors, and suggests using tools such as National Health Accounts to track and monitor changes in the financing of the health care system.

  3. The Kaiser Permanente Northern California Adult Member Health Survey

    PubMed Central

    Gordon, Nancy; Lin, Teresa

    2016-01-01

    Introduction The Kaiser Permanente Northern California (KPNC) Member Health Survey (MHS) is used to describe sociodemographic and health-related characteristics of the adult membership of this large, integrated health care delivery system to monitor trends over time, identify health disparities, and conduct research. Objective To provide an overview of the KPNC MHS and share findings that illustrate how survey statistics and data have been and can be used for research and programmatic purposes. Methods The MHS is a large-scale, institutional review board-approved survey of English-speaking KPNC adult members. The confidential survey has been conducted by mail triennially starting in 1993 with independent age-sex and geographically stratified random samples, with an option for online completion starting in 2005. The full survey sample and survey data are linkable at the individual level to Health Plan and geocoded data. Respondents are assigned weighting factors for their survey year and additional weighting factors for analysis of pooled survey data. Results Statistics from the 1999, 2002, 2005, 2008, and 2011 surveys show trends in sociodemographic and health-related characteristics and access to the Internet and e-mail for the adult membership aged 25 to 79 years and for 6 age-sex subgroups. Pooled data from the 2008 and 2011 surveys show many significant differences in these characteristics across the 5 largest race/ethnic groups in KPNC (non-Hispanic whites, blacks, Latinos, Filipinos, and Chinese). Conclusion The KPNC MHS has yielded unique insights and provides an opportunity for researchers and public health organizations outside of KPNC to leverage our survey-generated statistics and collaborate on epidemiologic and health services research studies. PMID:27548806

  4. 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

  5. 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.

  6. 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.

  7. SUPPORT Tools for evidence-informed health Policymaking (STP) 1: What is evidence-informed policymaking?

    PubMed

    Oxman, Andrew D; Lavis, John N; Lewin, Simon; Fretheim, Atle

    2009-12-16

    This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. In this article, we discuss the following three questions: What is evidence? What is the role of research evidence in informing health policy decisions? What is evidence-informed policymaking? Evidence-informed health policymaking is an approach to policy decisions that aims to ensure that decision making is well-informed by the best available research evidence. It is characterised by the systematic and transparent access to, and appraisal of, evidence as an input into the policymaking process. The overall process of policymaking is not assumed to be systematic and transparent. However, within the overall process of policymaking, systematic processes are used to ensure that relevant research is identified, appraised and used appropriately. These processes are transparent in order to ensure that others can examine what research evidence was used to inform policy decisions, as well as the judgements made about the evidence and its implications. Evidence-informed policymaking helps policymakers gain an understanding of these processes.

  8. Evidence summary: the relationship between oral health and pulmonary disease.

    PubMed

    Manger, D; Walshaw, M; Fitzgerald, R; Doughty, J; Wanyonyi, K L; White, S; Gallagher, J E

    2017-04-07

    Introduction This paper is the second of four reviews exploring the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policymakers.Aim This review aimed to explore the most contemporary evidence on whether poor oral health and pulmonary disease occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes, and discuss the implication of any findings for health services and future research.Methods The work was undertaken by a group comprising consultant clinicians from medicine and dentistry, trainees, public health, and academics. The methodology involved a streamlined rapid review process and synthesis of the data.Results The results identified a number of systematic reviews of medium to high quality which provide evidence that oral health and oral hygiene habits have an impact on incidence and outcomes of lung diseases, such as pneumonia and chronic obstructive pulmonary disease in people living in the community and in long-term care facilities. The findings are discussed in relation to the implications for service and future research.Conclusion The cumulative evidence of this review suggests an association between oral and pulmonary disease, specifically COPD and pneumonia, and incidence of the latter can be reduced by oral hygiene measures such as chlorhexidine and povidone iodine in all patients, while toothbrushing reduces the incidence, duration, and mortality from pneumonia in community and hospital patients.

  9. 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.

  10. Adult Day Health Center Participation and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

    2010-01-01

    Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

  11. Amplifying diffusion of health information in low-literate populations through adult education health literacy classes.

    PubMed

    Freedman, Ariela M; Miner, Kathleen R; Echt, Katharina V; Parker, Ruth; Cooper, Hannah L F

    2011-01-01

    Over the next decade, as literacy rates are predicted to decline, the health care sector faces increasing challenges to effective communication with low-literate groups. Considering the rising costs of health care and the forthcoming changes in the American health care system, it is imperative to find nontraditional avenues through which to impart health knowledge and functional skills. This article draws on classroom observations and qualitative interviews with 21 students and 3 teachers in an adult education health literacy class to explore the efficacy of using adult education courses to teach functional health literacy skills to low-literate populations. Data were analyzed using a combination of thematic and content analyses. Results describe the motivation of students to share information within the classroom and with friends and family outside the classroom. This article also provides several recommendations to help ensure accuracy of diffused information both within and outside of the classroom. Ultimately, this study suggests that the adult education system is in a prime position to impart functional health literacy skills to low-literate populations in the classroom. Significantly, this study demonstrates that adult education students themselves may be a powerful vehicle for health communication beyond the walls of the classroom.

  12. 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…

  13. 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.

  14. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52... knowledge and skills necessary to manage care requirements in the home. Adult day health care is...

  15. 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.

  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. 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

  18. Youth-Adult Connectedness:: A Key Protective Factor for Adolescent Health.

    PubMed

    Sieving, Renee E; McRee, Annie-Laurie; McMorris, Barbara J; Shlafer, Rebecca J; Gower, Amy L; Kapa, Hillary M; Beckman, Kara J; Doty, Jennifer L; Plowman, Shari L; Resnick, Michael D

    2017-03-01

    Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships.

  19. [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.

  20. Implications of evidence-based practice for mental health nursing.

    PubMed

    Fisher, Jacklin E; Happell, Brenda

    2009-06-01

    The introduction of evidence-based practice (EBP) and the hierarchical approach to evidence it engenders within research and evaluation has aroused controversy in the mental health professions. The aim of this paper is to present a critique of EBP with a specific relationship to mental health nursing. It will be argued that in its current form, EBP presents a potential impediment to the facilitation of consumer participation in mental health services and to the recovery model. The need for the consumer voice and the importance of the lived experience of mental illness are not readily reconciled with a strong scientific paradigm that promotes detachment and objectivity. The importance of evidence in contemporary mental health care will also be acknowledged and discussed in light of the current climate of increased consumer knowledge, fiscal constraint, and extensive social criticism of mental health-care services. The current approach to EBP requires reconstruction to support the consumer-focused nature of mental health nursing, and to facilitate the implementation of a recovery model for mental health care.

  1. 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.

  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. An oral health literacy intervention for Indigenous adults in a rural setting in Australia

    PubMed Central

    2012-01-01

    a functional, context-specific oral health literacy intervention to improve oral health literacy-related outcomes amongst rural-dwelling Indigenous adults. Outcomes of this study will have implications for policy and planning by providing evidence for the effectiveness of such interventions as well as provide a model for working with Indigenous communities. PMID:22716205

  4. Health as an economic engine: evidence for the importance of health in economic development.

    PubMed

    Mirvis, David M; Chang, Cyril F; Cosby, Arthur

    2008-01-01

    Most discussions on the relationships between health and economic conditions have focused on the impact of differences in personal finances or national economic conditions on health. Recently, however, the role of health as an 'economic engine' has been promoted. This paradigm proposes that better health leads to economic development. Evidence from historical, national, and transnational studies have shown that improved health increases economic growth through impacts on micro- and macro-economic factors. In this review, we will summarize the evidence supporting these concepts as a basis for discussing their implications for underdeveloped regions within the United States.

  5. Social disconnectedness, perceived isolation, and health among older adults.

    PubMed

    Cornwell, Erin York; Waite, Linda J

    2009-03-01

    Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However multiple forms of isolation are rarely studied together making it difficult to determine which aspects of isolation are most deleterious for health. Using population-based data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously.

  6. Social Disconnectedness, Perceived Isolation, and Health among Older Adults*

    PubMed Central

    CORNWELL, ERIN YORK; WAITE, LINDA J.

    2009-01-01

    Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However, multiple forms of isolation are rarely studied together, making it difficult to determine which aspects of isolation are most deleterious for health. Using population-based data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously. PMID:19413133

  7. Life and health satisfaction in the adult population of Iran

    PubMed Central

    2016-01-01

    OBJECTIVES Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran. METHODS We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables. RESULTS On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent. CONCLUSIONS The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction. PMID:27809456

  8. 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…

  9. 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

  10. Health-related quality of life and trauma history in adults with schizophrenia spectrum disorders.

    PubMed

    Lysaker, Paul H; LaRocco, Valerie A

    2009-05-01

    Many with schizophrenia report exposure to trauma which may reduce health-related quality of life (HRQOL). To explore whether different forms of trauma are linked to different domains of HRQOL, and whether multiple trauma experiences have a cumulative effect, trauma history was gathered along with a measure of HRQOL among 102 adults with schizophrenia spectrum disorders. Participants were divided into those with and without report of sexual trauma, assault trauma, and trauma related to harm to others. Analysis of variance revealed that participants endorsing sexual trauma had poorer levels of general health, vitality, emotional-related role function, and mental health. Participants endorsing trauma related to harm to others reported poorer physical-related role function, general health, social function, and emotional-related role function. No evidence was found linking assaulted-related trauma to HRQOL. Greater numbers of trauma were related to poorer HRQOL. Results suggest differing forms of trauma may individually and cumulatively impact HRQOL in schizophrenia.

  11. Evidence for a General Factor Model of ADHD in Adults

    ERIC Educational Resources Information Center

    Gibbins, Christopher; Toplak, Maggie E.; Flora, David B.; Weiss, Margaret D.; Tannock, Rosemary

    2012-01-01

    Objective: To examine factor structures of "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for…

  12. 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.

  13. 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

  14. 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…

  15. Trajectories of Health and Behavioral Health Services Use among Community Corrections–Involved Rural Adults

    PubMed Central

    Mowbray, Orion; McBeath, Bowen; Bank, Lew; Newell, Summer

    2016-01-01

    This article seeks to establish time-based trajectories of health and behavioral health services utilization for community corrections–involved (CCI) adults and to examine demographic and clinical correlates associated with these trajectories. To accomplish this aim, the authors applied a latent class growth analysis (LCGA) to services use data from a sample of rural CCI adults who reported their medical, mental health, and substance use treatment utilization behavior every 60 days for 1.5 years. LCGA established 1.5-year trajectories and demographic correlates of health services among rural CCI adults. For medical services, three classes emerged (stable-low users, 13%; stable-intermediate users, 40%; and stable-high users, 47%). For mental health and substance use services, three classes emerged (stable-low, 69% and 61%, respectively; low-baseline-increase, 10% and 12%, respectively; high-baseline decline, 21% and 28%, respectively). Employment, gender, medication usage, and depression severity predicted membership across all services. Results underscore the importance of social workers and other community services providers aligning health services access with the needs of the CCI population, and highlight CCI adults as being at risk of underservice in critical prevention and intervention domains. PMID:27257353

  16. 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

  17. Enhancing the evidence base for health impact assessment

    PubMed Central

    Mindell, J; Boaz, A; Joffe, M; Curtis, S; Birley, M

    2004-01-01

    Health impact assessment differs from other purposes for which evidence is collated in a number of ways, including: These have implications for commissioning and conducting reviews. Methods must be developed to: facilitate comprehensive searching across a broad range of disciplines and information sources; collate appropriate quality criteria to assess a range of study designs; synthesise different kinds of evidence; and facilitate timely stakeholder involvement. Good practice standards for reviews are needed to reduce the risk of poor quality recommendations. Advice to decision makers must make explicit limitations resulting from absent, conflicting, or poor quality evidence. PMID:15194713

  18. Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

    PubMed

    McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

    2012-06-01

    Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours.

  19. Health Selection Among Migrants from Mexico to the U.S.: Childhood Predictors of Adult Physical and Mental Health

    PubMed Central

    Breslau, Joshua; Borges, Guilherme; Tancredi, Daniel J.; Saito, Naomi; Anderson, Heather; Kravitz, Richard; Hinton, Ladson; Aguilar-Gaxiola, Sergio; Medina Mora, Maria-Elena

    2011-01-01

    Objectives We tested whether positive selection on childhood predictors of adult mental and physical health contributed to health advantages of Mexican-born immigrants to the United States relative to U.S.-born Mexican Americans. Methods We combined data from surveys conducted during 2000–2003 in Mexico and the U.S. with the same structured interview. We examined retrospective reports of childhood (i.e., <16 years of age) predictors of adult health—education, height, childhood physical illness, childhood mental health, early substance use, and childhood adversities—as predictors of migration from Mexico to the U.S. at ≥16 years of age. We estimated overall selection by comparing migrants to all non-migrants. We also examined selection at the family (members of families of migrants vs. members of families without a migrant) and individual (migrants vs. non-migrants within families of migrants) levels. Results Distinguishing between family and individual selection revealed evidence of positive health selection that is obscured in the overall selection model. In particular, respondents in families with migrants were more likely to have ≥12 years of education (odds ratio [OR] = 1.60) and be in the tallest height quartile (OR=1.72) than respondents in families without migrants. At both the family and individual levels, migrants are disadvantaged on mental health profiles, including a higher prevalence of conduct problems, phobic fears, and early substance use. Conclusions Positive health selection may contribute to physical health advantages among Mexican immigrants in the U.S. relative to their U.S.-born descendants. Mental health advantages likely reflect a lower prevalence of psychiatric disorders in Mexico, rather than protective factors that distinguish migrants. PMID:21553665

  20. 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…

  1. 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

  2. Young Adults' Perceptions of Calcium Intake and Health.

    PubMed

    Marcinow, Michelle L; Randall Simpson, Janis A; Whiting, Susan J; Jung, Mary E; Buchholz, Andrea C

    2017-02-01

    Many young Canadian adults are not meeting dietary calcium recommendations. This is concerning as adequate calcium is important throughout young adulthood to maximize peak bone mass for osteoporosis prevention. There are limited studies that have explored young adults' perceptions toward calcium and health. Our objectives were to determine young adults' (18-34 years) knowledge of calcium in relation to health, facilitators and barriers to adequate calcium intake, and to explore both their suggestions for individual strategies to increase calcium intake and ways to communicate calcium-related messaging to this population. Eight gender-specific focus groups (18 men; 35 women) were conducted using a semistructured interview guide, guided by social cognitive theory. Deductive thematic analysis was used to generate themes. Participants perceived adequate calcium intake to be important for children and older adults but were uncertain of the benefits for their own age group. Perceived positive outcomes (e.g., aesthetics such as strong nails) associated with adequate calcium intake were cited as a motivator to increase intake. Perceived barriers to achieving increased calcium intake included the high cost and inconvenience of milk products and negative practices of dairy farmers. Participants suggested planning healthy well-balanced meals and forming a habit of consuming calcium-rich foods as individual strategies to increase calcium intake. Strategies to convey calcium-related information to young adults included increasing awareness of the importance of calcium via credible sources of information and developing nutrition education curricula. Social media and advertising were perceived as ineffective. Our findings provide key information for nutrition education initiatives.

  3. 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

  4. 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.

  5. Evidence-Based Psychotherapy Practice in College Mental Health

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    2005-01-01

    This lead off article to the special volume on evidence-based psychotherapy (EBP) in college and university counseling and mental health centers presents an overview of the topic and outlines the structure of this publication. A focus on EBP research and practice generally, and in institutions of higher education specifically, is provided for…

  6. 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

  7. 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.

  8. Establishing an Evidence-Based Adult Education System. NCSALL Occasional Paper.

    ERIC Educational Resources Information Center

    Comings, John P.; Beder, Hal; Bingman, Beth; Reder, Stephen; Smith, Cristine

    To benefit from the support of public and private sector leaders and to ensure that all students receive effective services, the adult education system must identify program models that have empirical evidence to support claims of effectiveness. The U.S. Department of Education's Institute of Education Sciences defines evidence-based education as…

  9. 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.

  10. 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.

  11. 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…

  12. 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.

  13. 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

  14. Social engagement and health in younger, older, and oldest-old adults in the Louisiana Healthy Aging Study.

    PubMed

    Cherry, Katie E; Walker, Erin Jackson; Brown, Jennifer Silva; Volaufova, Julia; LaMotte, Lynn R; Welsh, David A; Su, L Joseph; Jazwinski, S Michal; Ellis, Rebecca; Wood, Robert H; Frisard, Madlyn I

    2013-02-01

    Social support has been shown to influence health outcomes in later life. In this study, we focus on social engagement as an umbrella construct that covers select social behaviors in a life span sample that included oldest-old adults, a segment of the adult population for whom very little data currently exist. We examined relationships among social engagement, positive health behaviors, and physical health to provide new evidence that addresses gaps in the extant literature concerning social engagement and healthy aging in very old adults. Participants were younger (21-59 years), older (60-89 years), and oldest-old (90-97 years) adults (N = 364) in the Louisiana Healthy Aging Study (LHAS). Linear regression analyses indicated that age, gender, and hours spent outside of the house were significantly associated with self-reported health. The number of clubs and hours outside of home were more important factors in the analyses of objective health status than positive health behaviors, after considering age group and education level. These data strongly suggest that social engagement remains an important determinant of physical health into very late adulthood. The discussion focuses on practical applications of these results including social support interventions to maintain or improve late-life health.

  15. 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.

  16. 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

  17. Evidence-Based Assessment of Depression in Adults

    ERIC Educational Resources Information Center

    Joiner, Thomas E.; Walker, Rheeda L.; Pettit, Jeremy W.; Perez, Marisol; Cukrowicz, Kelly C.

    2005-01-01

    From diverse perspectives, there is little doubt that depressive symptoms cohere to form a valid and distinct syndrome. Research indicates that an evidence-based assessment of depression would include (a) measures with adequate psychometric properties; (b) adequate coverage of symptoms; (c) adequate coverage of depressed mood, anhedonia, and…

  18. What (or who) causes health inequalities: theories, evidence and implications?

    PubMed

    McCartney, Gerry; Collins, Chik; Mackenzie, Mhairi

    2013-12-01

    Health inequalities are the unjust differences in health between groups of people occupying different positions in society. Since the Black Report of 1980 there has been considerable effort to understand what causes them, so as to be able to identify actions to reduce them. This paper revisits and updates the proposed theories, evaluates the evidence in light of subsequent epidemiological research, and underlines the political and policy ramifications. The Black Report suggested four theories (artefact, selection, behavioural/cultural and structural) as to the root causes of health inequalities and suggested that structural theory provided the best explanation. These theories have since been elaborated to include intelligence and meritocracy as part of selection theory. However, the epidemiological evidence relating to the proposed causal pathways does not support these newer elaborations. They may provide partial explanations or insights into the mechanisms between cause and effect, but structural theory remains the best explanation as to the fundamental causes of health inequalities. The paper draws out the vitally important political and policy implications of this assessment. Health inequalities cannot be expected to reduce substantially as a result of policy aimed at changing health behaviours, particularly in the face of wider public policy that militates against reducing underlying social inequalities. Furthermore, political rhetoric about the need for 'cultural change', without the required changes in the distribution of power, income, wealth, or in the regulatory frameworks in society, is likely to divert from necessary action.

  19. Health contract calendars: a tool for health professionals with older adults.

    PubMed

    Haber, D; Looney, C

    2000-04-01

    A modification of the health contract technique was applied by 4 geriatric fellows from the Center on Aging, University of Texas Medical Branch, and 3 family medicine residents from the Department of Family Medicine, University of Texas Medical Branch, to a diverse group of 48 older adults. The innovation, a calendar component to the health contract, allowed for the calculation of specific success rates. Fifteen clients had a 100% success rate, and 21 were highly successful, 8 not too successful, and 4 unsuccessful.

  20. 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.

  1. Stress and resource pathways connecting early socioeconomic adversity to young adults' physical health risk.

    PubMed

    Wickrama, Kandauda K A S; Lee, Tae Kyoung; O'Neal, Catherine Walker; Kwon, Josephine A

    2015-05-01

    Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.

  2. Mitigating Nutrition and Health Deficiencies in Older Adults: A Role for Food Innovation?

    PubMed

    Baugreet, Sephora; Hamill, Ruth M; Kerry, Joseph P; McCarthy, Sinéad N

    2017-04-01

    The aim of this review is to describe the factors contributing to diminished food intake, resulting in nutritional deficiencies and associated health conditions in older adults and proposes food innovation strategies to mitigate these. Research has provided convincing evidence of a link between healthy eating patterns and healthy aging. There is a need to target new food product development (NPD) with functional health benefits specifically designed to address the particular food-related needs of older consumers. When developing foods for older adults, consideration should be given to the increased requirements for specific macro- and micronutrients, especially protein, calcium, vitamin D, and vitamin B. Changes in chemosensory acuity, chewing difficulties, and reduced or poor swallowing ability should also be considered. To compensate for the diminished appetite and reduced intake, foods should be energy dense, nutritionally adequate, and, most importantly, palatable, when targeting this cohort. This paper describes the potential of new food product development to facilitate dietary modification and address health deficiencies in older adults.

  3. Health care-associated pneumonia: an evidence-based review.

    PubMed

    Attridge, Russell T; Frei, Christopher R

    2011-08-01

    Health care-associated pneumonia is a relatively new classification of pneumonia that includes community-dwelling pneumonia patients having contact with the health care system. Current data indicate that health care-associated pneumonia patients present with more severe disease, are more likely to be infected with drug-resistant pathogens, and suffer increased mortality compared with community-acquired pneumonia patients. Guidelines recommend that these patients receive empiric antibiotics similar to those recommended for nosocomial pneumonia; however, it is not currently known if outcomes are improved when health care-associated pneumonia patients are treated with these therapies. In addition, the individual health care-associated pneumonia risk factors are based on limited data and are a poor predictor of patients likely to be infected with drug-resistant pathogens. Many questions remain on how to most appropriately care for this growing group of pneumonia patients. This review is an evidence-based discussion of current health care-associated pneumonia data, the individual health care-associated pneumonia risk factors, and limitations and additional considerations for the health care-associated pneumonia classification system.

  4. 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

  5. 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.

  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. 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…

  9. Complete Health: Prevalence and Predictors among U.S. Adults in 1995.

    ERIC Educational Resources Information Center

    Keyes, Corey L. M.; Grzywacz, Joseph G.

    2002-01-01

    Surveyed 3,032 U.S. adults to operationalize, estimate the prevalence, and ascertain the epidemiology of complete health. Overall, 19 percent of adults were completely healthy, 18.8 percent were completely unhealthy, and 62.2 percent had a version of incomplete health. Completely healthy adults were likely to be young (age 25-34 years) or old…

  10. Commentary: Assessing the Health Effects of Medicare Coverage for Previously Uninsured Adults: A Matter of Life and Death?

    PubMed Central

    McWilliams, J Michael; Meara, Ellen; Zaslavsky, Alan M; Ayanian, John Z

    2010-01-01

    In contrast to a previous study we conducted and other evidence, a recent study found no significant effects of Medicare coverage after age 65 on overall health for previously uninsured adults and significant adverse effects on survival for some of these adults. We discuss explanations for these inconsistent findings, particularly the different ways in which deaths were handled, a key methodological challenge in longitudinal analyses of health. We demonstrate that analytic approaches suitable for examining effects of coverage on health measures may not be suitable for effects on mortality. Thus, estimates may be misleading when these different outcomes are jointly modeled. We also present new survival analyses that suggest Medicare coverage significantly attenuated the rising risk of death for previously uninsured adults. PMID:20337735

  11. Consensus statements from the Workshop "Probiotics and Health: Scientific evidence".

    PubMed

    Guarner, F; Requena, T; Marcos, A

    2010-01-01

    This report shows the level of scientific consensus on definition, characteristics and health benefits of probiotics. The content of the report has derived from the scientific meeting: Workshop on Probiotics and Health. Scientific evidence, that congregated several Spanish experts, including gastroenterologists, microbiologists, nutritionists, immunologists and food technologists, among others, who have agreed with the statements shown in this document. Each statement has been sustained with the most relevant scientific aspects that were discussed during the Workshop and the following evaluation of the report by all experts who approved and signed it.

  12. Secondhand smoke exposure and mental health problems in Korean adults

    PubMed Central

    2016-01-01

    OBJECTIVES: To evaluate the association between secondhand smoke exposure (SHSE) and mental health problems among Korean adults. METHODS: We analyzed data from the 2011 Korean Community Health Survey. From the total of 229,226 participants aged 19 years or above, we excluded 48,679 current smokers, 36,612 former smokers, 3,036 participants with a history of stroke, 2,264 participants with a history of myocardial infarction, 14,115 participants who experienced at least one day in bed per month due to disability, and 855 participants for whom information regarding SHSE or mental health problems was not available. The final analysis was performed with 22,818 men and 100,847 women. Participants were classified into four groups according to the duration of SHSE: none, <1 hr/d, 1-<3 hr/d, and ≥3 hr/d. The presence of depressive symptoms, diagnosed depression, and high stress were measured by questionnaire. RESULTS: After adjusting for demographic factors, lifestyle, and chronic disease, the odds ratio (OR) and 95% confidence interval (CI) of depressive symptoms with 1-<3 hr/d and ≥3 hr/d SHSE were 1.44 (95% CI, 1.14 to 1.82) and 1.59 (95% CI, 1.46 to 1.74), respectively. However, SHSE ≥3 hr/d had a higher OR of 1.37 (95% CI, 1.20 to 1.58) for diagnosed depression. SHSE was also associated with high stress (1-<3 hr/d: OR, 1.56; 95% CI, 1.38 to 1.76; ≥3 hr/d: OR, 1.33 95% CI, 1.28 to 1.40). However, the association between SHSE and symptoms of depression and stress did not differ significantly by region. CONCLUSIONS: SHSE may be associated with mental health problems such as depression and stress in Korean adults. PMID:26988086

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

    PubMed Central

    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. PMID:24860496

  14. Kidney function and cognitive health in older adults: the Cardiovascular Health Study.

    PubMed

    Darsie, Brendan; Shlipak, Michael G; Sarnak, Mark J; Katz, Ronit; Fitzpatrick, Annette L; Odden, Michelle C

    2014-07-01

    Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular Health Study who were recruited from 4 US communities and studied from 1992 to 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFRcys). Cognitive function was assessed using the Modified Mini-Mental State Examination and the Digit Symbol Substitution Test, which were administered up to 7 times during annual visits. There was an association between eGFRcys and change in cognitive function after adjustment for confounders; persons with an eGFRcys of less than 60 mL/minute/1.73 m(2) had a 0.64 (95% confidence interval: 0.51, 0.77) points/year faster decline in Modified Mini-Mental State Examination score and a 0.42 (95% confidence interval: 0.28, 0.56) points/year faster decline in Digit Symbol Substitution Test score compared with persons with an eGFRcys of 90 or more mL/minute/1.73 m(2). Additional adjustment for intermediate cardiovascular events modestly affected these associations. Participants with an eGFRcys of less than 60 mL/minute/1.73 m(2) had fewer cognitive impairment-free life-years on average compared with those with eGFRcys of 90 or more mL/minute/1.73 m(2), independent of confounders and mediating cardiovascular events (mean difference = -0.44, 95% confidence interval: -0.62, -0.26). Older adults with lower kidney function are at higher risk of worsening cognitive function.

  15. Does socioeconomic status affect lengthy wait time in Canada? Evidence from Canadian Community Health Surveys.

    PubMed

    Hajizadeh, Mohammad

    2017-04-07

    Reasonable access to health services without financial or other barriers is a primary objective of the Canadian health system. Notwithstanding such concern about accessibility of services, long waiting times for health services have been a prominent health policy issue in recent years. Using pooled data from four nationally representative Canadian Community Health Surveys (CCHSs, 2000/01, 2003, 2005 and 2010; n = 266,962) we examine socioeconomic inequality in lengthy wait time (LWT) to health care among adults (aged 18-65) in Canada. The relative and absolute concentration indices (RC and AC, respectively) are used to quantify income-related inequality in LWT in Canada and for its provinces. Additionally, we decompose the RC and AC indices to identify factors affecting income-related inequality in LWT. Our descriptive results show that, on average, 5% of Canadian adults experienced LWT to access health services in the past 12 months. While 3% of the residents of British Columbia and Saskatchewan reported LWT to access health care services, this figure was 7% in Quebec. Our findings also demonstrated that LWT was mainly concentrated among the poor in Canada [RC = -0.039; 95% confidence interval (CI) -0.049 to -0.028 and AC = -0.067; CI -0.086 to -0.049]. The RC and AC suggested statistically significant pro-rich inequality of LWT in Nova Scotia, New Brunswick, Quebec, Manitoba, Saskatchewan and British Columbia. Decomposition analyses indicate that, besides income itself, health status (measured by a set of 15 chronic condition indicators), immigration status and geographical factors were the most important factors contributing to the concentration of LWT among the poor in Canada. These results provide some evidence that low-income individuals tend to have lengthier wait times for publicly-funded health care in Canada in comparison to their high-income counterparts. The observed negative gradient between income and long waiting time may be interpreted as

  16. The psychological benefits of yoga practice for older adults: evidence and guidelines.

    PubMed

    Bonura, Kimberlee Bethany

    2011-01-01

    Yoga is an effective complementary approach to health maintenance and promotion for older adults and has been demonstrated to support many dimensions of psychological wellbeing, from everyday stress to anxiety, depression, and coping with health challenges. Yoga has the potential to be even more effective when consciously and systematically integrated into an individual's overall self-care and medical care program, through deliberate and open dialogue among patients, healthcare professionals, and yoga professionals. The purpose of this article is to (1) briefly review the psychological benefits of yoga practice for older adults; (2) outline practice guidelines for older adult yoga, including key postures; and (3) provide some basic practical guidelines for both healthcare professionals referring patients to yoga and yoga teachers interested in working with older adults.

  17. Pathways from Childhood Abuse and Other Adversities to Adult Health Risks: The Role of Adult Socioeconomic Conditions

    PubMed Central

    Maguire-Jack, Kathryn

    2015-01-01

    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. PMID:26059537

  18. 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.

  19. Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review.

    PubMed

    Campbell, Megan Ann; Hunt, Jennifer; Scrimgeour, David J; Davey, Maureen; Jones, Victoria

    2017-03-07

    Objective Aboriginal Community-Controlled Health Services (ACCHSs) deliver comprehensive, culturally appropriate primary health care to Aboriginal people and communities. The published literature acknowledging and supporting the roles of ACCHSs in improving Aboriginal health is limited. This paper seeks to collate and analyse the published evidence supporting the contribution of ACCHSs to improving the health of Aboriginal people.Methods A conceptual framework for exploring the contribution of ACCHSs was developed, drawing on the literature on the core functions of ACCHSs and the components of quality primary health care. This framework was used to structure the search strategy, inclusion criteria and analysis of the review.Results ACCHSs contribute to improving the health and well being of Aboriginal peoples through several pathways, including community controlled governance, providing employment and training, strengthening the broader health system and providing accessible, comprehensive primary health care.Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples.What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health.What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Aboriginal health.What are the implications for practitioners? The conceptual framework and findings outlined in this paper illustrate that ACCHSs are making important contributions to improving Aboriginal health through several pathways. This information can be used to ensure actions to improve Aboriginal health are appropriate and effective

  20. Confusion: acetaminophen dosing changes based on NO evidence in adults.

    PubMed

    Krenzelok, Edward P; Royal, Mike A

    2012-06-01

    Acetaminophen (paracetamol) plays a vital role in American health care, with in excess of 25 billion doses being used annually as a nonprescription medication. Over 200 million acetaminophen-containing prescriptions, usually in combination with an opioid, are dispensed annually. While acetaminophen is recognized as a safe and effective analgesic and antipyretic, it is also associated with significant morbidity and mortality (hepatotoxicity) if doses in excess of the therapeutic amount are ingested inappropriately. The maximum daily therapeutic dose of 3900-4000 mg was established in separate actions in 1977 and 1988, respectively, via the Food and Drug Administration (FDA) monograph process for nonprescription medications. The FDA has conducted multiple advisory committee meetings to evaluate acetaminophen and its safety profile, and has suggested (but not mandated) a reduction in the maximum daily dosage from 3900-4000 mg to 3000-3250 mg. In 2011, McNeil, the producer of the Tylenol® brand of acetaminophen, voluntarily reduced the maximum daily dose of its 500 mg tablet product to 3000 mg/day, and it has pledged to change the labeling of its 325 mg/tablet product to reflect a maximum of 3250 mg/day. Generic manufacturers have not changed their dosing regimens and they have remained consistent with the established monograph dose. Therefore, confusion will be inevitable as both consumers and health care professionals try to determine the proper therapeutic dose of acetaminophen. Which is the correct dose of acetaminophen: 3000 mg if 500 mg tablets are used, 3250 mg with 325 mg tablets, or 3900 mg when 650 mg arthritis-strength products are used?

  1. 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 ...

  2. 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…

  3. 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"…

  4. 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

  5. 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.

  6. Why and How the Tobacco Industry Sells Cigarettes to Young Adults: Evidence From Industry Documents

    PubMed Central

    Ling, Pamela M.; Glantz, Stanton A.

    2002-01-01

    Objectives. To improve tobacco control campaigns, we analyzed tobacco industry strategies that encourage young adults (aged 18 to 24) to smoke. Methods. Initial searches of tobacco industry documents with keywords (e.g., “young adult”) were extended by using names, locations, and dates. Results. Approximately 200 relevant documents were found. Transitions from experimentation to addiction, with adult levels of cigarette consumption, may take years. Tobacco marketing solidifies addiction among young adults. Cigarette advertisements encourage regular smoking and increased consumption by integrating smoking into activities and places where young adults' lives change (e.g., leaving home, college, jobs, the military, bars). Conclusions. Tobacco control efforts should include both adults and youths. Life changes are also opportunities to stop occasional smokers' progress to addiction. Clean air policies in workplaces, the military, bars, colleges, and homes can combat tobacco marketing. (Am J Public Health. 2002;92:908–916) PMID:12036776

  7. 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.

  8. 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.

  9. 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

  10. 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…

  11. Healthy(?), wealthy, and wise: Birth order and adult health.

    PubMed

    Black, Sandra E; Devereux, Paul J; Salvanes, Kjell G

    2016-12-01

    While recent research has found that birth order affects outcomes such as education and earnings, the evidence for effects on health is more limited. This paper uses a large Norwegian dataset to focus on the relationship between birth order and a range of health and health-related behaviors, outcomes not previously available in datasets of this magnitude. Interestingly, we find complicated effects of birth order. First-borns are more likely to be overweight, to be obese, and to have high blood pressure and high triglycerides. For example, compared to fifth-borns, first-borns are about 5% points more likely to be obese and 7% points more likely to have high blood pressure. So, unlike education or earnings, there is no clear first-born advantage in health. However, first-borns are about 13% points less likely to smoke daily than fifth-borns and are more likely to report good physical and mental health. Later-borns also score lower on well-being with fifth-borns being about 9% points less likely than first-borns to report that they are happy. Our findings are generally monotonic with middle-borns having outcomes that are intermediate between first- and fifth-borns. We find that these effects are largely unaffected by conditioning on education and earnings, suggesting that these are not the only important pathways to health differentials by birth order. When we explore possible mechanisms, we find that early maternal investment may play a role in birth order effects on health.

  12. 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.

  13. 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…

  14. Sexual Orientation Discordance and Young Adult Mental Health.

    PubMed

    Lourie, Michael A; Needham, Belinda L

    2016-08-01

    During the course of sexual development, many people experience dissonance between dimensions of sexual orientation, including attraction, behavior, and identity. This study assesses the relationship between sexual orientation discordance and mental health. Data were obtained from the National Longitudinal Study of Adolescent to Adult Health (n = 8,915; female = 54.62 %; non-Hispanic black = 18.83 %, Hispanic = 14.91 %, other race (non-white) = 10.79 %). Multivariable linear regression evaluated the correlation between sexual orientation discordance and perceived stress and depressive symptomatology. Models were stratified by sex and sexual identity. Among self-identified heterosexual females and mostly heterosexual males, sexual orientation discordance predicted significantly increased depressive symptomatology. No other subpopulation demonstrated a significant correlation between sexual orientation discordance and depressive symptomatology or perceived stress. The association between sexual orientation discordance and depressive symptomatology suggests a link between sexuality, self-concept, and mental health.

  15. 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.

  16. 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

  17. 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

  18. Ethnic Variation in Oral Health and Social Integration among Older Rural Adults

    PubMed Central

    Arcury, Thomas A.; Chen, Haiying; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Bell, Ronny A.; Quandt, Sara A.

    2011-01-01

    This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, white) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size. Minority elders have poorer oral health than do white older adults. Most rural elders have substantial social engagement and social networks. Better oral health (greater number of teeth) is directly associated with social engagement, while the relationship of oral health to social network size is complex. The association of oral health with social engagement does not differ by ethnicity. Poorer oral health is associated with less social integration among African American, American Indian and white elders. More research on the ways oral health affects the lives of older adults is warranted. PMID:23788829

  19. Ethnic variation in oral health and social integration among older rural adults.

    PubMed

    Arcury, Thomas A; Chen, Haiying; Savoca, Margaret R; Anderson, Andrea M; Leng, Xiaoyan; Bell, Ronny A; Quandt, Sara A

    2013-04-01

    This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, White) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size. Minority elders have poorer oral health than do White older adults. Most rural elders have substantial social engagement and social networks. Better oral health (greater number of teeth) is directly associated with social engagement, whereas the relationship of oral health to social network size is complex. The association of oral health with social engagement does not differ by ethnicity. Poorer oral health is associated with less social integration among African American, American Indian, and White elders. More research on the ways oral health affects the lives of older adults is warranted.

  20. 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

  1. 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

  2. Health impact assessment of housing improvements: incorporating research evidence

    PubMed Central

    Thomson, H; Petticrew, M; Douglas, M

    2003-01-01

    Methods, results, and conclusions: A recent systematic review of housing intervention studies found a lack of research. The authors recommended that a broader evidence base would be needed to support HIA. In response to consultation with policymakers and HIA practitioners this paper presents a way in which research can be used to inform HIA. Based on the systematic review, the authors have developed a table of synthesised findings indicating the expected health effects of specific housing improvements. The authors also reviewed observational data of housing associated health risks to highlight the key impacts to consider when doing a housing HIA. The findings are presented and the authors discuss how they should be used to inform evidence based housing HIA. In addition to considering the existing research, HIA must consider the local relevance of research. Consultation with local stakeholders also needs to be incorporated to the final assessment. The lack of data and the difficulties in gathering and reviewing data mean that not all HIAs will be able to be informed by research evidence. Well conducted prospective validation of HIAs would contribute to the development of healthy housing investment by informing future housing HIA. PMID:12490642

  3. Green Tea and Bone Health: Evidence from Laboratory Studies

    PubMed Central

    Shen, Chwan-Li; Yeh, James K.; Cao, Jay J.; Chyu, Ming-Chien; Wang, Jia-Sheng

    2011-01-01

    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. PMID:21473914

  4. 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.

  5. 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).

  6. 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.

  7. Are employees informed about their health care coverage? Evidence from the buyers health care action group.

    PubMed

    Abraham, Jean; Feldman, Roger; Carlin, Caroline; Christianson, Jon; Davis, Linda

    2005-07-01

    More than half of all Americans receive health insurance coverage through an employer. The rising costs and escalating complexity of health insurance has led many employers to embark on extensive employee education campaigns. In 2002, 1,365 randomly selected employees from 16 Buyers Health Care Action Group firms in the Minneapolis region were surveyed to evaluate their awareness of employer-provided health plan quality information and the extent to which this information influences their enrollment decisions. The study found mixed evidence with respect to the value of employer communication. On one hand, employer communication does not significantly increase the probability that an employee responded correctly to the pharmacy benefit question posed in the survey. However, employer communication has a large effect on the awareness of quality information. How well those campaigns work, and by extension how well employees are informed about the health benefits decisions they make, is a key issue in health care today.

  8. Developing an Evidence-Based Fall Prevention Curriculum for Community Health Workers

    PubMed Central

    St. John, Julie A.; Shubert, Tiffany E.; Smith, Matthew Lee; Rosemond, Cherie A.; Howell, Doris A.; Beaudoin, Christopher E.; Ory, Marcia G.

    2015-01-01

    This perspective paper describes processes in the development of an evidence-based fall prevention curriculum for community health workers/promotores (CHW/P) that highlights the development of the curriculum and addresses: (1) the need and rationale for involving CHW/P in fall prevention; (2) involvement of CHW/P and content experts in the curriculum development; (3) best practices utilized in the curriculum development and training implementation; and (4) next steps for dissemination and utilization of the CHW/P fall prevention curriculum. The project team of CHW/P and content experts developed, pilot tested, and revised bilingual in-person training modules about fall prevention among older adults. The curriculum incorporated the following major themes: (1) fall risk factors and strategies to reduce/prevent falls; (2) communication strategies to reduce risk of falling and strategies for developing fall prevention plans; and (3) health behavior change theories utilized to prevent and reduce falls. Three separate fall prevention modules were developed for CHW/P and CHW/P Instructors to be used during in-person trainings. Module development incorporated a five-step process: (1) conduct informal focus groups with CHW/P to inform content development; (2) develop three in-person modules in English and Spanish with input from content experts; (3) pilot-test the modules with CHW/P; (4) refine and finalize modules based on pilot-test feedback; and (5) submit modules for approval of continuing education units. This project contributes to the existing evidence-based literature by examining the role of CHW/P in fall prevention among older adults. By including evidence-based communication strategies such as message tailoring, the curriculum design allows CHW/P to personalize the information for individuals, which can result in an effective dissemination of a curriculum that is evidence-based and culturally appropriate. PMID:25964920

  9. Health Problems Precede Traumatic Brain Injury in Older Adults

    PubMed Central

    Dams-O’Connor, Kristen; Gibbons, Laura E; Landau, Alexandra; Larson, Eric B; Crane, Paul K.

    2016-01-01

    Objectives To evaluate whether indices of pre-injury health and functioning were associated with risk for incident traumatic brain injury (TBI) with loss of consciousness (LOC), and evaluated health-related factors associated with mortality among those with an incident TBI. Design Prospective community cohort study. Setting Group Health, Seattle Washington. Participants 3,363 individuals aged 65 and older with no self-reported prior TBI with LOC were enrolled and followed every 2 years for an average of 7.5 years (range 0–18 years). Measurements We used Weibull survival models to evaluate baseline and time-varying predictors of incident TBI with LOC, including measures of depression, activities of daily living, cerebrovascular disease, and disease comorbidity. Results In an adjusted multivariate model, baseline depression symptoms as measured by CES-D score (hazard ratio (HR) and 95% confidence interval (CI) for 4 points = 1.34 (1.13, 1.58); p<0.05) and baseline impairment in activities of daily living (ADL; HR (95% CI) = 2.37 (1.24, 4.53); p<0.01) were associated with incident TBI. In a model that included time-dependent covariates, cerebrovascular disease at the previous visit (HR (95% CI) = 2.28 (1.37, 3.78); p<0.01), CES-D score the previous visit (HR for 4 points (95% CI) = 1.23 (1.02, 1.49); p<0.05) and baseline impairment in ADL (HR (95% CI) 2.14 (1.11, 4.13); p<0.05) predicted incident TBI. Of factors considered, cerebrovascular disease and ADL impairment were associated with earlier mortality among those with an incident TBI with LOC. Conclusion Indices of health, mood, and functional status predict incident TBI with LOC in older adults. These findings may have implications for injury prevention and post-injury clinical management. PMID:26925541

  10. 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.

  11. Risky Driving, Mental Health, and Health-Compromising Behaviors: Risk Clustering in Late Adolescents and Adults

    PubMed Central

    Sommers, Marilyn S.; Fargo, Jamison D.

    2014-01-01

    Background Health-compromising behaviors in adolescents and adults co-occur. Because motor vehicle crashes are the leading cause of death and disability for these age groups, understanding the association between risky driving and other health compromising behaviors is critical. Methods We performed a secondary analysis of data from a randomized controlled trial of an intervention for participants who screened positive for risky driving and problem drinking. Using baseline data, we examined relationships among conduct behavior problems before and after age 15, depressive symptoms, sleep, problem drinking, and risky driving (hostile, reckless and drinking and driving) in late adolescents ages 18–24 (n= 110) and adults ages 25–44 (n= 202). We developed a measurement model for the entire sample using confirmatory factor analysis, which was then specified as a multi-group structural equation model. Results Late adolescents and adults had some similar associations for pathways through problem drinking to drinking and driving; depression to reckless driving; and conduct behavior problems after 15 to hostile driving. Late adolescents, however, had more complex relationships: depressive symptoms and conduct behavior problems before 15 were associated with more risky driving behaviors through multiple pathways and males reported more risky driving. Conclusions Risky driving is associated with other health-compromising behaviors and mental health factors. It is a multidimensional phenomenon more pronounced in late adolescence than adulthood. In order to promote safe driving, the findings support the need to consider behaviors that are a health threat in the late adolescent population during driving training and licensure. PMID:24814717

  12. Appraising the evidence for public health policy components using the quality and impact of component evidence assessment.

    PubMed

    Barbero, Colleen; Gilchrist, Siobhan; Schooley, Michael W; Chriqui, Jamie F; Luke, Douglas A; Eyler, Amy A

    2015-03-01

    An essential strategy expected to reduce the global burden of chronic and cardiovascular disease is evidence-based policy. However, it is often unknown what specific components should constitute an evidence-based policy intervention. We have developed an expedient method to appraise and compare the strengths of the evidence bases suggesting that individual components of a policy intervention will contribute to the positive public health impact of that intervention. Using a new definition of "best available evidence," the Quality and Impact of Component (QuIC) Evidence Assessment analyzes dimensions of evidence quality and evidence of public health impact to categorize multiple policy component evidence bases along a continuum of "emerging," "promising impact," "promising quality," and "best." QuIC was recently applied to components from 2 policy interventions to prevent and improve the outcomes of cardiovascular disease: public-access defibrillation and community health workers. Results illustrate QuIC's utility in international policy practice and research.

  13. Tobacco Use among Foster Youth: Evidence of Health Disparities

    PubMed Central

    Braciszewski, Jordan M.; Colby, Suzanne M.

    2015-01-01

    Youth aging out of foster care face a challenging road to independence. Following exposure to myriad risk factors such as abuse, neglect, parental substance use, and severe housing mobility, supportive services decrease upon exit from care, often increasing risk for substance use, homelessness, and unemployment. Although tobacco use is also highly prevalent, little attention has been paid to screening, assessment, and treatment of tobacco use in this vulnerable group. The current study (N = 116) reports on tobacco use prevalence, consequences, and co-occurrence with other substances in a sample of youth (ages 18 to 19) exiting the foster care system. In the face of an overall decrease in tobacco use among general population adolescents and young adults, results suggest disproportionate levels of lifetime, recent, and daily use among foster youth. Prevalence of recent tobacco use (46%) is nearly triple national rates, while daily smoking (32%) is almost four times that of general population young adults. Tobacco users were more likely than non-users to drink (70% vs. 40%) and to smoke marijuana (72% vs. 25%). We strongly encourage researchers and practitioners to increase attention to this tobacco-related health disparity. PMID:26478645

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Confidentiality Protections for Adolescents and Young Adults in the Health Care Billing and Insurance Claims Process.

    PubMed

    2016-03-01

    The importance of protecting confidential health care for adolescents and young adults is well documented. State and federal confidentiality protections exist for both minors and young adults, although the laws vary among states, particularly for minors. However, such confidentiality is potentially violated by billing practices and in the processing of health insurance claims. To address this problem, policies and procedures should be established so that health care billing and insurance claims processes do not impede the ability of providers to deliver essential health care services on a confidential basis to adolescents and young adults covered as dependents on a family's health insurance plan.

  19. Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care

    PubMed Central

    2013-01-01

    Background Chronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers. Methods A sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission. Results Retrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p < 0.001) and Kaplan-Meier survival analysis found the median time to healing was 12 weeks (95% CI 9.3–14.7). Implementation of evidence based care was significantly related to improved healing outcomes (p < 0

  20. 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

  1. [Current evidence on health benefits of the mediterranean diet].

    PubMed

    Dussaillant, Catalina; Echeverría, Guadalupe; Urquiaga, Inés; Velasco, Nicolás; Rigotti, Attilio

    2016-08-01

    The Mediterranean diet is currently considered a functional diet with an increasing amount of scientific evidence that supports its beneficial effects in human health. Several observational cross-sectional and prospective cohort studies show an association between this diet and a lower prevalence and incidence of chronic diseases, such as cardiovascular disease, cancer, metabolic syndrome, diabetes, and neurodegenerative diseases as well as a reduced overall mortality. Additionally, clinical interventional studies, particularly the PREDIMED (Prevención con Dieta Mediterránea) initiative, have shown, with high quality scientific evidence, that a Mediterranean diet -supplemented either with olive oil or nuts- can lower by 30% the incidence of cardiovascular disease, reverse the metabolic syndrome, and prevent the development of diabetes and aging-related cognitive decline. Chile has one of the five Mediterranean ecosystems in the world, and therefore the implementation of this food pattern and lifestyle in our country may determine large benefits to the health status and quality of life in the Chilean population.

  2. 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.

  3. 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.

  4. Speechreading in Deaf Adults with Cochlear Implants: Evidence for Perceptual Compensation

    PubMed Central

    Pimperton, Hannah; Ralph-Lewis, Amelia; MacSweeney, Mairéad

    2017-01-01

    Previous research has provided evidence for a speechreading advantage in congenitally deaf adults compared to hearing adults. A ‘perceptual compensation’ account of this finding proposes that prolonged early onset deafness leads to a greater reliance on visual, as opposed to auditory, information when perceiving speech which in turn results in superior visual speech perception skills in deaf adults. In the current study we tested whether previous demonstrations of a speechreading advantage for profoundly congenitally deaf adults with hearing aids, or no amplificiation, were also apparent in adults with the same deafness profile but who have experienced greater access to the auditory elements of speech via a cochlear implant (CI). We also tested the prediction that, in line with the perceptual compensation account, receiving a CI at a later age is associated with superior speechreading skills due to later implanted individuals having experienced greater dependence on visual speech information. We designed a speechreading task in which participants viewed silent videos of 123 single words spoken by a model and were required to indicate which word they thought had been said via a free text response. We compared congenitally deaf adults who had received CIs in childhood or adolescence (N = 15) with a comparison group of hearing adults (N = 15) matched on age and education level. The adults with CI showed significantly better scores on the speechreading task than the hearing comparison group. Furthermore, within the group of adults with CI, there was a significant positive correlation between age at implantation and speechreading performance; earlier implantation was associated with lower speechreading scores. These results are both consistent with the hypothesis of perceptual compensation in the domain of speech perception, indicating that more prolonged dependence on visual speech information in speech perception may lead to improvements in the perception of

  5. 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.

  6. Short Sleep Duration and Dietary Intake: Epidemiologic Evidence, Mechanisms, and Health Implications12

    PubMed Central

    Dashti, Hassan S; Scheer, Frank AJL; Jacques, Paul F; Lamon-Fava, Stefania; Ordovás, José M

    2015-01-01

    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

  7. 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

  8. Social capital and health: evidence that ancestral trust promotes health among children of immigrants.

    PubMed

    Ljunge, Martin

    2014-12-01

    This paper presents evidence that generalized trust promotes health. Children of immigrants in a broad set of European countries with ancestry from across the world are studied. Individuals are examined within country of residence using variation in trust across countries of ancestry. The approach addresses reverse causality and concerns that the trust measure picks up institutional factors in the individual's contextual setting. There is a significant positive estimate of ancestral trust in explaining self-assessed health. The finding is robust to accounting for individual, parental, and extensive ancestral country characteristics. Individuals with higher ancestral trust are also less likely to be hampered by health problems in their daily life, providing evidence of trust influencing real life outcomes. Individuals with high trust feel and act healthier, enabling a more productive life.

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. Social and physical environmental correlates of adults' weekend sitting time and moderating effects of retirement status and physical health.

    PubMed

    Van Holle, Veerle; McNaughton, Sarah A; Teychenne, Megan; Timperio, Anna; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Salmon, Jo

    2014-09-19

    Emerging research suggests that prolonged sedentary behaviour (SB) is detrimental to health. Changes in SB patterns are likely to occur during particular life stages, for example at retirement age (55-65-year-old). Evidence on socio-ecological SB correlates is scarce and inconsistent in this age group. Moreover, the influence of socio-ecological correlates may vary depending on health and retirement status. This study examined social and environment correlates of overall weekend day sitting among adults at or approaching retirement age, and moderating effects of perceived physical health and retirement status. Baseline data from the Wellbeing, Eating and Exercise for a Long Life study in 2839 Australian adults (55-65-year-old) were analysed. Participants self-reported proximal social factors, neighbourhood social and physical environment, physical health and retirement status. MLwiN multilevel regression analyses were conducted. In the multivariable model, only social support from friends/colleagues to discourage sitting (B = -0.891; p = 0.036) was associated with overall weekend day sitting. No moderation of retirement status, nor physical health were found in the multivariable results. Results from this study suggest the importance of social factors in relation to weekend day sitting among 55-65-year-old adults. Health promotion initiatives in this age group should pay special attention to enhancing social interaction opportunities. Moreover, findings suggest that SB-specific correlates may need to be examined in future research.

  15. 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.

  16. 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

  17. 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…

  18. 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…

  19. The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

    PubMed

    Hernandez-Boussard, Tina; Burns, Carson S; Wang, N Ewen; Baker, Laurence C; Goldstein, Benjamin A

    2014-09-01

    The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009-11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19-25 before and after the ACA provision was implemented with changes in the same period for people ages 26-31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group--a relative change of -2.1 percent. The largest relative decreases were found in women (-3.0 percent) and blacks (-3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19-25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (-0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.

  20. 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

  1. Evolution of health coverage in Mexico: evidence of progress and challenges in the Mexican health system.

    PubMed

    Urquieta-Salomón, José E; Villarreal, Héctor J

    2016-02-01

    To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are

  2. The gender identity/gender dysphoria questionnaire for adolescents and adults: further validity evidence.

    PubMed

    Singh, Devita; Deogracias, Joseph J; Johnson, Laurel L; Bradley, Susan J; Kibblewhite, Sarah J; Owen-Anderson, Allison; Peterson-Badali, Michele; Meyer-Bahlburg, Heino F L; Zucker, Kenneth J

    2010-01-01

    This study aimed to provide further validity evidence for the dimensional measurement of gender identity and gender dysphoria in both adolescents and adults. Adolescents and adults with gender identity disorder (GID) were compared to clinical control (CC) adolescents and adults on the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA), a 27-item scale originally developed by Deogracias et al. (2007). In Study 1, adolescents with GID (n = 44) were compared to CC adolescents (n = 98); and in Study 2, adults with GID (n = 41) were compared to CC adults (n = 94). In both studies, clients with GID self-reported significantly more gender dysphoria than did the CCs, with excellent sensitivity and specificity rates. In both studies, degree of self-reported gender dysphoria was significantly correlated with recall of cross-gender behavior in childhood-a test of convergent validity. The research and clinical utility of the GIDYQ-AA is discussed, including directions for further research in distinct clinical populations.

  3. Safety of therapeutic methylphenidate in adults: a systematic review of the evidence.

    PubMed

    Godfrey, J

    2009-03-01

    Attention deficit hyperactivity disorder (ADHD) often persists into adulthood. Stimulant drugs, including methylphenidate, have showed efficacy in trials for ADHD in adults. Adult psychiatrists are likely to encounter increasing numbers of adult patients who may benefit from methylphenidate. A systematic review of the literature was made to examine the evidence on the safety of methylphenidate, when used therapeutically in adults. Twenty-six placebo-controlled trials were found, in which 811 adults received methylphenidate for ADHD and other conditions. In the short term, methylphenidate was well tolerated and no serious side effects were observed. There is little information on the long-term safety of methylphenidate in adults, although the number of serious adverse effects reported to regulatory authorities has, so far, been low. Methylphenidate is associated with a modest rise in blood pressure and heart rate. Surveys of stimulant use in US universities show that misuse of prescribed medication, for recreation or to enhance study, is fairly common although the level of harm that arises from this practice is unclear.

  4. 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

  5. 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.

  6. Defining ethnic enclave and its associations with self-reported health outcomes among Asian American adults in New York City

    PubMed Central

    Lim, Sungwoo; Yi, Stella S.; De La Cruz, Nneka Lundy; Trinh-Shevrin, Chau

    2016-01-01

    Evidence on ethnic enclave-health associations for Asian Americans is limited due to an inconsistent definition of ethnic enclave. The authors aimed to establish a robust criterion for defining Asian enclaves in New York City (NYC) and assessed the association between enclave residence and health outcomes among Asian American adults. Data came from 2009-12 NYC Community Health Surveys and 2008-12 American Community Survey. Asian enclave was defined as an area with high dissimilarity and isolation scores as well as high concentration of Asians. Five of 55 NYC community districts were identified as Asian enclaves. After controlling for confounding, enclave residence was associated with positive perception of general health with borderline significance (prevalence ratio = 1.06, 95% CI = 0.98, 1.15), but not with current smoking, hypertension, and diabetes. Ethnic enclave residence in urban areas may not produce a substantial impact on chronic health outcomes for Asian Americans beyond individual-level factors. PMID:26699378

  7. 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.

  8. 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.

  9. Child-Adult Relationship Enhancement (CARE): An evidence-informed program for children with a history of trauma and other behavioral challenges.

    PubMed

    Gurwitch, Robin H; Messer, Erica Pearl; Masse, Joshua; Olafson, Erna; Boat, Barbara W; Putnam, Frank W

    2016-03-01

    Child maltreatment impacts approximately two million children each year, with physical abuse and neglect the most common form of maltreatment. These children are at risk for mental and physical health concerns and the ability to form positive social relationships is also adversely affected. Child Adult Relationship Enhancement (CARE) is a set of skills designed to improve interactions of any adult and child or adolescent. Based on parent training programs, including the strong evidence-based treatment, Parent-Child Interaction Therapy (PCIT), CARE was initially developed to fill an important gap in mental health services for children of any age who are considered at-risk for maltreatment or other problems. CARE subsequently has been extended for use by adults who interact with children and youth outside of existing mental health therapeutic services as well as to compliment other services the child or adolescent may be receiving. Developed through discussions with Parent-Child Interaction Therapy (PCIT) therapists and requests for a training similar to PCIT for the non-mental health professional, CARE is not therapy, but is comprised of a set of skills that can support other services provided to families. Since 2006, over 2000 caregivers, mental health, child welfare, educators, and other professionals have received CARE training with a focus on children who are exposed to trauma and maltreatment. This article presents implementation successes and challenges of a trauma-informed training designed to help adults connect and enhance their relationships with children considered at-risk.

  10. The oral health status of adults with a visual impairment, their dental care and oral health information needs.

    PubMed

    Watson, E K; Moles, D R; Kumar, N; Porter, S R

    2010-04-24

    AIM There is little information available concerning the impact of visual impairment upon oral health. The present study sought to identify the oral health and experiences of adults with a visual impairment together with the nature, source and access to oral health information. In addition the study evaluated the oral health status of a group of individuals with a visual impairment with respect to oral health markers, treatment choice and attendance patterns in comparison to a reference group from the general population in the United Kingdom. METHOD One hundred adults with a visual impairment were examined and completed a questionnaire concerning their experience of oral health care and available information sources. The information collected was directly compared with data from the Adult Dental Health Survey 1998 for the south region of England. RESULTS The present group of individuals with a visual impairment had better oral hygiene practices, and similar levels of oral hygiene and hard tissue disease to those of a comparable group of the Adult Dental Health Survey 1998 (ADHS 1998). However 24% of those with a visual impairment were not registered with a dentist and 26% of the patients wished for appropriate information concerning oral health care. CONCLUSIONS There is a need to develop oral health promotion that ensures patients with a visual impairment have appropriate information regarding oral health care and its provision.

  11. Forms of attrition in a longitudinal study of religion and health in older adults and implications for sample bias

    PubMed Central

    Hayward, R. David; Krause, Neal

    2014-01-01

    The use of longitudinal designs in the field of religion and health makes it important to understand how attrition bias may affect findings in this area. This study examines attrition in a 4-wave, 8-year study of older adults. Attrition resulted in a sample biased towards more educated and more religiously-involved individuals. Conditional linear growth curve models found that trajectories of change for some variables differed among attrition categories. Ineligibles had worsening depression, declining control, and declining attendance. Mortality was associated with worsening religious coping styles. Refusers experienced worsening depression. Nevertheless, there was no evidence of bias in the key religion and health results. PMID:25257794

  12. Forms of Attrition in a Longitudinal Study of Religion and Health in Older Adults and Implications for Sample Bias.

    PubMed

    Hayward, R David; Krause, Neal

    2016-02-01

    The use of longitudinal designs in the field of religion and health makes it important to understand how attrition bias may affect findings in this area. This study examines attrition in a 4-wave, 8-year study of older adults. Attrition resulted in a sample biased toward more educated and more religiously involved individuals. Conditional linear growth curve models found that trajectories of change for some variables differed among attrition categories. Ineligibles had worsening depression, declining control, and declining attendance. Mortality was associated with worsening religious coping styles. Refusers experienced worsening depression. Nevertheless, there was no evidence of bias in the key religion and health results.

  13. Ultrastructural evidence of exosome secretion by progenitor cells in adult mouse myocardium and adult human cardiospheres.

    PubMed

    Barile, Lucio; Gherghiceanu, Mihaela; Popescu, Laurentiu M; Moccetti, Tiziano; Vassalli, Giuseppe

    2012-01-01

    The demonstration of beneficial effects of cell therapy despite the persistence of only few transplanted cells in vivo suggests secreted factors may be the active component of this treatment. This so-called paracrine hypothesis is supported by observations that culture media conditioned by progenitor cells contain growth factors that mediate proangiogenic and cytoprotective effects. Cardiac progenitor cells in semi-suspension culture form spherical clusters (cardiospheres) that deliver paracrine signals to neighboring cells. A key component of paracrine secretion is exosomes, membrane vesicles that are stored intracellularly in endosomal compartments and are secreted when these structures fuse with the cell plasma membrane. Exosomes have been identified as the active component of proangiogenic effects of bone marrow CD34⁺ stem cells in mice and the regenerative effects of embryonic mesenchymal stem cells in infarcted hearts in pigs and mice. Here, we provide electron microscopic evidence of exosome secretion by progenitor cells in mouse myocardium and human cardiospheres. Exosomes are emerging as an attractive vector of paracrine signals delivered by progenitor cells. They can be stored as an "off-the-shelf" product. As such, exosomes have the potential for circumventing many of the limitations of viable cells for therapeutic applications in regenerative medicine.

  14. Contemporary extracorporeal membrane oxygenation therapy in adults: Fundamental principles and systematic review of the evidence.

    PubMed

    Squiers, John J; Lima, Brian; DiMaio, J Michael

    2016-07-01

    Extracorporeal membrane oxygenation (ECMO) provides days to weeks of support for patients with respiratory, cardiac, or combined cardiopulmonary failure. Since ECMO was first reported in 1974, nearly 70,000 runs of ECMO have been implemented, and the use of ECMO in adults increased by more than 400% from 2006 to 2011 in the United States. A variety of factors, including the 2009 influenza A epidemic, results from recent clinical trials, and improvements in ECMO technology, have motivated this increased use in adults. Because ECMO is increasingly becoming available to a diverse population of critically ill patients, we provide an overview of its fundamental principles and a systematic review of the evidence basis of this treatment modality for a variety of indications in adults.

  15. 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.

  16. Perceptions about community applications of RE-AIM in the promotion of evidence-based programs for older adults.

    PubMed

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

    2015-03-01

    Despite the growing literature about the RE-AIM framework as a planning, implementation, and evaluation tool, little is known about practitioners' adoption of the framework, confidence to utilize framework elements, or perceptions of its usefulness. To assess how RE-AIM was implemented by state aging service providers and public health partners, data were collected using an Internet-delivered, cross-sectional survey from 40 stakeholders in 27 funded states in an evidence-based disease prevention initiative for older adults. Most participants agreed the framework was useful for planning, implementation, and evaluation and relevant for evaluators, providers, community leaders, and policy makers. Yet nearly half felt monitoring RE-AIM requirements requires special expertise, and one third felt the different RE-AIM elements were difficult to measure. Findings indicate the RE-AIM's appropriateness and utility for planning and evaluating the dissemination of evidence-based programs to older adults; however, additional trainings, resources, and technical assistance are warranted to enhance uptake in community-wide intervention efforts.

  17. State Constitutional Commitment to Health and Health Care and Population Health Outcomes: Evidence From Historical US Data

    PubMed Central

    2015-01-01

    Objectives. I investigated whether the introduction of health and health care provisions in US state constitutions can make health systems more equitable and improve health outcomes by urging state policymakers and administrative agencies to uphold their human rights obligations at state level. Methods. I constructed a panel of infant mortality rates from 50 US states over the period 1929 through 2000 to examine their association with the timing and details of introducing a constitutional right to health and health care provisions. Results. The introduction of a stronger constitutional commitment that obligates state legislature to provide health care was associated with a subsequent reduction in the infant mortality rate of approximately 7.8%. The introduction of provisions explicitly targeting the poor was also associated with a reduction in the infant mortality rate of 6.5%. These health benefits are primarily evident in non-White populations. Conclusions. This empirical result supports Elizabeth Leonard’s view that although state constitutional rights have been poorly enforced through the judiciary, a constitutional expression of health care duties has fueled the political and social process, ultimately allowing states to identify the best way to address citizens’ health inequality concerns. PMID:25905857

  18. A New Functional Health Literacy Scale for Japanese Young Adults Based on Item Response Theory.

    PubMed

    Tsubakita, Takashi; Kawazoe, Nobuo; Kasano, Eri

    2017-03-01

    Health literacy predicts health outcomes. Despite concerns surrounding the health of Japanese young adults, to date there has been no objective assessment of health literacy in this population. This study aimed to develop a Functional Health Literacy Scale for Young Adults (funHLS-YA) based on item response theory. Each item in the scale requires participants to choose the most relevant term from 3 choices in relation to a target item, thus assessing objective rather than perceived health literacy. The 20-item scale was administered to 1816 university students and 1751 responded. Cronbach's α coefficient was .73. Difficulty and discrimination parameters of each item were estimated, resulting in the exclusion of 1 item. Some items showed different difficulty parameters for male and female participants, reflecting that some aspects of health literacy may differ by gender. The current 19-item version of funHLS-YA can reliably assess the objective health literacy of Japanese young adults.

  19. 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

  20. Health Behavior Decision-making in African-American Adults Diagnosed with Schizophrenia.

    PubMed

    Findlay, Lillian J; El-Mallakh, Peggy; Howard, Patricia B; Hatcher, Jennifer; Clark, James J

    2015-07-01

    Little is known about the factors that influence health behavior decision-making among people with schizophrenia. The purpose of this qualitative study was to describe the processes used by 10 African-American adults with schizophrenia when making health behavior decisions and identification of perceived barriers and facilitators to health. Three phases of health behavior decision-making were identified: Recognizing Complex Components of Health, Personalizing Components of Health, and Tracking Health Status. Findings may guide clinicians' efforts to improve the health status of patients, as well as influence future research in understanding health behavior decision-making among vulnerable populations.

  1. Health and access to care among employed and unemployed adults: United States, 2009-2010.

    PubMed

    Driscoll, Anne K; Bernstein, Amy B

    2012-01-01

    Lack of health insurance has been shown to be associated with problems obtaining needed health care (3), and the unemployed are less likely to have health insurance than are their employed counterparts. The number and rate of adults aged 18–64 years lacking health insurance has been increasing, in part due to the historically high unemployment rates. However, even having comprehensive health insurance coverage does not guarantee access to needed services, in part because of cost-sharing, including copayments and deductibles. Unemployed persons may retain their health insurance through the Consolidated Omnibus Budget Reconciliation Act (COBRA) or through other programs, but COBRA payments in particular may be quite expensive, and individual insurance plans may be less comprehensive than many employer-sponsored plans (4). Thus, although some unemployed adults may retain coverage for some period of time, they may be less able to meet cost-sharing requirements because of reduced income associated with unemployment. This analysis compares the health status and access to care of employed and unemployed adults and shows that unemployment is associated with unfavorable health and access to care among adults in the labor force over and above the loss of health insurance. However, it is not possible to know from these data the extent to which unemployment is a cause or effect of poor health. Poor health may be both a cause and effect of unemployment. Adults with private health insurance were more likely to have serious psychological distress and respondent-reported fair or poor health status if they were unemployed. In fact, unemployed privately insured persons were more than three times as likely to have serious psychological distress as their employed counterparts. Similar patterns were found for adults with public insurance and no health insurance. There were no significant differences between employed and unemployed adults in the percentage who had ever been diagnosed

  2. Substance Use, Health, and Functioning Characteristics of Medical Marijuana Program Participants Compared to the General Adult Population in Ontario (Canada).

    PubMed

    Fischer, Benedikt; Ialomiteanu, Anca R; Aeby, Samantha; Rudzinski, Katherine; Kurdyak, Paul; Rehm, Jürgen

    2017-01-01

    Existent profiles of Medical Marijuana Program (MMP) participants indicate common and co-morbid chronic diseases, yet evidence on disability or functioning as well as comparisons with general populations are largely lacking. This study compared health, substance use, and functioning status among formally approved MMP participants with the general adult population in Ontario (Canada). A community-recruited sample (n = 53) of MMP participants was compared to a sub-sample (n = 510) of the representative Centre for Addiction and Mental Health (CAMH) Monitor (2015 cycle) survey of Ontario general population adults (ages 18+) based on identical telephone-based interviews regarding substance use, health, and functioning measures. Means and standard deviations for all indicators were computed by sex, controlled for age and education, and compared by regression techniques. MMP participants were more likely to be male, younger, and less socio-economically integrated; they indicated more common psychoactive substance (e.g., tobacco, daily cannabis) and psychotropic medication use, as well as overall worse physical and mental health and functioning status. Marked differences between MMP participants and general population adults were observed. MMPs appear to attract individuals with complex chronic health problems; however, little is known about the impact of MMP participation on these.

  3. 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.

  4. 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

  5. "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.…

  6. The Relationship Between Health, Education, and Health Literacy: Results From the Dutch Adult Literacy and Life Skills Survey

    PubMed Central

    van der Heide, Iris; Wang, Jen; Droomers, Mariël; Spreeuwenberg, Peter; Rademakers, Jany; Uiters, Ellen

    2013-01-01

    Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by which level of education affects health status. Health literacy was measured by the Health Activities and Literacy Scale, using data from a subsample of 5,136 adults between the ages of 25 and 65 years, gathered within the context of the 2007 Dutch Adult Literacy and Life Skills Survey. Linear regression analyses were used in separate models to estimate the extent to which health literacy mediates educational disparities in self-reported general health, physical health status, and mental health status as measured by the Short Form-12. Health literacy was found to partially mediate the association between low education and low self-reported health status. As such, improving health literacy may be a useful strategy for reducing disparities in health related to education, as health literacy appears to play a role in explaining the underlying mechanism driving the relationship between low level of education and poor health. PMID:24093354

  7. The relationship between health, education, and health literacy: results from the Dutch Adult Literacy and Life Skills Survey.

    PubMed

    van der Heide, Iris; Wang, Jen; Droomers, Mariël; Spreeuwenberg, Peter; Rademakers, Jany; Uiters, Ellen

    2013-01-01

    Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by which level of education affects health status. Health literacy was measured by the Health Activities and Literacy Scale, using data from a subsample of 5,136 adults between the ages of 25 and 65 years, gathered within the context of the 2007 Dutch Adult Literacy and Life Skills Survey. Linear regression analyses were used in separate models to estimate the extent to which health literacy mediates educational disparities in self-reported general health, physical health status, and mental health status as measured by the Short Form-12. Health literacy was found to partially mediate the association between low education and low self-reported health status. As such, improving health literacy may be a useful strategy for reducing disparities in health related to education, as health literacy appears to play a role in explaining the underlying mechanism driving the relationship between low level of education and poor health.

  8. 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

  9. Oral health-related quality of life in Swedish young adults.

    PubMed

    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.

  10. Evidence for Reduced Efficiency and Successful Compensation in Older Adults during Task Switching

    PubMed Central

    Hakun, Jonathan G.; Zhu, Zude; Johnson, Nathan F.; Gold, Brian T.

    2014-01-01

    Older adults often show different functional activation patterns than younger adults in prefrontal cortex (PFC) when performing cognitive control tasks. These differences include age-related increases in PFC activation magnitude and reorganized PFC functional connectivity patterns. However, it remains unclear whether age-related alterations in brain activation patterns reflect a positive mechanism (e.g. compensatory response) or a sign of brain dysfunction (e.g. reduced efficiency). Here we used functional magnetic resonance imaging (fMRI) to compare PFC activation magnitudes and PFC connectivity patterns between younger and older adult groups during performance of a task switching paradigm. Results indicated age-related increases both in PFC activation magnitudes and in PFC functional connectivity with inferotemporal (IT) regions. However, these age-related fMRI increases were differentially associated with task performance. Whereas increased PFC activation magnitudes tended to be either unrelated to task RT or associated with poorer task performance, increased PFC-IT connectivity was associated with better task performance in older adults. Our results provide new evidence suggesting that mechanisms subserving age-related reductions in efficiency and successful compensation can coexist in older adults in the context of the same task. PMID:25614233

  11. 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.

  12. The restorative benefits of walking in urban and rural settings in adults with good and poor mental health.

    PubMed

    Roe, Jenny; Aspinall, Peter

    2011-01-01

    People differ in their potential for psychological restoration but there is little evidence on the role of varying mental health state or settings in the process. This paper reports two quasi-experiments which compare the restorative benefits of walking in urban and rural settings in two groups of adults with good and poor mental health. Two aspects of restoration are examined, firstly mood, the other using personal project techniques (Little, 1983) to capture an under-explored aspect of cognitive restoration through reflection on everyday life tasks. Results are consistent with a restorative effect of landscape: the rural walk was advantageous to affective and cognitive restoration in both health groups when compared to an urban walk. However, beneficial change took place to a greater extent in the poor health group. Differential outcomes between health groups were found in the urban setting, which was most advantageous to restoration in the poor mental health group. This study extends restorative environments research by showing that the amount of change and context for restoration can differ amongst adults with variable mental health.

  13. Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults

    PubMed Central

    2017-01-01

    Objectives The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults. Methods A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables. Results Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker. Conclusions In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA. PMID:28173688

  14. Use of Hospital-based Services among Young Adults with Behavioral Health Diagnoses Before and After Health Insurance Expansions

    PubMed Central

    Golberstein, Ezra; Zaha, Rebecca; Greenfield, Shelly F.; Beardslee, William R.; Busch, Susan H.

    2014-01-01

    Importance Young adults have high levels of behavioral health needs but often lack health insurance. Recent health reforms have increased coverage, but it is unclear how use of hospital-based care changed after expanding insurance. Objective To evaluate the association between health insurance coverage expansions and use of hospital-based care among young adults with behavioral health diagnoses. Design Quasi-experimental analyses of hospital inpatient and emergency department use from 2003–2009 based on hospital discharge data, comparing differential changes in service use among young adults with behavioral health diagnoses in Massachusetts versus other states before and after Massachusetts’ 2006 health reform. Setting Hospital inpatient departments in the U.S. and emergency departments in Massachusetts and Maryland. Participants Population-based sample of inpatient admissions (n=12,821,746 across 7 years) nationwide and emergency department visits (n=6,756,303 across 7 years) from Maryland and Massachusetts for 12 to 25 year olds. Main Outcomes and Measures Inpatient admission rates per 1000 population for primary diagnosis of any behavioral health disorder, by diagnosis; emergency department visit rates per 1000 population by behavioral health diagnosis; and insurance coverage for discharges. Results After 2006, uninsurance among 19 to 25 year olds in Massachusetts fell from 26% to 10% (16 percentage points; 95% CI, 13–20). Young adults experienced relative declines in inpatient admission rates of 2.0 per 1000 for primary diagnoses of any behavioral health disorder (95% CI, 0.88–3.1), 0.38 for depression (95% CI, 0.18–0.58), and 1.3 for substance use disorder (95% CI, 0.68–1.8). The rise in emergency department visits with any behavioral health diagnosis after 2006 was lower among young adults in Massachusetts compared to Maryland (16.5 per 1000; 95% CI, 11.4–21.6). Among young adults in Massachusetts, the percent of behavioral health discharges

  15. 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

  16. 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

  17. 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…

  18. Coverage of newborn and adult male circumcision varies among public and private US payers despite health benefits.

    PubMed

    Clark, Sarah J; Kilmarx, Peter H; Kretsinger, Katrina

    2011-12-01

    Studies have shown that male circumcision greatly reduces the risk for heterosexual transmission of HIV, other sexually transmitted infections, infant urinary tract infections, penile cancer, and other adverse health outcomes. Given recent data regarding these health benefits and the cost-effectiveness of newborn male circumcision, national policy makers are developing new recommendations regarding circumcision for newborn, adolescent, and adult males. To investigate the implications, this study assessed insurance coverage and reimbursement for routine newborn and adult male circumcision in private and public health plans in 2009. We found that coverage varies across private and public payers. Private insurance provides far broader coverage than state Medicaid programs for routine newborn male circumcision. Specifically, Medicaid programs in seventeen states do not cover it, even though low-income populations have a higher risk of HIV and other sexually transmitted diseases compared to higher-income groups. For adult male circumcision, coverage is generally sparse across public and private plans. Presentation of evidence-based recommendations--for example, from the Centers for Disease Control and Prevention--may be necessary if coverage for newborn and adult male circumcision is to be expanded.

  19. 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

  20. Determinants of health insurance coverage rates for young adults: an analytical literature review.

    PubMed

    Cantiello, John; Fottler, Myron D; Oetjen, Dawn; Zhang, Ning Jackie

    2011-01-01

    This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status, perceived value, and perceived need are all examined in order to determine what the literature reveals regarding each variable and how each variable impacts a young adult's decision to purchase health insurance. Results indicate that socioeconomic status, demographics, perceived value, and perceived need were the most significant determinates of health insurance status of young adults. A conceptual framework is also examined and used to illustrate theoretical implications. Managerial implications for marketing health plans to young adults are also addressed. Finally, policy implications concerning the new Patient Protection and Affordable Care Act are addressed.

  1. A path analysis of Internet health information seeking behaviors among older adults.

    PubMed

    Chang, Sun Ju; Im, Eun-Ok

    2014-01-01

    The Internet has emerged as an innovative tool that older adults can use to obtain health-related information. However, the relationships among predictors of Internet health information seeking behaviors (IHISB) in this population are not well understood. To fill this gap, this study examined the direct and indirect pathways of potential predictors of IHISB among older South Korean adults, using the modified Technology Acceptance Model 3. Participants were 300 older South Korean adults who had used the Internet to obtain health information within the past month. Data were collected via a self-report questionnaire and were analyzed through structural equation modeling. Two variables-prior experience and behavioral intention to use-had positive direct effects on IHISB. These findings imply that health care providers promoting IHISB among older adults should consider these individuals' prior experience with the Internet and their willingness to use the Internet as a source of health information.

  2. [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.

  3. Epidemiologic evidence of relationships between reproductive and child health outcomes and environmental chemical contaminants.

    PubMed

    Wigle, Donald T; Arbuckle, Tye E; Turner, Michelle C; Bérubé, Annie; Yang, Qiuying; Liu, Shiliang; Krewski, Daniel

    2008-05-01

    This review summarizes the level of epidemiologic evidence for relationships between prenatal and/or early life exposure to environmental chemical contaminants and fetal, child, and adult health. Discussion focuses on fetal loss, intrauterine growth restriction, preterm birth, birth defects, respiratory and other childhood diseases, neuropsychological deficits, premature or delayed sexual maturation, and certain adult cancers linked to fetal or childhood exposures. Environmental exposures considered here include chemical toxicants in air, water, soil/house dust and foods (including human breast milk), and consumer products. Reports reviewed here included original epidemiologic studies (with at least basic descriptions of methods and results), literature reviews, expert group reports, meta-analyses, and pooled analyses. Levels of evidence for causal relationships were categorized as sufficient, limited, or inadequate according to predefined criteria. There was sufficient epidemiological evidence for causal relationships between several adverse pregnancy or child health outcomes and prenatal or childhood exposure to environmental chemical contaminants. These included prenatal high-level methylmercury (CH(3)Hg) exposure (delayed developmental milestones and cognitive, motor, auditory, and visual deficits), high-level prenatal exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related toxicants (neonatal tooth abnormalities, cognitive and motor deficits), maternal active smoking (delayed conception, preterm birth, fetal growth deficit [FGD] and sudden infant death syndrome [SIDS]) and prenatal environmental tobacco smoke (ETS) exposure (preterm birth), low-level childhood lead exposure (cognitive deficits and renal tubular damage), high-level childhood CH(3)Hg exposure (visual deficits), high-level childhood exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (chloracne), childhood ETS exposure (SIDS, new-onset asthma, increased

  4. Levels of Health Literacy in a Community-Dwelling Population of Chinese Older Adults

    PubMed Central

    Li, Yu; Dong, XinQi

    2014-01-01

    Background. Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults. Methods. The PINE study is an epidemiological cohort of 3,159 community-dwelling Chinese older adults, 95% of whom do not speak or read English. Chinese older adults’ health literacy levels were examined using the Chinese version of the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test. Kruskal–Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level. Results. The mean age among this sample of Chinese older adults was 72.8 years (SD = 8.3, range = 60–105) and the mean REALM-R test score was 6.9 [SD = 2.3, range (0–8)]. Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy. Health literary was not associated with self-reported health status or quality of life. Conclusions. In this Chicago Chinese population, older adults had reasonable levels of health literacy in Chinese. Future longitudinal research is needed to understand risk/protective factors associated with health literacy level in Chinese older adults. PMID:25378449

  5. 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.

  6. Older adult social participation and its relationship with health: Rural-urban differences.

    PubMed

    Vogelsang, Eric M

    2016-11-01

    In an aging world, there is increased need to identify places and characteristics of places that promote health among older adults. This study examines whether there are rural-urban differences in older adult social participation and its relationship with health. Using the 2003 and 2011 waves of the Wisconsin Longitudinal Study (n=3006), I find that older adults living in rural counties are less socially active than their counterparts in more-urban counties. I also find that relationships between social participation and health vary by the type of activity and rural-urban context.

  7. Does social status predict adult smoking and obesity? Results from the 2000 Mexican National Health Survey.

    PubMed

    Buttenheim, A M; Wong, R; Goldman, N; Pebley, A R

    2010-01-01

    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.

  8. 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

  9. Predicting Cognitive Function from Clinical Measures of Physical Function and Health Status in Older Adults

    PubMed Central

    Bolandzadeh, Niousha; Kording, Konrad; Salowitz, Nicole; Davis, Jennifer C.; Hsu, Liang; Chan, Alison; Sharma, Devika; Blohm, Gunnar; Liu-Ambrose, Teresa

    2015-01-01

    Introduction Current research suggests that the neuropathology of dementia—including brain changes leading to memory impairment and cognitive decline—is evident years before the onset of this disease. Older adults with cognitive decline have reduced functional independence and quality of life, and are at greater risk for developing dementia. Therefore, identifying biomarkers that can be easily assessed within the clinical setting and predict cognitive decline is important. Early recognition of cognitive decline could promote timely implementation of preventive strategies. Methods We included 89 community-dwelling adults aged 70 years and older in our study, and collected 32 measures of physical function, health status and cognitive function at baseline. We utilized an L1–L2 regularized regression model (elastic net) to identify which of the 32 baseline measures were strongly predictive of cognitive function after one year. We built three linear regression models: 1) based on baseline cognitive function, 2) based on variables consistently selected in every cross-validation loop, and 3) a full model based on all the 32 variables. Each of these models was carefully tested with nested cross-validation. Results Our model with the six variables consistently selected in every cross-validation loop had a mean squared prediction error of 7.47. This number was smaller than that of the full model (115.33) and the model with baseline cognitive function (7.98). Our model explained 47% of the variance in cognitive function after one year. Discussion We built a parsimonious model based on a selected set of six physical function and health status measures strongly predictive of cognitive function after one year. In addition to reducing the complexity of the model without changing the model significantly, our model with the top variables improved the mean prediction error and R-squared. These six physical function and health status measures can be easily implemented in a

  10. 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…

  11. Interrelations between Subjective Health and Episodic Memory Change in Swedish and Canadian Samples of Older Adults

    ERIC Educational Resources Information Center

    Wahlin, Ake; Maitland, Scott B.; Backman, Lars; Dixon, Roger A.

    2003-01-01

    Recent research has documented associations between subjective health ratings and objective indicators of disease and death. Less is known about relations between subjective health ratings and level of cognitive performance in older adults. In this study, we explored whether subjective health ratings are related to episodic memory performance,…

  12. 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.…

  13. 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…

  14. 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.…

  15. 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…

  16. 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…

  17. 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…

  18. 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.

  19. 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…

  20. 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'…

  1. 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…

  2. Health Care Resources: You Are the Consumer. 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 care resources in order to know how to keep themselves healthy, when they need to see a health professional, and where to go if they do need to see someone. It contains information sheets, student worksheets, and answers to the worksheets. The information sheets are…

  3. 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…

  4. 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

  5. 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.

  6. 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

  7. Limited Health Literacy and Decline in Executive Function in Older Adults

    PubMed Central

    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. PMID:24093352

  8. [Evidence-based medicine and public health law: statutory health insurance].

    PubMed

    Dreher, Wolfgang

    2004-09-01

    Beyond all differences in terminology and legal principles between the laws governing private health insurance, the governmental financial support for civil, servants and statutory health insurance the fundamental issues to be solved by the courts in case of litigation are quite similar. But only a part of these refer to the quality of medical services, which is the main concern of Evidence-based Medicine (EbM); EbM, though, is not able to contribute towards answering the equally important question of how to distinguish between "treatment" and "(health-relevant) lifestyle". The respective definitions that have been developed in the particular fields of law are only seemingly divergent from each other and basically unsuitable to aid the physician in his clinical decision-making because the common blanket clauses of public health law are regularly interpreted as rules for the exclusion of certain claims and not as a confirmatory paraphrase of what is clinically necessary. If on the other hand medical quality is what lies at the core of litigation, reference to EbM may become necessary. In fact, it is already common practice in the statutory health insurance system that decision-making processes in the Federal Committee being responsible for quality assurance (Bundesausschuss) are based on EbM principles and that in exceptional cases only the courts have to medically review the Federal Committee's decisions.

  9. 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…

  10. [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…

  11. Enhancing Primary Health Care Services for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Melville, C. A.; Finlayson, J.; Cooper, S.-A.; Allan, L.; Robinson, N.; Burns, E.; Martin, G.; Morrison, J.

    2005-01-01

    Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training…

  12. When is adult hippocampal neurogenesis necessary for learning? evidence from animal research.

    PubMed

    Castilla-Ortega, Estela; Pedraza, Carmen; Estivill-Torrús, Guillermo; Santín, Luis J

    2011-01-01

    The hippocampus is a key brain structure involved in the short- and long-term processing of declarative memory. Since adult hippocampal neurogenesis was first found, numerous studies have tried to establish the contribution of newborn neurons to hippocampus-dependent cognitive functions. However, this large amount of research has generated contradictory results. In this paper, we review the body of evidence investigating the relationship between hippocampal neurogenesis and learning to conclude the functional role of adult-born hippocampal neurons. First, factors that could explain discrepancies among experiments are taken into account. Then, in addition to methodological differences, we emphasize the importance of the age of the newborn neurons studied, as to how their maturation influences both their properties and potential functionality. Next, we discuss which declarative memory components could require involvement of adult hippocampal neurogenesis, taking into consideration the representational demands of the task, its difficulty and the level of performance reached by the subject. Finally, other factors that could modulate neurogenesis and memory, such as stress levels or previous experience of the animal, should also be taken into consideration in interpreting experiments focused on neurogenesis. In conclusion, our analysis of published studies suggests that new adult-born neurons, under certain circumstances, have a crucial and irreplaceable role in hippocampal learning.

  13. "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.

  14. Meeting the Needs of Older Adult Refugee Populations With Home Health Services.

    PubMed

    Miner, Sarah M; Liebel, Dianne; Wilde, Mary H; Carroll, Jennifer K; Zicari, Elizabeth; Chalupa, Stephanie

    2015-12-27

    The United States resettles close to 70,000 refugees each year more than any other country in the world. Adult refugees are at risk for negative health outcomes and inefficient health resource use, and meeting the multiple health needs of this vulnerable population is a challenge. The purpose of this study was to assess the impact of a home health care (HHC) pilot project on meeting the needs of older adult refugee patients. A retrospective chart review of 40 refugee adult patients who participated in an HHC pilot was done to analyze their health outcomes using OASIS-C data. Participants' pain level, anxiety level, medication management, and activities of daily living management all significantly improved over the course of their HHC episode. Results of this study indicate that HHC has great potential to improve the health of vulnerable refugee populations and assist the families involved in their care.

  15. 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.

  16. Dietary copper and human health: Current evidence and unresolved issues.

    PubMed

    Bost, Muriel; Houdart, Sabine; Oberli, Marion; Kalonji, Esther; Huneau, Jean-François; Margaritis, Irène

    2016-05-01

    Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

  17. 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…

  18. 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

  19. Clinical Evidence in Guardianship of Older Adults Is Inadequate: Findings From a Tri-State Study

    PubMed Central

    Moye, Jennifer; Wood, Stacey; Edelstein, Barry; Armesto, Jorge C.; Bower, Emily H.; Harrison, Julie A.; Wood, Erica

    2014-01-01

    Purpose This preliminary study compared clinical evaluations for guardianship in three states with varying levels of statutory reform. Design and Methods Case files for 298 cases of adult guardianship were reviewed in Massachusetts, Pennsylvania, and Colorado, three states with varying degrees of statutory reform. The quality and content of the written clinical evidence for guardianship and the hearing outcome were recorded. Results The quality of the written clinical evidence for guardianship was best in Colorado, the state with the most progressive statutory reform, earning a grade of B in our ratings, and worst in Massachusetts, a state with minimal reform, earning a grade of D – with nearly two thirds of the written evidence illegible. Information on specific functional deficits was frequently missing and conclusory statements were common. Information about the individual’s key values and preferences was almost never provided, and individuals were rarely present at the hearing. Limited orders were used for 34% of the cases in Colorado, associated with more complete clinical testimony, but such orders were used in only 1 case in either Massachusetts or Pennsylvania. Implications In this study, states with progressive statutes that promote functional assessment are associated with increased quality of clinical testimony and use of limited orders. A continuing dialogue between clinical and legal professionals is needed to advance reform in guardianship, and thereby provide for the needs and protect the rights of adults who face guardianship proceedings. PMID:17989402

  20. Public mental health: the time is ripe for translation of evidence into practice

    PubMed Central

    Wahlbeck, Kristian

    2015-01-01

    Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental health in all public policy areas. Stigmatization of mental disorders is a widespread phenomenon that constitutes a barrier for help-seeking and for the development of health care services, and is thus a core issue in public mental health actions. Lately, there has been heightened interest in the promotion of positive mental health and wellbeing. Effective programmes have been developed for promoting mental health in everyday settings such as families, schools and workplaces. New evidence indicates that many mental disorders and suicides are preventable by public mental health interventions. Available evidence favours the population approach over high-risk approaches. Public mental health emphasizes the role of primary care in the provision of mental health services to the population. The convincing evidence base for population-based mental health interventions asks for actions for putting evidence into practice. PMID:25655149

  1. Exercise and sleep in community-dwelling older adults: evidence for a reciprocal relationship.

    PubMed

    Dzierzewski, Joseph M; Buman, Matthew P; Giacobbi, Peter R; Roberts, Beverly L; Aiken-Morgan, Adrienne T; Marsiske, Michael; McCrae, Christina S

    2014-02-01

    Exercise behaviour and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into later life. The current investigation examined both the chronic and acute relationships between exercise behaviour and self-reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy-nine community-dwelling, initially sedentary, older adults (mean age = 63.58 years, SD = 8.66 years) completed daily home-based assessments of exercise behaviour and sleep using daily diary methodology. Assessments were collected weekly and continued for 18 consecutive weeks. Multilevel models revealed a small positive chronic (between-person mean-level) association between exercise and wake time after sleep onset, and a small positive acute (within-person, day-to-day) association between exercise and general sleep quality rating. The within-person exercise and general sleep quality rating relationship was found to be reciprocal (i.e. sleep quality also predicted subsequent exercise behaviour). As such, it appears exercise and sleep are dynamically related in older adults. Efforts to intervene on either sleep or exercise in late-life would be wise to take the other into account. Light exposure, temperature regulation and mood may be potential mechanisms of action through which exercise can impact sleep in older adults.

  2. 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…

  3. Adult Female Victims of Child Sexual Abuse: Multitype Maltreatment and Disclosure Characteristics Related to Subjective Health

    ERIC Educational Resources Information Center

    Jonzon, Eva; Lindblad, Frank

    2005-01-01

    This study examined the impact of child sexual abuse and disclosure characteristics on adult psychological and psychosomatic symptoms. Data on abuse characteristics, disclosure-related events, and subjective health were collected through semistructured interviews and questionnaires from 123 adult women reporting having been sexually abused in…

  4. 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…

  5. 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…

  6. 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…

  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. 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…

  10. 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 =…

  11. The Prevalence and Incidence of Mental Ill-Health in Adults with Autism and Intellectual Disabilities

    ERIC Educational Resources Information Center

    Melville, Craig A.; Cooper, Sally-Ann; Morrison, Jill; Smiley, Elita; Allan, Linda; Jackson, Alison; Finlayson, Janet; Mantry, Dipali

    2008-01-01

    The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem…

  12. Attitudinal and Psychosocial Outcomes of a Fitness and Health Education Program on Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Heller, Tamar; Hsieh, Kelly; Rimmer, James H.

    2004-01-01

    Attitudinal and psychosocial outcomes of a fitness and health education program for adults with Down syndrome were examined. Participants were 53 adults with Down syndrome ages 30 years and older (29 females, 24 males, M age = 39.72 years) who were randomized into a training (n = 32) or control group (n = 21). The training group participated in a…

  13. Is group singing special? Health, well-being and social bonds in community-based adult education classes.

    PubMed

    Pearce, Eiluned; Launay, Jacques; Machin, Anna; Dunbar, Robin I M

    Evidence demonstrates that group singing improves health and well-being, but the precise mechanisms remain unknown. Given that cohesive social networks also positively influence health, we focus on the social aspects of singing, exploring whether improvements in health and well-being are mediated by stronger social bonds, both to the group as a whole (collective-bonding) and to individual classmates (relational-bonding). To do so, seven newly-formed community-based adult education classes (four singing, N=84, and three comparison classes studying creative writing or crafts, N=51) were followed over seven months. Self-report questionnaire data on mental and physical health, well-being, and social bonding were collected at Months 1, 3 and 7. We demonstrate that physical and mental health and satisfaction with life significantly improved over time in both conditions. Path analysis did not show any indirect effects via social bonding of Condition on health and well-being. However, higher collective-bonding at timepoint 3 significantly predicted increased flourishing, reduced anxiety and improved physical health independently of baseline levels. In contrast, relational-bonding showed no such effects, suggesting that it is feeling part of a group that particularly yields health and well-being benefits. Moreover, these results indicate that singing may not improve health and well-being more than other types of activities. Nonetheless, these findings encourage further work to refine our understanding of the social aspects of community-based adult education classes in promoting health, well-being and community cohesion.

  14. Public health policy, evidence, and causation: lessons from the studies on obesity.

    PubMed

    Russo, Federica

    2012-05-01

    The paper addresses the question of how different types of evidence ought to inform public health policy. By analysing case studies on obesity, the paper draws lessons about the different roles that different types of evidence play in setting up public health policies. More specifically, it is argued that evidence of difference-making supports considerations about 'what works for whom in what circumstances', and that evidence of mechanisms provides information about the 'causal pathways' to intervene upon.

  15. Effectiveness of Evidence-based Pneumonia CPOE Order Sets Measured by Health Outcomes

    PubMed Central

    Krive, Jacob; Shoolin, Joel S.; Zink, Steven D.

    2015-01-01

    Objective Evidence-based sets of medical orders for the treatment of patients with common conditions have the potential to induce greater efficiency and convenience across the system, along with more consistent health outcomes. Despite ongoing utilization of order sets, quantitative evidence of their effectiveness is lacking. In this study, conducted at Advocate Health Care in Illinois, we quantitatively analyzed the benefits of community acquired pneumonia order sets as measured by mortality, readmission, and length of stay (LOS) outcomes. Methods In this study, we examined five years (2007–2011) of computerized physician order entry (CPOE) data from two city and two suburban community care hospitals. Mortality and readmissions benefits were analyzed by comparing “order set” and “no order set” groups of adult patients using logistic regression, Pearson’s chi-squared, and Fisher’s exact methods. LOS was calculated by applying one-way ANOVA and the Mann-Whitney U test, supplemented by analysis of comorbidity via the Charlson Comorbidity Index. Results The results indicate that patient treatment orders placed via electronic sets were effective in reducing mortality [OR=1.787; 95% CF 1.170-2.730; P=.061], readmissions [OR=1.362; 95% CF 1.015-1.827; P=.039], and LOS [F (1,5087)=6.885, P=.009, 4.79 days (no order set group) vs. 4.32 days (order set group)]. Conclusion Evidence-based ordering practices have the potential to improve pneumonia outcomes through reduction of mortality, hospital readmissions, and cost of care. However, the practice must be part of a larger strategic effort to reduce variability in patient care processes. Further experimental and/or observational studies are required to reduce the barriers to retrospective patient care analyses. PMID:26392842

  16. Sugars and health: a review of current evidence and future policy.

    PubMed

    Evans, Charlotte Elizabeth Louise

    2016-12-05

    The automation of the process of extracting sugars in the 1900s reduced cost and increased availability of sugars leading to a dramatic rise in consumption, which reached a peak in the 1970s. There are different definitions for sugars not naturally available in foods, and free sugars is the term used by WHO. The epidemiological evidence of the associations between sugars and obesity and type 2 diabetes mellitus is fairly strong and consistent, particularly for sugar sweetened drinks in adults. The Department of Health in the UK and many other countries have recently updated their recommendations for free sugars as a result of this scientific evidence. In the UK the recommended amount of free sugars is currently 5 % of energy (reduced from 10 %), which is difficult to meet and very different from current British dietary patterns. Reducing intakes of free sugars is a challenge and will necessitate a range of different actions and policies. Public Health England has put forward eight suggestions but the four most likely to improve dietary behaviour based on available evidence are social marketing, reduction of marketing of high sugar foods and drinks to children, reformulation and reductions in portion size and a sugar excise tax. Any action taken needs to be evaluated to check inequalities are not widened. The new childhood obesity strategy has incorporated some but not all of these strategies and may not go far enough. It is likely that government policies alone will not be sufficient and a change in the food culture is necessary to see real progress.

  17. 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

  18. Regional Variation in Use of Complementary Health Approaches by U.S. Adults

    PubMed Central

    Peregoy, Jennifer A.; Clarke, Tainya C.; Jones, Lindsey I.; Stussman, Barbara J.; Nahin, Richard L.

    2015-01-01

    Complementary health approaches are defined as “a group of diverse medical and health care interventions, practices, products, or disciplines that are not generally considered part of conventional medicine” (1). They range from practitioner-based approaches, such as chiropractic manipulation and massage therapy, to predominantly self-care approaches, such as nonvitamin, nonmineral dietary supplements, meditation, and yoga. This report presents estimates of the four most commonly used complementary health approaches among adults aged 18 and over in nine geographic regions, using data from the 2012 National Health Interview Survey adult alternative medicine supplement (2). PMID:24750666

  19. Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

    PubMed Central

    El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

    2015-01-01

    Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can

  20. 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)

  1. Civic Engagement for Older Adults With Functional Limitations: Piloting an Intervention for Adult Day Health Participants

    ERIC Educational Resources Information Center

    Dabelko-Schoeny, Holly; Anderson, Keith A.; Spinks, Katie

    2010-01-01

    Purpose: Past research has demonstrated the importance of civic engagement for older adults, yet previous studies have not focused specifically on the potential benefits of civic engagement for older adults with functional limitations. This pilot study explored the feasibility and effectiveness of an intervention designed to promote civic…

  2. Beliefs about tobacco, health, and addiction among adults in Cambodia: findings from a national survey.

    PubMed

    Yel, Daravuth; Bui, Anthony; Job, Jayakaran S; Knutsen, Synnove; Singh, Pramil N

    2013-09-01

    There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n=13,988) of all provinces of Cambodia, we found that (1) 88-93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86-93% believe that the Wat (temple) should be a smoke-free area; (3) 93-95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.

  3. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health.

    PubMed

    Cranney, Ann; Weiler, Hope A; O'Donnell, Siobhan; Puil, Lorri

    2008-08-01

    The objective of this evidence review was to synthesize the literature on the effectiveness and safety of nutritional and ultraviolet radiation sources of vitamin D with respect to bone health outcomes at all stages of life. The goals were to identify knowledge gaps for the research community and to highlight areas that required further research. We completed an extensive literature search of multiple databases and a multilevel selection process with synthesis of results from 167 included studies. We included a variety of outcomes (eg, falls, bone mineral density, fractures, and adverse events). This report provides an overview of the methods and a summary of the key findings. In addition, we discuss areas where the evidence is inconclusive, as well as methodologic issues that we encountered. We found inconsistent evidence of an association between serum 25-hydroxyvitamin D [25(OH)D] concentration and bone mineral content in infants and fair evidence of an association with bone mineral content or density in older children and older adults. The evidence of an association between serum 25(OH)D concentration and some clinical outcomes (fractures, performance measures) in postmenopausal women and older men was inconsistent, and the evidence of an association with falls was fair. We found good evidence of a positive effect of consuming vitamin D-fortified foods on 25(OH)D concentrations. The evidence for a benefit of vitamin D on falls and fractures varied. We found fair evidence that adults tolerated vitamin D at doses above current dietary reference intake levels, but we had no data on the association between long-term harms and higher doses of vitamin D.

  4. Adipose tissue gene expression and metabolic health of obese adults

    PubMed Central

    Das, Swapan Kumar; Ma, Lijun; Sharma, Neeraj

    2014-01-01

    Obese subjects with a similar body mass index (BMI) exhibit substantial heterogeneity in gluco- and cardio-metabolic heath phenotypes. However, defining genes that underlie the heterogeneity of metabolic features among obese individuals and determining metabolically healthy and unhealthy phenotypes remain challenging. We conducted unsupervised hierarchical clustering analysis of subcutaneous adipose tissue transcripts from 30 obese men and women ≥40 years old. Despite similar BMIs in all subjects, we found two distinct subgroups, one metabolically healthy (Group 1) and one metabolically unhealthy (Group 2). Subjects in Group 2 showed significantly higher total cholesterol (p=0.005), LDL cholesterol (p=0.006), 2h-Insulin during OGTT (p=0.015) and lower insulin sensitivity (SI, p=0.029) compared to Group 1. We identified significant up-regulation of 141 genes (e.g. MMP9 and SPP1) and down-regulation of 17 genes (e.g. NDRG4 and GINS3) in group 2 subjects. Intriguingly, these differentially expressed transcripts were enriched for genes involved in cardiovascular disease-related processes (p=2.81×10−11–3.74×10−02) and pathways involved in immune and inflammatory response (p=8.32×10−5–0.04). Two down-regulated genes, NDRG4 and GINS3, have been located in a genomic interval associated with cardiac repolarization in published GWASs and zebra fish knockout models. Our study provides evidence that perturbations in the adipose tissue gene expression network are important in defining metabolic health in obese subjects. PMID:25520251

  5. Chronic low-level hydrogen sulfide exposure and potential effects on human health: a review of the epidemiological evidence.

    PubMed

    Lewis, R Jeffrey; Copley, G Bruce

    2015-02-01

    The effects of exposure to high concentrations of hydrogen sulfide (H2S) on human health are well known. However, the potential human health hazards posed by low-level chronic environmental H2S exposure are being debated. Accordingly, we reviewed the literature regarding the effects of chronic, environmentally-relevant H2S exposures on human health. All human observational studies using an analytical study design (e.g. cohort, cross-sectional, case-control) to evaluate chronic-duration low-level H2S exposure (approximately ≤ 10 ppm on average, for 1 year or more), were evaluated for a range of health outcomes. Respiratory symptoms in both adults and children were the most consistently reported symptoms on the increase. When reported, such effects appear to be temporary, given that there is no consistent evidence of pulmonary function deficit in either age group, among those chronically exposed to low H2S concentrations. While sparse, some data also suggest potential ocular symptoms and disorders associated with chronic ambient level H2S exposure in adults (not children), but the limited data on H2S exposures, co-exposures and/or strong odor stimulus of H2S, temper interpretation. Neurological symptoms and deficits have been reported in some studies, but the highest quality evidence, obtained using objective outcome measures and a reasonably detailed assessment of exposure, does not support a neurological-related risk in adults (only one study in children). For the other endpoints assessed (cardiovascular, reproductive and developmental, and carcinogenicity), the results were mixed and/or conflicting, but did not indicate a potential health hazard, although this literature has several major limitations, particularly with regard to exposure estimation and the ability to assess exposure-response.

  6. Eco-Health Linkages: evidence base and socio-economic considerations for linking ecosystem goods and services to human health

    EPA Science Inventory

    Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...

  7. Sparse evidence for equine or avian influenza virus infections among Mongolian adults with animal exposures.

    PubMed

    Khurelbaatar, Nyamdavaa; Krueger, Whitney S; Heil, Gary L; Darmaa, Badarchiin; Ulziimaa, Daramragchaa; Tserennorov, Damdindorj; Baterdene, Ariungerel; Anderson, Benjamin D; Gray, Gregory C

    2013-11-01

    In recent years, Mongolia has experienced recurrent epizootics of equine influenza virus (EIV) among its 2·1 million horses and multiple incursions of highly pathogenic avian influenza (HPAI) virus via migrating birds. No human EIV or HPAI infections have been reported. In 2009, 439 adults in Mongolia were enrolled in a population-based study of zoonotic influenza transmission. Enrollment sera were examined for serological evidence of infection with nine avian, three human, and one equine influenza virus strains. Seroreactivity was sparse among participants suggesting little human risk of zoonotic influenza infection.

  8. Early-life origin of adult disease: evidence from natural experiments.

    PubMed

    Vaiserman, Alexander

    2011-01-01

    Until the present time, disease susceptibility was believed to be determined solely by the genetic information carried in the DNA sequence. In recent years, however, it has become clear that epigenetic rearrangements play an equally essential role in the disease development and that this process, particularly at key developmental stages, is very susceptible to environmental modulations. The extensive studies, both human and animal, have shown that early-life environment is probably the most important causal component in the etiology of some diseases including cancer as well as metabolic and cardiovascular disorders. This review considers the natural experiment-based evidence regarding the developmental origin of human adult disease.

  9. Associations between working memory, health literacy, and recall of the signs of stroke among older adults.

    PubMed

    Ganzer, Christine A; Insel, Kathleen C; Ritter, Leslie S

    2012-10-01

    Stroke remains a major cause of mortality and disability among older adults. Although early treatment after stroke is known to reduce both mortality and disability, the first step in seeking early treatment is dependent on the rapid recognition of the signs of stroke. Recall of the signs of stroke may be dependent on factors that exist before the stroke itself. Although it is known that both working memory and health literacy decline with advancing age, these factors have not been thoroughly examined with respect to recall of the signs of stroke. Therefore, the purpose of the current study was to investigate associations between working memory, health literacy, and recall of the signs of stroke among older adults. Community dwelling older adults (≥65 years of age) were recruited from two senior centers. Fifty-six participants meeting inclusion criteria provided demographic and health information and were asked to read a public service brochure listing the five warning signs of stroke. Working memory was then assessed using the Wechsler Adult Intelligence Scale 3rd Edition Working Memory Index. Health literacy was assessed by the Short Test of Functional Health Literacy in Adults. Participants' recall of the five warning signs of stroke was evaluated. The mean age was 80.4 years. The mean number of the signs of stroke recalled was 2.9 ± 1.33. Working memory and health literacy were positively correlated with recall of the signs of stroke (r = .38, p < 0.01; r = .44, p < 0.01). In a simultaneous regression, only health literacy remained a significant predictor of recall. There was no statistically significant interaction between working memory and health literacy. Findings from this study indicate that working memory and health literacy were associated with successful recall of the warning signs of stroke in older adults. Further studies are needed to determine if programs that include cognitive and literacy assessments could identify older adults who need

  10. 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

  11. New evidence regarding racial and ethnic disparities in mental health: policy implications.

    PubMed

    McGuire, Thomas G; Miranda, Jeanne

    2008-01-01

    Minorities have, in general, equal or better mental health than white Americans, yet they suffer from disparities in mental health care. This paper reviews the evidence for mental health and mental health care disparities, comparing them to patterns in health. Strategies for addressing disparities in health care, such as improving access to and quality of care, should also work to eliminate mental health care disparities. In addition, a diverse mental health workforce, as well as provider and patient education, are important to eliminating mental health care disparities.

  12. The effect of physician supply on health status: Canadian evidence.

    PubMed

    Piérard, Emmanuelle

    2014-10-01

    We estimate the relationship between per capita supply of physicians, both general practitioners and specialists, and health status of Canadians. We use data from the Canadian National Population Health Survey and the Canadian Institute for Health Information. Two measures of quality of life, self-assessed health status and the Health Utility Index, are explored. Random effects ordered probits are used to model self-assessed health status, and quantile regressions are used for the Health Utility Index. A higher supply of general practitioners is correlated with better health outcomes as measured by both measures of health status, albeit for different age groups, and it is correlated with a higher HUI for some individuals who report having a chronic condition. A higher supply of specialists is correlated with worse health outcomes for the HUI for some individuals. It is possible that a higher supply of general practitioners increases the likelihood of diagnosing and treating health conditions in a timely manner and that this in turn affects health status. Specialists, due to the nature of their expertise could affect negatively health, both through the use of riskier procedures and due to their clientele being in relatively worse health. Based on our findings, we therefore would recommend maintaining a robust supply and distribution of GPs across Canada.

  13. Labour market outcomes of public health graduates: evidence from Australia.

    PubMed

    Li, Ian W; Awofeso, Niyi

    2014-09-01

    Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories.

  14. The "Good Governance" of Evidence in Health Policy

    ERIC Educational Resources Information Center

    Hawkins, Benjamin; Parkhurst, Justin

    2016-01-01

    Calls for evidence-based policy often fail to recognise the fundamentally political nature of policy making. Policy makers must identify, evaluate and utilise evidence to solve policy problems in the face of competing priorities and political agendas. Evidence should inform but cannot determine policy choices. This paper draws on theories of…

  15. 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

  16. 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

  17. SUPPORT Tools for evidence-informed Policymaking in health 11: Finding and using evidence about local conditions

    PubMed Central

    2009-01-01

    This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Evidence about local conditions is evidence that is available from the specific setting(s) in which a decision or action on a policy or programme option will be taken. Such evidence is always needed, together with other forms of evidence, in order to inform decisions about options. Global evidence is the best starting point for judgements about effects, factors that modify those effects, and insights into ways to approach and address problems. But local evidence is needed for most other judgements about what decisions and actions should be taken. In this article, we suggest five questions that can help to identify and appraise the local evidence that is needed to inform a decision about policy or programme options. These are: 1. What local evidence is needed to inform a decision about options? 2. How can the necessary local evidence be found? 3. How should the quality of the available local evidence be assessed? 4. Are there important variations in the availability, quality or results of local evidence? 5. How should local evidence be incorporated with other information? PMID:20018101

  18. 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.

  19. An exploration of search patterns and credibility issues among older adults seeking online health information.

    PubMed

    Robertson-Lang, Laura; Major, Sonya; Hemming, Heather

    2011-12-01

    The Internet is an important resource for health information, among younger and older people alike. Unfortunately, there are limitations associated with online health information. Research is needed on the quality of information found online and on whether users are being critical consumers of the information they find. Also, there is a need for research investigating online use among adults aged 65 and over - a rapidly growing demographic of Internet users. The current study presents important descriptive data about the search patterns of older adults seeking online health information, the types of health topics they research, and whether they consider credibility issues when retrieving online health information. A comparison is also made between search strategies used in printed text and hypertext environments. The results, which have implications with respect to credibility issues, highlight the need to increase awareness about critical searching skills among older adult Internet users.

  20. Contraception, communication and counseling for sexuality and reproductive health in adolescents and young adults with CF.

    PubMed

    Tsang, Anna; Moriarty, Carmel; Towns, Susan

    2010-06-01

    With survival now into the fourth decade and rapid growth of the adolescent and adult population of people with cystic fibrosis CF sexual and reproductive health issues are integral to the management of adolescents and adults with CF. Education and counseling for sexual health related issues must be included in the daily routine of CF care. With advances in genetic counseling, contraception, assisted reproductive technology and collaborative management adolescents and young adults with CF realizing their sexual and reproductive potentials safely and realistically can be possible .

  1. Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study.

    PubMed

    Peitzmeier, Sarah; Gardner, Ivy; Weinand, Jamie; Corbet, Alexandra; Acevedo, Kimberlynn

    2017-01-01

    Chest binding involves the compression of chest tissue for masculine gender expression among people assigned a female sex at birth, particularly transgender and gender non-conforming individuals. There are no peer-reviewed studies that directly assess the health impacts of chest binding, yet transgender community resources commonly discuss symptoms such as pain and scarring. A cross-sectional 32-item survey was administered online to an anonymous, non-random sample of adults who were assigned a female sex at birth and had had experience of binding (n = 1800). Multivariate regression models were used to identify practices associated with self-reported health outcomes. Of participants, 51.5% reported daily binding. Over 97% reported at least one of 28 negative outcomes attributed to binding. Frequency (days/week) was consistently associated with negative outcomes (22/28 outcomes). Compression methods associated with symptoms were commercial binders (20/28), elastic bandages (14/28) and duct tape or plastic wrap (13/28). Larger chest size was primarily associated with dermatological problems. Binding is a frequent activity for many transmasculine individuals, despite associated symptoms. Study findings offer evidence of how binding practices may enhance or reduce risk. Clinicians caring for transmasculine patients should assess binding practices and help patients manage risk.

  2. Gender and Health Behavior Clustering among U.S. Young Adults

    PubMed Central

    Olson, Julie Skalamera; Hummer, Robert A.; Harris, Kathleen Mullan

    2016-01-01

    U.S. trends in population health suggest alarming disparities among young adults who are less healthy across most measureable domains than their counterparts in other high-income countries; these international comparisons are particularly troubling for women. To deepen our understanding of gender disparities in health and underlying behavioral contributions, we document gender-specific clusters of health behavior among U.S. young adults using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. We find high levels of poor health behavior, but especially among men; 40 percent of men clustered into a group characterized by unhealthy behavior (e.g., poor diet, no exercise, substance use), compared to only 22 percent of women. Additionally, women tend to age out of unhealthy behaviors in young adulthood more than men. Further, we uncover gender differences in the extent to which sociodemographic position and adolescent contexts inform health behavior clustering. For example, college education was more protective for men, whereas marital status was equally protective across gender. Parental drinking mattered for health behavior clustering among men, whereas peer drinking mattered for clustering among women. We discuss these results in the context of declining female advantage in U.S. health and changing young adult social and health contexts. PMID:28287308

  3. Health benefits of primary care social work for adults with complex health and social needs: a systematic review.

    PubMed

    McGregor, Jules; Mercer, Stewart W; Harris, Fiona M

    2016-04-05

    The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self-management of long-term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care.

  4. Longitudinal predictors of adult socioeconomic attainment: the roles of socioeconomic status, academic competence, and mental health.

    PubMed

    Slominski, Lisa; Sameroff, Arnold; Rosenblum, Katherine; Kasser, Tim

    2011-02-01

    Educational attainment and occupational status are key markers of success in adulthood. We expand upon previous research that focused primarily on the contributions of academic competence and family socioeconomic status (SES) by investigating the role of mental health in predicting adult SES. In a longitudinal study spanning 30 years, we used structural equation modeling to examine how parental mental health in early childhood and family SES, offspring academic competence, and offspring mental health in adolescence relate to occupational and educational attainment at age 30. Results were that adolescent academic competence predicted adult educational attainment, and that educational attainment then predicted occupational attainment. The pathways between academic competence and occupational attainment, family SES and educational attainment, and family SES and occupational attainment were not significant. In contrast, adolescent mental health not only predicted educational attainment, but was also directly related to adult occupational attainment. Finally, early maternal mental health was associated with offspring's adult socioeconomic attainment through its relations with adolescent academic competence and mental health. These results highlight the importance of mental health to adult socioeconomic attainment.

  5. HEALTH LITERACY, MEDICATION ADHERENCE, AND BLOOD PRESSURE LEVEL AMONG HYPERTENSIVE OLDER ADULTS TREATED AT PRIMARY HEALTH CARE CENTERS.

    PubMed

    Wannasirikul, Phitchayaphat; Termsirikulchai, Lakkhana; Sujirarat, Dusit; Benjakul, Sarunya; Tanasugarn, Chanuantong

    2016-01-01

    We conducted this study to explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers in Sa Kaeo Province, Thailand. Six hundred hypertensive older adults had their blood pressure level recorded and were interviewed using questionnaires. Structural Equation Modeling (SEM) was used to determine the effect size, both direct and indirect, among factors. Almost half (48.7%) of studied subjects had inadequate health literacy, 98.3% had good medication adherence, and 80% had good blood pressure levels. The highest effect size on health literacy was literacy, followed by cognitive ability, and culture and society. Medication adherence was affected directly and indirectly by cognitive ability, literacy, and culture and society. Health literacy had not only a direct effect on medication adherence but was also the mediator. Finally, the highest effect size on blood pressure level was critical and communicative health literacy. These findings suggest that health literacy should be considered in the Health Literacy Program of the National Public Health Policy and Plan, Ministry of Public Health.

  6. The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

    PubMed Central

    2013-01-01

    Background Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice. Methods A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data. Results The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task. Conclusions If health practitioners are to be effective at communicating research evidence, we suggest that more research

  7. Are the health messages in schoolbooks based on scientific evidence? A descriptive study

    PubMed Central

    2011-01-01

    Background Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. Methods The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. Results 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. Conclusion Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively. PMID:21269446

  8. Overview of systematic reviews: yoga as a therapeutic intervention for adults with acute and chronic health conditions.

    PubMed

    McCall, Marcy C; Ward, Alison; Roberts, Nia W; Heneghan, Carl

    2013-01-01

    Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results.

  9. Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions

    PubMed Central

    McCall, Marcy C.; Ward, Alison; Roberts, Nia W.; Heneghan, Carl

    2013-01-01

    Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results. PMID:23762174

  10. How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence.

    PubMed

    van de Ven, Wynand P M M; van Vliet, René C J A; van Kleef, Richard C

    2017-03-01

    If consumers have a choice of health plan, risk selection is often a serious problem (e.g., as in Germany, Israel, the Netherlands, the United States of America, and Switzerland). Risk selection may threaten the quality of care for chronically ill people, and may reduce the affordability and efficiency of healthcare. Therefore, an important question is: how can the regulator show evidence of (no) risk selection? Although this seems easy, showing such evidence is not straightforward. The novelty of this paper is two-fold. First, we provide a conceptual framework for showing evidence of risk selection in competitive health insurance markets. It is not easy to disentangle risk selection and the insurers' efficiency. We suggest two methods to measure risk selection that are not biased by the insurers' efficiency. Because these measures underestimate the true risk selection, we also provide a list of signals of selection that can be measured and that, in particular in combination, can show evidence of risk selection. It is impossible to show the absence of risk selection. Second, we empirically measure risk selection among the switchers, taking into account the insurers' efficiency. Based on 2-year administrative data on healthcare expenses and risk characteristics of nearly all individuals with basic health insurance in the Netherlands (N > 16 million) we find significant risk selection for most health insurers. This is the first publication of hard empirical evidence of risk selection in the Dutch health insurance market.

  11. Formal home-care utilisation by older adults in Ireland: evidence from the Irish Longitudinal Study on Ageing (TILDA).

    PubMed

    Murphy, Catriona M; Whelan, Brendan J; Normand, Charles

    2015-07-01

    The aim of this study was to provide a population-based estimate of the utilisation of publicly financed formal home care by older adults in Ireland and to identify the principal characteristics of those utilising formal home care. Data were collected through computer-aided personal interviews from a representative sample of community living older adults in Ireland. The interviews were conducted between 2009 and 2011 as part of the first wave of the Irish Longitudinal Study on Ageing (TILDA). The study is cross-sectional in design and limited to participants aged 65 years and older (n = 3507). Results reveal that 8.2% (95% CI 7.1%-9.3%) of participants utilised publicly financed formal home care in the form of home help and/or personal care. Key determinants of formal home-care utilisation were Instrumental Activity of Daily Living (IADL) difficulty (Adj OR 3.8, 95% CI 2.7-5.3), older age (Adj OR 3.4, 95% CI 2.4-4.8) and living alone (Adj OR 2.6, 95% CI 1.9-3.8). Almost half of those utilising formal care did not self-report an Activity of Daily Living (ADL) difficulty or an IADL difficulty. Government policy aims to reduce the need for long-term residential care by providing formal home care for older adults with low to moderate levels of dependency. This requires an increasing emphasis on personal care provision in the home. No evidence was found in this study to suggest that a shift in emphasis from formal domestic to personal care is taking place in Ireland. The absence of standardised assessment and eligibility criteria are deemed to be barriers to reorientation of the system. From a health services perspective, the current situation is not sustainable into the future and requires a focused policy response.

  12. Pertussis knowledge, attitude and practices among European health care professionals in charge of adult vaccination

    PubMed Central

    Hanlon, David; Benninghoff, Bernd; Calcoen, Stijn

    2011-01-01

    Despite successful infant vaccination program, pertussis remains endemic in many countries. Waning immunity leaves adolescents and adults susceptible to disease and potential reservoirs of infection allowing transmission to vulnerable infants. Misdiagnosis leads to significant underestimation of disease burden and inappropriate treatment. This online survey of 517 European health care professionals (HCP) examined their knowledge, attitudes and practices regarding pertussis and adult vaccination. Compared with other vaccine-preventable diseases, HCPs did not perceive pertussis as a serious disease in adults and there was a low perceived need for adult vaccination; only 17% mentioned pertussis as a disease they would usually vaccinate adults against. Pertussis incidence was considered to be low. Although the majority of HCPs agreed that vaccination is useful to prevent pertussis transmission from adults to susceptible infants, respondents discussed pertussis vaccination with ≤5% of patients; 58% respondents had never prescribed a pertussis vaccine to adults. The perceived low incidence of pertussis in adults and the lack of official guidelines/recommendations were cited as key reasons for not administering pertussis boosters. Despite only taking place in four countries, our results suggest that the incidence and burden of adult pertussis is not reflected in the attitudes of European HCP s to the disease. Awareness of adult pertussis, its diagnosis and guidance on pertussis boosters should be raised to protect adults and vulnerable infants and to manage the consequences of waning pertussis immunity. PMID:21368583

  13. Pertussis knowledge, attitude and practices among European health care professionals in charge of adult vaccination.

    PubMed

    Hoffait, Muriel; Hanlon, David; Benninghoff, Bernd; Calcoen, Stijn

    2011-02-01

    Despite successful infant vaccination programmes, pertussis remains endemic in many countries. Waning immunity leaves adolescents and adults susceptible to disease and potential reservoirs of infection allowing transmission to vulnerable infants. Misdiagnosis leads to significant underestimation of disease burden and inappropriate treatment. This online survey of 517 European health care professionals (HCP) examined their knowledge, attitudes and practices regarding pertussis and adult vaccination. Compared with other vaccine-preventable diseases, HCPs did not perceive pertussis as a serious disease in adults and there was a low perceived need for adult vaccination; only 17% mentioned pertussis as a disease they would usually vaccinate adults against. Pertussis incidence was considered to be low. Although the majority of HCPs agreed that vaccination is useful to prevent pertussis transmission from adults to susceptible infants, respondents discussed pertussis vaccination with ≤5% of patients; 58% respondents had never prescribed a pertussis vaccine to adults. The perceived low incidence of pertussis in adults and the lack of official guidelines/ recommendations were cited as key reasons for not administering pertussis boosters. Despite only taking place in four countries, our results suggest that the incidence and burden of adult pertussis is not reflected in the attitudes of European HCPs to the disease. Awareness of adult pertussis, its diagnosis and guidance on pertussis boosters should be raised to protect adults and vulnerable infants and to manage the consequences of waning pertussis immunity.

  14. Sex-specific associations of low birth weight with adult-onset diabetes and measures of glucose homeostasis: Brazilian Longitudinal Study of Adult Health

    PubMed Central

    Yarmolinsky, James; Mueller, Noel T; Duncan, Bruce B; Chor, Dóra; Bensenor, Isabela M; Griep, Rosane H; Appel, Lawrence J; Barreto, Sandhi M; Schmidt, Maria Inês

    2016-01-01

    Emerging evidence suggests sex differences in the early origins of adult metabolic disease, but this has been little investigated in developing countries. We investigated sex-specific associations between low birth weight (LBW; <2.5 kg) and adult-onset diabetes in 12,525 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Diabetes was defined by self-reported information and laboratory measurements. In confounder-adjusted analyses, LBW (vs. 2.5–4 kg) was associated with higher prevalence of diabetes in women (Prevalence Ratio (PR) 1.54, 95% CI: 1.32–1.79), not in men (PR 1.06, 95% CI: 0.91–1.25; Pheterogeneity = 0.003). The association was stronger among participants with maternal diabetes (PR 1.60, 95% CI: 1.35–1.91), than those without (PR 1.15, 95% CI: 0.99–1.32; Pheterogeneity = 0.03). When jointly stratified by sex and maternal diabetes, the association was observed for women with (PR 1.77, 95% CI: 1.37–2.29) and without (PR 1.45, 95% CI: 1.20–1.75) maternal diabetes. In contrast, in men, LBW was associated with diabetes in participants with maternal diabetes (PR 1.45, 95% CI: 1.15–1.83), but not in those without (PR 0.92, 95% CI: 0.74–1.14). These sex-specific findings extended to continuous measures of glucose homeostasis. LBW was associated with higher diabetes prevalence in Brazilian women, and in men with maternal diabetes, suggesting sex-specific intrauterine effects on adult metabolic health. PMID:27845438

  15. [Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

    PubMed

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2007-01-01

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  16. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

    PubMed

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2006-11-18

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  17. The Health Literacy and ESL Study: A Community-Based Intervention for Spanish-Speaking Adults

    PubMed Central

    MAS, FRANCISCO SOTO; JI, MING; FUENTES, BRENDA O.; TINAJERO, JOSEFINA

    2015-01-01

    Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits. PMID:25602615

  18. The Health Literacy and ESL study: a community-based intervention for Spanish-speaking adults.

    PubMed

    Soto Mas, Francisco; Ji, Ming; Fuentes, Brenda O; Tinajero, Josefina

    2015-04-01

    Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits.

  19. A review of the evidence linking adult attachment theory and chronic pain: presenting a conceptual model.

    PubMed

    Meredith, Pamela; Ownsworth, Tamara; Strong, Jenny

    2008-03-01

    It is now well established that pain is a multidimensional phenomenon, affected by a gamut of psychosocial and biological variables. According to diathesis-stress models of chronic pain, some individuals are more vulnerable to developing disability following acute pain because they possess particular psychosocial vulnerabilities which interact with physical pathology to impact negatively upon outcome. Attachment theory, a theory of social and personality development, has been proposed as a comprehensive developmental model of pain, implicating individual adult attachment pattern in the ontogenesis and maintenance of chronic pain. The present paper reviews and critically appraises studies which link adult attachment theory with chronic pain. Together, these papers offer support for the role of insecure attachment as a diathesis (or vulnerability) for problematic adjustment to pain. The Attachment-Diathesis Model of Chronic Pain developed from this body of literature, combines adult attachment theory with the diathesis-stress approach to chronic pain. The evidence presented in this review, and the associated model, advances our understanding of the developmental origins of chronic pain conditions, with potential application in guiding early pain intervention and prevention efforts, as well as tailoring interventions to suit specific patient needs.

  20. Implementation of an Evidence-Based Exercise Program for Older Adults in South Florida

    PubMed Central

    Page, Timothy; Vieira, Edgar; Seff, Laura

    2016-01-01

    Introduction. This study aimed to examine how well an evidence-based physical activity program could be translated for wide scale dissemination and adoption to increase physical activity among community-dwelling older adults. Methods. Between October 2009 and December 2012, reach, fidelity, dosage, ease of implementation, and barriers to translation of EnhanceFitness (EF) were assessed. To assess effectiveness, a pretest-posttest design was used to measure increases in functional fitness (chair stands, arm curls, and the up-and-go test). Results. Fourteen community-based agencies offered 126 EF classes in 83 different locations and reached 4,490 older adults. Most participants were female (72%). Thirty-eight percent of participants did not complete the initial 16-week EF program. The 25% who received the recommended dose experienced an increase in upper and lower body strength and mobility. Further, participants reported high satisfaction with the program. Conclusion. EF was successfully implemented in a variety of settings throughout South Florida and reached a large number of older adults. However, challenges were encountered in ensuring that those who participated received a program dose that would lead to beneficial gains in functional fitness. PMID:27800182