Ihle, Andreas; Jopp, Daniela S.; Oris, Michel; Fagot, Delphine; Kliegel, Matthias
Health research suggests that findings on young-old adults cannot be generalized to old-old adults and thus that old-old age seems not a simple continuation of young-old age due to qualitative changes that result in a discontinuity in old age. Specifically, it would be of conceptual and methodological importance to inform research regarding estimates around which chronological age the beginning of old-old age could be placed at a population level, and whether this is universal or domain-specific. To derive such criteria, we investigated potential discontinuity of age relations between young-old and old-old age in a large population-based sample considering measures in different domains (processing speed, verbal abilities, general health status, activity participation, and life satisfaction). For processing speed, verbal abilities, general health status, and life satisfaction we observed some very small indication that there might be a discontinuity of age relations at the end of individuals’ eighties, and for activity participation already at the beginning of individuals’ eighties. In conclusion, models conceptualizing aging as a gradual development might not suffice to adequately represent the differences between the stages of young-old and old-old age due to some very small indication that there might be discontinuity in late adulthood. PMID:27827960
Yuen, John W; Ng, Chi-Fai; Chiu, Peter Ka Fung; Teoh, Jeremy Yuen Chun; Yee, C H
A cross-sectional study was conducted to explore the prevalence and severity of health-related complaints perceived by adult males of Hong Kong by using the Hong Kong Traditional Chinese versions of the Aging males' symptoms (AMS) scale and the 5-dimensional and 3-level European Quality of life (EQ-5D-3L) questionnaire. A total of 825 adult males aged 40 years or above were surveyed, and observed that 80% of the population was living with little-to-mild levels of aging symptoms with mean total scores ranged between 26.02 ± 7.91 and 32.99 ± 7.91 in different age groups. Such symptoms were correlated with age, especially for the somato-vegetative and sexual symptoms. The most severe AMS symptoms were observed in the oldest age group at 70 years or above, with 76%, 34% and 70% living with moderate-to-severe levels of somato-vegetative, psychological and sexual symptoms, respectively. The result was highly correlated with the EQ-5D-3L questionnaire. Secondly, the Hong Kong Aging males' symptoms (AMS) scale was shown to have good reliability with test-retest coefficient at 0.79 (ranged 0.66-0.87) and Cronbach's alpha coefficient at 0.88 (ranged 0.70-0.84). In summary, the population of Hong Kong male adults was commonly living with little-to-mild levels of aging symptoms, whereas their severity was correlated with age.
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Burr, Hermann; Pohrt, Anne; Rugulies, Reiner; Holtermann, Andreas; Hasselhorn, Hans Martin
Objective Due to the growing proportion of older employees in the work force in several countries, the importance of age in the association between work and health is becoming increasingly relevant. Few studies have investigated whether age modifies the association of physical work demands with health. We hypothesized that the association of demanding body postures with deteriorated self-rated health (SRH) is stronger among older employees than among younger employees. Method We analyzed three 5-year cohorts in the Danish Work Environment Cohort Study comprising 8318 observations from 5204 employees (follow-up participation rate 83%) with good baseline SRH. Physical work demands were assessed as demanding body postures. Age was divided into tertiles; young (18-32 years), middle-aged (33-43 years) and old (44-59 among men and 44-54 years among women). Poor SRH ("fairly good", "poor", and "very poor") was measured with a single item. Log binomial regressions were stratified by gender. Effect modification (ie, interaction) was defined as deviation from additivity and examined by calculating the relative excess risk due to interaction (RERI). The reference group was employees aged 18-32 years with low physical exposure. Results When predicting deterioration of SRH, an interaction between demanding body postures and age was found among men [RERI: 0.75, 95% confidence interval (95% CI) 0.16-1.34, regarding the age group 44-59 years] and among women (RERI: 0.84, 95% CI 0.19-1.34, for the age group 33-43 years; and 1.17, 95% CI 0.42-1.93, for the age group 44-54 years). Conclusion The study findings suggest that demanding body postures have a stronger impact on health among older compared to younger employees.
... this page: https://medlineplus.gov/definitions/generalhealthdefinitions.html Definitions of Health Terms: General Health To use the ... by learning these general health terms. Find more definitions on Fitness | General Health | Minerals | Nutrition | Vitamins Basal ...
This thesis is centered on self-rated health (SRH) as an outcome measure, as a predictor, and as a marker. The thesis uses primary data from the WHO Study on global AGEing and adult health (SAGE) implemented in India in 2007. The structural equation modeling approach is employed to understand the pathways through which the social environment, disability, disease, and sociodemographic characteristics influence SRH among older adults aged 50 years and above. Cox proportional hazard model is used to explore the role of SRH as a predictor for mortality and the role of disability in modifying this effect. The hierarchical ordered probit modeling approach, which combines information from anchoring vignettes with SRH, was used to address the long overlooked methodological concern of interpersonal incomparability. Finally, multilevel model-based small area estimation techniques were used to demonstrate the use of large national surveys and census information to derive precise SRH prevalence estimates at the district and sub-district level. The thesis advocates the use of such a simple measure to identify vulnerable communities for targeted health interventions, to plan and prioritize resource allocation, and to evaluate health interventions in resource-scarce settings. The thesis provides the basis and impetus to generate and integrate similar and harmonized adult health and aging data platforms within demographic surveillance systems in different regions of India and elsewhere.
Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M.; Bohr, Vilhelm A.
The IARU Congress on Aging, Longevity and Health, held on 5–7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health. PMID:21820462
Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M; Bohr, Vilhelm A
The IARU Congress on Aging, Longevity and Health, held on 5-7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health.
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Stuck, Andreas E; Kharicha, Kalpa; Dapp, Ulrike; Anders, Jennifer; von Renteln-Kruse, Wolfgang; Meier-Baumgartner, Hans Peter; Iliffe, Steve; Harari, Danielle; Bachmann, Martin D; Egger, Matthias; Gillmann, Gerhard; Beck, John C; Swift, Cameron G
Background This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people – Assessment in GEneralists' practices) project. Methods/Design A group of general practitioners (GPs) in London (U.K.), Hamburg (Germany) and Solothurn (Switzerland) were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O) instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period). Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons) in the randomised controlled study was 2503 (66.0%) in London, 2580 (53.6%) in Hamburg, and 2284 (67.5%) in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible) enrolled in the concurrent comparison group was 636 (48.8%) in London, 746 (35.7%) in Hamburg, and 1171 (63.0%) in Solothurn. Discussion PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with different
National Inst. on Aging (DHHS/NIH), Bethesda, MD.
This document contains a glossary which defines 275 basic terms frequently used by gerontologists. The glossary is designed for use by a general population, including older persons and their families, students in the field of aging, librarians, medical reporters, health care providers, and others interested in older persons. It was developed to…
Health maintenance visit - women - ages 40 to 64; Physical exam - women - ages 40 to 64; Yearly exam - ... 64; Checkup - women - ages 40 to 64; Women's health - ages 40 to 64; Preventive care - women - ages ...
Health maintenance visit - men - over age 65; Physical exam - men - over age 65; Yearly exam - men - over age 65; Checkup - men - over age 65; Men's health - over age 65; Preventive care exam - men - over ...
Health maintenance visit - women - over age 65; Physical exam - women - over age 65; Yearly exam - women - over age 65; Checkup - women - over age 65; Women's health - over age 65; Preventive care exam - women - over ...
Health maintenance visit - men - ages 40 to 64; Physical exam - men - ages 40 to 64; Yearly exam - ... 64; Checkup - men - ages 40 to 64; Men's health - ages 40 to 64; Preventive care - men - ages ...
Health maintenance visit - women - ages 18 to 39; Physical exam - women - ages 18 to 39; Yearly exam - ... 39; Checkup - women - ages 18 to 39; Women's health - ages 18 to 39; Preventive care - women - ages ...
Jones, W. L.
Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.
gender such that energy level declined with older age for males, but energy level was lowest for females in the 35-49 age group. The correlations...psychosocial function," Journal of the American Medical Association, Vol. 185, 1963, pp. 914-919. Health Status 42 Koenig, H., "Depression and dysphoria among
Health maintenance visit - men - ages 18 to 39; Physical exam - men - ages 18 to 39; Yearly exam - ... 39; Checkup - men - ages 18 to 39; Men's health - ages 18 to 39; Preventive care exam - men - ...
Steptoe, Andrew; Deaton, Angus; Stone, Arthur A
Subjective wellbeing and health are closely linked to age. Three aspects of subjective wellbeing can be distinguished-evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, anger, stress, and pain), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in the specialty of psychological wellbeing, and present new analyses about the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, a continuing survey in more than 160 countries, shows a U-shaped relation between evaluative wellbeing and age in high-income, English speaking countries, with the lowest levels of wellbeing in ages 45-54 years. But this pattern is not universal. For example, respondents from the former Soviet Union and eastern Europe show a large progressive reduction in wellbeing with age, respondents from Latin America also shows decreased wellbeing with age, whereas wellbeing in sub-Saharan Africa shows little change with age. The relation between physical health and subjective wellbeing is bidirectional. Older people with illnesses such as coronary heart disease, arthritis, and chronic lung disease show both increased levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing might also have a protective role in health maintenance. In an analysis of the English Longitudinal Study of Ageing, we identify that eudemonic wellbeing is associated with increased survival; 29·3% of people in the lowest wellbeing quartile died during the average follow-up period of 8·5 years compared with 9·3% of those in the highest quartile. Associations were independent of age, sex, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of elderly people is an important objective for both economic and health policy. Present psychological and economic theories do not adequately account for the variations in patterns
Palmer, Keith T; Goodson, Nicola
Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter, we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered.
Palmer, Keith; Goodson, Nicola
Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses, and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237
The rapid increase in admission rates to mental hospitals in many countries in recent decades threatens to create serious problems. These may be to some extent remediable in that social factors are important in deciding the chances of admission to hospital, as well as the frequency of suicide, which reaches a peak among the aged in most countries. All communities possess valuable assets in the form of existing links between the aged and their families which may be lost by indiscriminate community planning. Although some psychological decline is inevitable during senescence, it is becoming clear that much that once passed for the ineluctable effects of mental and physical aging is due to disease that may be ameliorated or cured. The relationship between mental and physical health is particularly close in old age, and the effective treatment of the aged person with a psychiatric disorder demands the full resources of general medicine as well as psychiatry. For successful rehabilitation a full community service for the aged and proper integration of the work of the family doctor with that of preventive and hospital services are essential. The possibilities of prevention can be enhanced by fostering physical well-being and healthy adjustment during earlier stages of life, as well as by ascertaining, and remedying as far as possible, the mental and physical disorders of the aged in the early stages of their development. There is great scope for biological, medical and sociological research to define reasons for the wide variations in mental and physical well-being in old age. PMID:14439413
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Mestheneos, Elizabeth; Withnall, Alexandra
The health of ageing populations is a real concern across the world so that the concept of active ageing has been advocated as a framework for appropriate educational policies and programmes to support people as they grow older. The other elements discussed here are health and healthy life expectancy (HLE) acknowledging that as people age, they…
Leventhal, Elaine A.; And Others
Health behavior may be influenced by age, beliefs, and symptomatology. To examine age-related health beliefs and behaviors with respect to six diseases (the common cold, colon-rectal cancer, lung cancer, heart attack, high blood pressure, and senility), 396 adults (196 males, 200 females) divided into three age groups completed a questionnaire…
Thomas, R K; Pol, L G
The U.S. health care industry has been hampered in the development of a mature marketing function in part due to characteristics unique to the industry. These characteristics include a lack of market data, poorly developed market research techniques, and a poor understanding of consumer behavior within the industry. Some of the deficiencies are being addressed through the development of an emerging field that is being referred to as "health demography." Health demography and those who have begun to refer to themselves as health demographers are drawing from the fields of demography, epidemiology, biostatistics, and the social sciences to formulate a new discipline uniquely related to the needs of today's health care marketers and planners. Those involved with health demography are developing databases and models for application to concrete problems in health care delivery. The development of this field is contributing to the advancement of the state of marketing in health care and serving to reduce many of the barriers that have retarded the development of a mature marketing function within the health care industry.
Yuan, Anastasia S. Vogt
Although perceived discrimination (especially due to race-ethnicity) decreases mental health, the influence of perceived discrimination due to other reasons on mental health needs to be explored. This study examines the relationship between perceived age discrimination and mental health and determines whether psychosocial resources explain or…
Rattan, Suresh I S
Ageing occurs in spite of complex pathways of maintenance and repair. There is no "enemy within", which has the specific evolution-selected function to cause ageing and death. This understanding of ageing should transform our approach towards interventions from therapeutic "anti-ageing" to maintaining health. But what is health? Ideally, health is a state of complete physical and mental independence in activities of daily living. But in pragmatic terms, health is a state of adequate physical and mental independence in activities of daily living. In order to identify a set of measurable, evidence-based and demonstratable parameters of health, robustness and resilience at various levels, the concept of homeodynamic space can be a useful one. Age-related health problems for which there are no clear-cut causative agents, except the complex process of ageing, may be better tackled by focusing on health mechanisms and their maintenance, rather than disease management and treatment. Continuing the disease-oriented research approaches are economically, socially and psychologically unsustainable as compared with health-oriented and preventive strategies, such as hormesis. Supporting health-oriented research is the urgency of our time.
Burdman, Geral Dene M.
This study of futurism is important to gerontology in order to bridge the gap between theory, policy statement, and actual practice in the field of aging. There is a need to prepare competent individuals for direct service, and to provide increased exposure to gerontology throughout the curriculum. (Author/LPG)
Aoun, Samar; Johnson, Lyn
A project to promote rural men's health through diabetes education and screening in the workplace involved 446 men aged 40-65 in Western Australia. Of the 287 men identified at high risk of developing diabetes and referred to their general practitioner, 76 percent visited their physician. However, physician's advice on lifestyle changes was…
Mariño, R J
The emphasis of Australian Government policy is on the promotion of good health in later life and positive experiences with ageing. Conceptually, a new gerontology framework has replaced the study of disease, decline, loss and disability. Within this framework, health promotion offers a mechanism by which individuals can be assisted to create environments that offer better opportunities for continued participation in society and improved quality of health and self-care. Oral health is instrumental to older people's health, life satisfaction, quality of life and perception of self. Australia is culturally diverse, composed of numerous ethno-cultural groups coexisting within a larger, predominant culture, creating a multicultural and multiracial society. However, despite this cultural diversity, the well documented ageing profile of the Australian population and repeated calls for comprehensive geriatric assessment, the oral health of older adults remains a challenge for oral health providers and for society. A major challenge will be to translate existing knowledge and experience of disease prevention and health promotion into appropriate programmes for older adults. Health promotion is the key to improving oral health in later life as it encourages older adults to be proactive in regard to their health. Therefore, increased efforts should be directed towards identifying opportunities for health promotion activities and the development of community based models that encourage older people to improve and maintain their oral health. Ignoring opportunities for health promotion may increase inequalities in oral health and may lead to even greater demands for curative and oral rehabilitative services from these groups This article firstly provides a brief rationale for oral health promotion. Its second part explores the influence of culture on health beliefs, behaviours and outcomes in older adults and how oral health can relate to cultural background. The last section
The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.
Jacobson, Cara; Bailin, Alexandra; Milanaik, Ruth; Adesman, Andrew
This article examines the health implications of new age technology use among adolescents. As Internet prevalence has increased, researchers have found evidence of potential negative health consequences on adolescents. Internet addiction has become a serious issue. Pornography is now easily accessible to youth and studies have related pornography with several negative health effects. Cyberbullying has become a large problem as new age technologies have created a new and easy outlet for adolescents to bully one another. These technologies are related to increased morbidity and mortality, such as suicides due to cyberbullying and motor vehicle deaths due to texting while driving.
Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan
Human exposures to pesticides can occur in the workplace, in the household and through the ambient environment. While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings, to the best of our knowledge, this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations. In this article, we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations. This article also highlighted questions arising from these studies, including our recent analyses using the data from the Canadian Health Measures Survey (CHMS), for future research. We found few studies have addressed the impact of environmental pesticide exposures on respiratory health, especially on lung function, in general populations. In the studies using the data from CHMS Cycle 1, exposures to OP insecticides, pyrethroid insecticides, and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population, but no significant associations were observed for the herbicide 2,4-D. Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population, and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures. Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems, and thereafter providing greater benefit to the general population.
Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona
This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.
Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona
Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821
Waters, William F; Gallegos, Carlos A
Middle-income countries like Ecuador are in the process of demographic and epidemiological transitions, and their populations are aging. The challenges associated with providing services to growing numbers of citizens who experience the inevitable deterioration associated with aging are mirrored by the manner in which aging is perceived in a culturally heterogeneous society. This paper presents the results of qualitative research conducted among older men and women in indigenous communities in the Ecuadorian highlands in order to investigate the perceptions regarding the ability of family and community networks to provide adequate and appropriate support for older persons in the context of their perceptions of health, health care, and aging. The principal findings are that: (i) perceptions of aging are shaped by chronic illness, fatigue, deteriorating sensory capacities, and vulnerability to accidents; (ii) barriers to health care are exacerbated among aging members of indigenous communities, although in some cases they can be addressed through traditional alternatives; (iii) the sense of identity shifts as aging people are increasingly unable to work the land and participate in community activities; and (iv) family and community support networks for older adults are not as strong as is generally thought. These findings represent the context within which issues related aging in a culturally heterogeneous society can be best understood and addressed.
Pinkerton, JoAnn V; Stovall, Dale W
Changes in ovarian hormone production may affect numerous health outcomes including vasomotor symptoms, cardiovascular disease (CVD), osteoporosis, cognition, depression, mood disorders, sexual function, and vaginal atrophy. We will compare age-related changes to those associated with reproductive aging and menopause and the effects of estrogen therapy on selected health outcomes. Hormone therapy (HT) reduces frequency and severity of hot flashes, prevents bone loss and osteoporotic fractures, and relieves vaginal atrophy. Nonhormone therapy trials with antidepressants or gabapentin for hot flash relief are promising. To date, clinical trial data are insufficient to recommend the use of HT for prevention or treatment of CVD, mood disorders, cognition, or sleep disorders. For some disease states, such as CVD and cognition, a "critical time window" has been proposed but not proven, such that estrogen use early in the menopause transition may be beneficial while estrogen use later in life would lead to increased health risks.
Malaspina, Dolores; Gilman, Caitlin; Kranz, Thorsten Manfred
The influence of paternal age on the risk for sporadic forms of Mendelian disorders is well known, but a burgeoning recent literature also demonstrates a paternal age effect for complex neuropsychiatric conditions, including schizophrenia, autism, bipolar disorder and even for learning potential, expressed as intelligence. Mental illness is costly to the patients, the family and the public health system, accounting for the largest portion of disability costs in our economy. The delayed onset of neuropsychiatric conditions and lack of physical manifestations at birth are common frequencies in the population that have obscured the recognition that a portion of the risks for mental conditions is associated with paternal age. Identification of these risk pathways may be leveraged for knowledge about mental function and for future screening tests. However, only a small minority of at-risk offspring are likely to have such a psychiatric or learning disorder attributable to paternal age, including the children of older fathers. PMID:25956369
Kendig, Hal; Dykstra, Pearl A.; van Gaalen, Ruben I.; Melkas, Tuula
This article reviews and presents research findings on the relationships between parenthood and health over the life span. Existing research shows lacunae. The links between reproductive behavior and longevity generally focus on family size rather than contrasting parents and nonparents. Studies of marital status differentials in survival…
Despite acknowledging India's crucial need for health education for school aged children, government institutions have failed to provide the necessary support. Past experience has shown that while the government has drafted policy statements concerning school health, scant action has followed. What little has been done consists primarily of perfunctory medical check-ups of school children, a service mostly limited to urban centers. Evident from the current status of health education for the school aged, several changes must take place: 1) Government institutions must reach a consensus regarding the content of school health services. Since school health is intended to improve both children's health status and cognitive capability, such a service demands a comprehensive program that includes regular and complete health surveillance. And it also means that the schools themselves must be healthy environments, and that teachers must serve as role models of good health. 2) School health efforts must involve and be supported by the parents and the community. 3) Government policies must take into account children who are not attending school. This means both a long-term policy to solve the problem of drop-outs and a short-term policy of providing non formal education -- including health education -- for these children. 4) Of critical importance, the health and education sectors need to work together; they must have "joint responsibility." 5) A related issue is that both the health and education sectors accord a low priority to the issue of school health -- something that needs to change. 6) Finally, the government must change its generally weak commitment to providing school health services.
Payne, Carolyn; Hedberg, E. C.; Kozloski, Michael; Dale, William
Introduction. National Social Life, Health, and Aging Project (NSHAP) included five unique mental health measures in Waves 1 and 2 that researchers can use to measure the overall emotional health of participants: depressive symptoms, happiness–unhappiness, anxiety symptoms, perceived stress, and felt loneliness. For each, we detail the rationale for its development and explain how to score, analyze, and interpret results. Method. NSHAP developed its measures by modifying traditional short-form scales to improve response efficiency and reduce respondent burden. Scoring protocols and interpretations were developed for each measure. U.S. population estimates for older adults born between 1920 and 1947 were generated using age-eligible samples from Waves 1 and 2. Results. NSHAP’s protocols yielded U.S. prevalence rates similar to other nationally representative studies of older adults and comparable between waves. Higher estimates of anxiety symptoms and perceived stress in Wave 2 compared with Wave 1 were explained by age, administration mode, and time period. Analytic strategies for longitudinal analyses are provided. In Wave 2, mental health generally was worse at older ages, with women having more symptoms at younger ages than men. Women had fewer anxiety symptoms at the oldest ages. Discussion. NSHAP’s mental health measures were successfully integrated into the project’s survey and showed acceptable external reliability as well as moderately stable individual characteristics across the 5 years between Waves 1 and 2. Depressive symptoms and unhappiness may form a mental health cluster in the elderly, distinct from anxiety symptoms, perceived stress, and felt loneliness. Gender differences in age-specific patterns of mental health were evident using the exact age of participants rather than the traditional decade groupings. Administration mode and time period (between 2005–2006 and 2010–2011) were determined to be potential confounds that need to be
Jansà, Josep M
Foreign migration in Spain is at present a priority in the social and demographic context the country. At a worldwide level, trends in the evolution of population and social, political and economical indicators, appear to maintain for the coming years, the present trends on migrations from poor countries to the rich ones. In the health area, considering migration as a relatively recent phenomena in Spain, and considering that is mainly constituted by young and healthy population, there are not still data available on the main health needs of migrants related to aging. Data from other countries with a longer migrant tradition, shows mental health disorders and social and cultural barriers for adaptation, as basic health determinants for older migrants. Related to the effects in the health system, the inclusion of the aging factor in general population and migrant needs, offer an optimistic panorama for future planning. Migrant aging in Spain, despite of its middle and long term perspective, do require a progressive adaptation of knowledge and resources to cover future needs. Considering this coming future, health professionals do need to be trained in intercultural skills and knowledge.
... Start Your Family Health History My Family Health Portrait Tool English Web Tool Printable Versions Source Code ... your family's health history. My Family Health History Portrait Tool Find out about this web-based tool ...
Chalmers, J M
The ageing Australian population living in the new millennium has dental needs that are very different and more complex than those experienced by previous older adult cohorts during the twentieth century. A summary of the oral health status of older Australians is presented, together with a review of the important relationships between general health and oral health. The key to maintaining and improving older adults' oral health status is the use of oral health promotion strategies that focus not only on dental characteristics, but also on the life characteristics of older adults, and on their quality of life issues. Traditionally, there has been very limited geriatric oral health promotion, with several myths contributing to this situation. Contemporary geriatric oral health promotion in the new millenium has an evidence-based and planned approach. It encompasses not only the treatment of oral diseases and conditions, but has an increased focus on the prevention of oral diseases and conditions to enhance oral health status and older adults' quality of life. Using the Ottawa Charter and a functional dependence classification, a geriatric oral health promotion matrix is presented, using a specific example of Australian residential care.
Huizinga, W.; Poot, D. H. J.; Roshchupkin, G.; Bron, E. E.; Ikram, M. A.; Vernooij, M. W.; Rueckert, D.; Niessen, W. J.; Klein, S.
Both normal aging and neurodegenerative diseases such as Alzheimer's disease cause morphological changes of the brain. To better distinguish between normal and abnormal cases, it is necessary to model changes in brain morphology owing to normal aging. To this end, we developed a method for analyzing and visualizing these changes for the entire brain morphology distribution in the general aging population. The method is applied to 1000 subjects from a large population imaging study in the elderly, from which 900 were used to train the model and 100 were used for testing. The results of the 100 test subjects show that the model generalizes to subjects outside the model population. Smooth percentile curves showing the brain morphology changes as a function of age and spatiotemporal atlases derived from the model population are publicly available via an interactive web application at agingbrain.bigr.nl.
Koritsas, Stella; Iacono, Teresa; Davis, Robert
In 2007 the Australian Commonwealth Government announced the Medicare Health Assessment for People with an Intellectual Disability as part of the Enhanced Primary Care (EPC) program (Department of Health and Ageing, 2008). The annual health assessment is a structured framework for general practitioners (GPs), which enables an annual comprehensive…
Cho, C M; Hirsch, R; Johnstone, S
Cannabis, commonly known as marijuana, is the most frequently used illicit drug in Australia. Therefore, oral health care providers are likely to encounter patients who are regular users. An upward trend in cannabis use is occurring in Australia, with 40 per cent of the population aged 14 and above having used the drug. There are three main forms of cannabis: marijuana, hash and hash oil, all of which contain the main psychoactive constituent delta-9-tetrahydrocannabinol (THC). Cannabis is most commonly smoked, however it can be added to foods. THC from cannabis enters the bloodstream and exerts its effects on the body via interaction with endogenous receptors. Cannabis affects almost every system of the body, particularly the cardiovascular, respiratory and immune systems. It also has acute and chronic effects on the mental health of some users. Therefore, chronic abuse is a concern because of its negative effects on general physical and mental health. Cannabis abusers generally have poorer oral health than non-users, with an increased risk of dental caries and periodontal diseases. Cannabis smoke acts as a carcinogen and is associated with dysplastic changes and pre-malignant lesions within the oral mucosa. Users are also prone to oral infections, possibly due to the immunosuppressive effects. Dental treatment on patients intoxicated on cannabis can result in the patient experiencing acute anxiety, dysphoria and psychotic-like paranoiac thoughts. The use of local anaesthetic containing epinephrine may seriously prolong tachycardia already induced by an acute dose of cannabis. Oral health care providers should be aware of the diverse adverse effects of cannabis on general and oral health and incorporate questions about patients' patterns of use in the medical history.
Mandal, Priyanka; Tank, Krishna; Monday, Tapas; Chen, Chih-Hung; Deen, M Jamal
A simple, low-power and wearable health analyzer for early identification and management of some diseases is presented. To achieve this goal, we propose a walking pattern analysis system that uses features such as speed, energy, turn ratio, and bipedal behavior to characterize and classify individuals in distinct walking-ages. A database is constructed from 74 healthy young adults in the age range of 18 to 60 years using the combination of inertial signals from an accelerometer and a gyroscope on a level path including turns. An efficient advanced signal decomposition method called improved complete ensemble empirical mode decomposition with adaptive noise (Improved CEEMDAN) was used for feature extraction. Analyses show that the gait of healthy able-bodied individuals exhibits a natural bipedal asymmetry to a certain level depending on the activity-type and age, which relate to individual's functional attributes rather than pathological gait. The analysis of turn ratio, a measure of activity-transition9 energy change and stability, indicated turning to be less locally stable than straight-line walking making it a more reliable measure for determining falls and other health issues. Extracted features were used to analyze two distinct walking-age groups of the healthy young adults based on their walking pattern, classifying 18-45 years old individuals in one group and 46-60 years old in the other group. Our proposed simple, inexpensive walking analyzer system can be easily used as an ambulatory screening tool by clinicians to identify at risk population at the early onset of some diseases.
Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.
This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. It states that a review of research on mental health revealed two findings. First, the efficacy of treatment is well documented, and second, a range of treatment exists for most mental…
Jasien, Joan; Daimon, Caitlin M.; Maudsley, Stuart; Shapiro, Bruce K.; Martin, Bronwen
Low bone mass density (BMD), a classical age-related health issue and a known health concern for fair skinned, thin, postmenopausal Caucasian women, is found to be common among individuals with developmental/intellectual disabilities (D/IDs). It is the consensus that BMD is decreased in both men and women with D/ID. Maintaining good bone health is important for this population as fractures could potentially go undetected in nonverbal individuals, leading to increased morbidity and a further loss of independence. This paper provides a comprehensive overview of bone health of adults with D/ID, their risk of fractures, and how this compares to the general aging population. We will specifically focus on the bone health of two common developmental disabilities, Down syndrome (DS) and cerebral palsy (CP), and will discuss BMD and fracture rates in these complex populations. Gaining a greater understanding of how bone health is affected in individuals with D/ID could lead to better customized treatments for these specific populations. PMID:22888344
Raphael, Sarah L
Cardiovascular disease (CVD) and type 2 diabetes are common systemic illnesses with reliable, predictive risk factors. CVD is the number one killer worldwide accounting for nearly 30% of deaths and type 2 diabetes has reached epidemic proportions in many western industrialized countries. Both of these illnesses can go undiagnosed in an alarming number of people for significant periods of time. The relationship between oral health and systemic health has become the focus of much discussion and research in recent times. It is now widely accepted that periodontal disease is associated with systemic illnesses such as CVD and type 2 diabetes. Cigarette smoking and obesity are major risk factors accounting for a large portion of the global disease burden. Many periodontal patients may be at risk of systemic conditions but be asymptomatic and undiagnosed. With an aging population who are mostly retaining their natural dentition, the need for periodontal management will continue to rise in the future. Dental professionals are well placed to perform general health screening for their patients. Therefore, risk assessment during the periodontal examination may facilitate the early identification of the large proportion of people who are unaware of their risk status. As identification and intervention of patients with increased risk factors is key to lowering the systemic disease burden, general health screening during periodontal examinations may present an important opportunity for many patients.
Raphael, Sarah L.
Cardiovascular disease (CVD) and type 2 diabetes are common systemic illnesses with reliable, predictive risk factors. CVD is the number one killer worldwide accounting for nearly 30% of deaths and type 2 diabetes has reached epidemic proportions in many western industrialized countries. Both of these illnesses can go undiagnosed in an alarming number of people for significant periods of time. The relationship between oral health and systemic health has become the focus of much discussion and research in recent times. It is now widely accepted that periodontal disease is associated with systemic illnesses such as CVD and type 2 diabetes. Cigarette smoking and obesity are major risk factors accounting for a large portion of the global disease burden. Many periodontal patients may be at risk of systemic conditions but be asymptomatic and undiagnosed. With an aging population who are mostly retaining their natural dentition, the need for periodontal management will continue to rise in the future. Dental professionals are well placed to perform general health screening for their patients. Therefore, risk assessment during the periodontal examination may facilitate the early identification of the large proportion of people who are unaware of their risk status. As identification and intervention of patients with increased risk factors is key to lowering the systemic disease burden, general health screening during periodontal examinations may present an important opportunity for many patients. PMID:21523218
Background Lived health is a person’s level of functioning in his or her current environment and depends both on the person’s environment and biological health. Our study addresses the question whether biological health or lived health is more predictive of self-reported general health (SRGH). Methods This is a psychometric study using cross-sectional data from the Spanish Survey on Disability, Independence and Dependency Situation. Data was collected from 17,739 people in the community and 9,707 from an institutionalized population. The following analysis steps were performed: (1) a biological health and a lived health score were calculated for each person by constructing a biological health scale and a lived health scale using Samejima’s Graded Response Model; and (2) variable importance measures were calculated for each study population using Random Forest, with SRGH as the dependent variable and the biological health and the lived health scores as independent variables. Results The levels of biological health were higher for the community-dwelling population than for the institutionalized population. When technical assistance, personal assistance or both were received, the difference in lived health between the community-dwelling population and institutionalized population was smaller. According to Random Forest’s variable importance measures, for both study populations, lived health is a more important predictor of SRGH than biological health. Conclusions In general, people base their evaluation of their own health on their lived health experience rather than their experience of biological health. This study also sheds light on the challenges of assessing biological health and lived health at the general population level. PMID:24555764
van Staveren, W. A.
The ageing process is—apart from chance or good luck—not only influenced by factors intrinsic to the individual, but also by extrinsic factors that include environmental and lifestyle variables. This paper deals with the epidemiological evidence for the role of dietary patterns and key nutritional concerns in relation to survival and ageing related disorders that present themselves in later life. Dietary patterns, such as the Mediterranean diet, characterized by mainly plant foods including protective factors e.g. vegetables, nuts and monounsaturated fatty acids and excluding harmful factors e.g. trans-fatty acids and foods with a high glycemic factor, appear to be relevant even in old age. Specific nutritional concerns focus on general undernutrition, vitamin D and vitamin B12. Prevalence of nutritional inadequacies, diagnostic criteria, causes and health consequences are described. The paper ends with recommendations for guidance on healthy diets for elderly people. An important challenge should be research to further expand the knowledge base, acknowledging the complexity of the ageing process and integrating different dimensions of research into human healthy ageing in properly designed studies. In the mean time reversing poor adherence to existing guidelines for a healthy diet remains a first challenge in public health nutritional practices. PMID:20495957
O'Connell, J M
The purpose of this study was to analyse national health expenditures of OECD countries relative to their age structures. Using econometric techniques designed to analyse cross-sectional time series data, the ageing of the population was found to affect health spending in several countries while having no effect in others. In addition, the effect of income on health spending was lower than that generally reported in the literature. These findings suggest that unobserved country-specific factors play a major role in determining the amount of resources allocated to health services in a country. Such factors also determine if the ageing of the population with increased health spending.
... 29 Labor 8 2010-07-01 2010-07-01 false General safety and health provisions. 1926.20 Section 1926.20 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION General Safety and...
Kenney, W Larry; Craighead, Daniel H; Alexander, Lacy M
This brief review is based on a President's Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review was to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth's average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress resulting from prolonged elevations in ambient temperature and prolonged physical activity in hot environments creates a high demand on the left ventricle to pump blood to the skin to dissipate heat. Even healthy aging is accompanied by altered cardiovascular function, which limits the extent to which older individuals can maintain stroke volume, increase cardiac output, and increase skin blood flow when exposed to environmental extremes. In the elderly, the increased cardiovascular demand during heat waves is often fatal because of increased strain on an already compromised left ventricle. Not surprisingly, excess deaths during heat waves 1) occur predominantly in older individuals and 2) are overwhelmingly cardiovascular in origin. Increasing frequency and severity of heat waves coupled with a rapidly growing at-risk population dramatically increase the extent of future untoward health outcomes.
GENERAL THOMAS DRESSER WHITE: RENAISSANCE MAN IN A DARK AGE BY CHRIS WINKLEPLECK A THESIS PRESENTED TO THE FACULTY OF...remain a plebe but for a matter of months due to the shortened program. In all, his class spent only two years at the...short of swamp. No injury except for skinned finger and stiff back. Ambassador apparently calm and very decent about matter . He sent wires to the
Background The health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and better living environment. The general aim of the AMI cohort was to study health and aging in elderly farmers living in rural area through a multidisciplinary approach, with a main focus on dementia. Methods/design The study initially included 1 002 participants, randomly selected from the Farmer Health Insurance rolls. Selection criteria were: being 65 years and older; living in rural area in Gironde (South-Western France); being retired from agriculture after at least 20 years of activity and being affiliated to the Health Insurance under own name. The study started in 2007, with two follow-up visits over 5 years. Baseline visits were conducted at home by a neuropsychologist then by a geriatrician for all cases suspected of dementia, Parkinson’s disease and depression (to confirm the diagnosis), and by a nurse for others. A large panel of data were collected through standardised questionnaires: complete neuropsychological assessment, material and social living environment, psychological transition to retirement, lifestyle (smoking, alcohol and diet), medications, disability in daily living, sensory impairments and some clinical measures (blood pressure, depression symptomatology, anxiety, visual test, anthropometry…). A blood sampling was performed with biological measurements and constitution of a biological bank, including DNA. Brain MRI were also performed on
Robert, S; House, J S
Despite the general persistence and even increase of strong socioeconomic status (SES) differentials in health in the United States, research suggests that SES differentials in health may diminish or become nonexistent at older ages. However, most research has used only limited measures of SES (e.g. education, income), and has not thoroughly investigated intra-elderly age differences in this trend. The current study investigates how SES differentials in health vary by age in the United States, using fairly detailed age categories (through ages 85+), and 2 alternative indicators (home ownership and liquid assets) of a major additional dimension of SES, financial assets, which may be especially important at older ages. We address (a) how strongly financial assets are associated with health, considered both alone and net of education and income; (b) if the health effects of financial assets vary by age; and, more specifically, (c) if their effects are especially pronounced in older age, again considered both alone and net of or relative to education and income. Results show that financial assets, especially liquid assets, considered both alone and net of education and income, are associated with health throughout adulthood and old age, at least until ages 85+. Furthermore, financial assets remain associated with health until quite late in life and become more important relative to education and income at older ages for some measures of health.
BACKGROUND: The patient self-rating questionnaire is commonly used as a research tool to identify patients with 'unrecognized' depression. There is no evidence to support its use as a clinical tool in general practice. AIM: To determine whether use of the 30-item general health questionnaire (GHQ) is a practical means of increasing identification of 'new' episodes of emotional distress among patients consulting their general practitioner (GP). METHOD: A randomized controlled trial was carried out in a Scottish new town practice with eight partners. In the waiting room, 1912 patients aged over 14 years and consulting over a 10-month period attempted to complete the GHQ. The 'clinical judgement' group posted the questionnaire into a box then attended the doctor as normal. The 'screened' group presented the questionnaire to the doctor. After the consultation, the doctor completed an assessment questionnaire. The main outcome measures were GHQ scores and doctors' assessments of mental health. RESULTS: In total, 1589 patients were eligible to participate. However, 207 patients in the screened group were excluded because the doctor did not look at the questionnaire. The clinical judgement group (59.7% patients) and the screened group (40.3%) were compared. Although the doctors' diagnoses of distress were low in the clinical judgement group (8.1%), they were significantly greater in the screened group (13.9%) where the diagnosis of depression was doubled. The percentage of patients scoring greater than or equal to 9 (GHQ+) was 21.5% and 21.0% respectively. The level of agreement between the doctors' diagnoses of distress and the questionnaires scoring GHQ+ rose from 19% in the clinical judgement group to 35% in the screened group. CONCLUSIONS: The general health questionnaire used in a practice setting increases the identification of patients with emotional distress. However, the use made of the questionnaires in the screened group raises questions of doctor and patient
... Grow Older (Office of Disease Prevention and Health Promotion) Also in Spanish Latest News What's the 'SuperAgers' ... Nurses feature in winter health video. Article: Health promotion among older adults in Austria: a qualitative study. ...
LIPSITT, DON R
General hospitals have had an illustrious role in the evolution of psychiatry. They have provided a rich soil for the growth of inpatient psychiatric units, consultation-liaison psychiatry, psychosomatic medicine, med-psych units, outpatient psychiatric clinics, emergency services and a whole spectrum of resources for the communities in which they dwell. In some respects, whether attached to universities or not, they have functioned as small colleges for the education and training of scores of health professionals. In the setting of the general hospital, psychiatry has had opportunities to become remedicalized and integrated into the mainstream of medicine. However, recent trends in health care run the risk of jeopardizing these accomplishments. Managed care has had a profound impact on the way psychiatry is practiced, taught, and reimbursed. Concerns about cost-containment have raised questions about whether the general hospital will remain the best and most economical setting for psychiatric services. If the primacy of the patient is lost, psychiatry's role in the general hospital will be uncertain. The need to safeguard psychiatry's achievements must be a worldwide endeavor. PMID:16946901
Harris, Roma; Wathen, C Nadine; MacGregor, Jennifer C D; Dennhardt, Silke; Naimi, Anthony; Ellis, Kathleen S
Amid growing concern about the graying population, an emerging theme in public health discourse is that of "successful aging." In this article, we use a governmentality lens to analyze a Canadian health promotion video, titled "Make Health Last: What Will Your Last 10 Years Look Like?" and viewers' responses to its message. The video presents starkly different scenarios of the last decade of life, conveying a neo-liberal rationality in which health in old age is positioned as a matter of individual choice. Our analysis suggests that while viewers generally support the video's message of personal responsibility for health, some are uneasy about implied claims that age-related illness can be prevented by choosing to be healthy. We argue that the video's simplistic messaging about health in later life raises disturbing questions about health promotion campaigns that deny the "normal" aging body and blame the elderly for "deciding" not to remain youthful and healthy.
Dadvand, Payam; Bartoll, Xavier; Basagaña, Xavier; Dalmau-Bueno, Albert; Martinez, David; Ambros, Albert; Cirach, Marta; Triguero-Mas, Margarita; Gascon, Mireia; Borrell, Carme; Nieuwenhuijsen, Mark J
Green spaces are associated with improved health, but little is known about mechanisms underlying such association. We aimed to assess the association between greenness exposure and subjective general health (SGH) and to evaluate mental health status, social support, and physical activity as mediators of this association. This cross-sectional study was based on a population-based sample of 3461 adults residing in Barcelona, Spain (2011). We characterized outcome and mediators using the Health Survey of Barcelona. Objective and subjective residential proximity to green spaces and residential surrounding greenness were used to characterize greenness exposure. We followed Baron and Kenny's framework to establish the mediation roles and we further quantified the relative contribution of each mediator. Residential surrounding greenness and subjective residential proximity to green spaces were associated with better SGH. We found indications for mediation of these associations by mental health status, perceived social support, and to less extent, by physical activity. These mediators altogether could explain about half of the surrounding greenness association and one-third of the association for subjective proximity to green spaces. We observed indications that mental health and perceived social support might be more relevant for men and those younger than 65years. The results for objective residential proximity to green spaces were not conclusive. In conclusion, our observed association between SGH and greenness exposure was mediated, in part, by mental health status, enhanced social support, and physical activity. There might be age and sex variations in these mediation roles.
Sheldon, G F
Since 1990, society has been evolving through a period of significant transformation. In response to an increasingly information-rich and knowledge-based environment, the work force for most of society is becoming more specialized. Medicine is one of the few areas developing a work force which emphasizes generalism. For our current needs, the transitional work force has overproduced physicians. Because the overproduction has been uneven by specialty, it is deceptive to evaluate growth collectively rather than by individual subspecialty. Future shifts in age and types of illness combined with enhanced technology will transform the public's expectations of the American health care system. The type and number of physicians that will be needed in the future will be substantially different than in the past, so current patterns in physician education may not address the population's future demands. Images Figure 1. PMID:7677453
Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R. Paul
The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states. PMID:27594848
Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R Paul
The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states.
Marshall, Victor W.; Altpeter, Mary
The rapid growth of the population of older adults and their concomitant physical status and health needs have captured the attention, collaboration, and funding support of an array of leaders in the fields of aging and health care. To help fill the void of literature available to social workers interested in health promotion and aging, the…
Phillips, A.; Morrison, J.; Davis, R. W.
The community general practitioner (GP) has a central role in the provision of primary health care to people with intellectual disability (ID) as an indirect result of deinstitutionalization in Australia. This population, however, continues to experience poor health care compared to the general population. The current paper describes results from…
Golubev, A G
Aging and longevity are interrelated so intimately that they should be treated with a unified theory. The longevity of every single cohort of living beings is determined by the rate of their dying-out. In most cases, mortality rates increase in accelerated fashions to reach values making the bulk of each finite cohort completely exhausted within a relatively narrow time interval shifted to the end of its resulting lifespan. Among simple functions with biologically interpretable parameters, the best fit to this pattern is demonstrated by the Gompertz-Makeham Law (GML): mu = C + lambda x e(gamma x t). A generalized form of GML mu = C(t) + lambda x e(-E(t)) is suggested and interpreted as a law of the dependency of mortality upon vitality rather than on age. It is reduced to the conventional GML when E depends linearly on t, that the age is an observable correlate of unobservable vitality. C(t) captures the inherently irresistible causes of death. The generalized GML can accommodate any mode of age-dependent functional decline, which should be placed into the exponent index to be translated into changes in mortality rate, and is compatible with any sort of cohort heterogeneity, which may be captured by substituting of GML parameters with relevant distributions or by combining of several generalized GML models. The generalized GML is suggested to result from the origin of life from the chemical world, which was associated with the transition of the role of the main variable in the Arrhenius equation k = A x exp[-Ea/(R x T)] for the dependency of chemical disintegration on temperature from T to Ea upon the transition from molecular to multimolecular prebiotic entities. Thus, the generalized GML is not a result of biological evolution but is a sort of chemical legacy of biology, which makes an important condition for life to evolve.
Sharma, P; Busby, M; Chapple, L; Matthews, R; Chapple, I
Aim The primary research question addressed in this paper was 'are lower than average oral health scores observed for those patients who report problems with general health and high-risk lifestyle factors?'Methods A population analysis was conducted on the first 37,330 patients, assessed by 493 dentists in the UK, to receive a Denplan PreViser Patient Assessment (DEPPA) at their dental practice. The Oral Health Score (OHS) was generated using a mixture of patient-reported factors and clinical findings and is an integrated component of DEPPA. Patients' self-reported risk factors included diabetes status, tobacco use and alcohol consumption. Patients' general health was measured by self-report, that is, a yes/no answer to the question 'have you experienced any major health problems in the last year for example a stroke, heart attack or cancer?' Multivariable linear regression analysis was employed to study the association between the OHS and general health and risk factors for patients in the DEPPA cohort.Results The mean age of participants was 54 years (range 17-101; S.D. 16 years) and the mean OHS for the group was 78.4 (range 0-100; S.D. 10). 1,255 (3%) of patients reported experiencing a major health problem in the previous year. In the fully adjusted model, diabetes, tobacco use, excessive alcohol consumption (three or more drinks per day), and poor overall health in the preceding year were all associated with a statistically significant drop in the mean OHS of patients. Having diabetes was associated with a 1.7 point (95% CI 1.3-2.1, P <0.001) drop in OHS, tobacco use was associated with a 2.7 point (95% CI 2.5-2.9, P <0.001) drop in OHS, and excessive alcohol consumption was associated with a 1.8 point (95% CI 1.3-2.4, P <0.001) drop in OHS. The mean OHS in patients who reported a major health problem in the preceding year was 0.7 points (95% CI 0.2-1.2, P = 0.006) lower than that of patients who did not report a major health problem in the preceding year
Petkovska, Miodraga Stefanovska; Bojadziev, Marjan I.; Stefanovska, Vesna Velikj
AIM: The aim of the study is to analyze the internal consistency; validity and factor structure of the twelve item General Health Questionnaire for the Macedonian general population. MATERIAL AND METHODS: Data came from nationally representative sample of 1603 randomly selected Macedonians all aged 18 years or older. RESULTS: The mean GHQ score in the general sample was found to be 7.9 (SD = 4.3). The results revealed a higher GHQ score among women (M = 8.91, SD = 4.5) compared to men (M = 6.89; SD = 4.2). The participants from the rural areas obtained a lower GHQ score (M = 7.55, SD = 3.8) compared to participants coming from the urban areas (M = 9.37, SD = 4.1). The principal component analysis with oblique rotation (direct oblimin) with maximum likelihood procedure solution was performed and the results yielded a three factor solution which jointly accounted for 57.17% of the total variance: Factor I named social management (items 1, 3, 4, 6, 7 and 8); Factor II stress (items 2, 5 and 9) and Factor III named self-confidence (items 10, 11 and 12). Its factor structure is in line with representative research from other population groups. CONCLUSION: The GHQ-12 can be used effectively for assessment of the overall psychological well-being and detection of non-psychotic psychiatric problems among the Macedonian population. PMID:27275274
Holahan, Carole K.; Suzuki, Rie
This study investigated adulthood predictors of health-promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (Terman et al., 1925), who responded in 1999 at an average age of 86 to a mailout questionnaire which included questions concerning their positive health behavior. Adulthood variables were…
Szucs, Thomas D
Health economics has experienced a substantial rise within the healthcare industry over the past few years. Several disciplines have developed new techniques to evaluate the economic impact of pharmaceuticals in clinical care. Clinicians, pharmacists, economists, epidemiologists, and operations researchers have contributed to this field. Given the economic reality that resources are limited and needs and expectations are not infinite, medical economists try to find solutions on how these resources can be allocated optimally, to maximize the production of health or what society perceives as health. Health economists differentiate allocation efficiency and production efficiency. From the perspective of a health insurance plan allocation efficiency is reached when those drug classes or clinical programs are covered that will produce most health per expenditure. This requires a common monetary metric of health gains across the broad spectrum of diseases, conditions, and health outcomes. Once it is decided to cover a specific treatment or clinical program, economists try to identify the most cost-effective product within a class of comparable choices using cost-effectiveness and cost-utility analyses. Both allocation and production efficiency are two critically important concepts for the economic success of biotech products. This article will provide a rationale why health economics is critically important for the future of healthcare and explains fundamental economic tools for evaluating products and services with special emphasis on gene-derived technologies.
In Costa Rica, three sequential health paradigms have been identified over the last 50 years. The first began to develop during the 40's and has been called that of the deficiency diseases, since with a diachronic approach it placed excessive emphasis on malnutrition. The second began in 1970 and it is known as that of the infectious diseases, since through a holistic or synchronic approach, it underlined the importance of infections in high rates of morbidity and mortality. The third and last is the paradigm of the chronic diseases, it appeared in the 80's and is presently in process, doing battle with the chronic ailments, life styles, and environment, and it also utilizes a holistic approach. The recognition of these three paradigms has permitted Costa Rica a rapid advance in improving the health of its population, to the point that with a per capita outlay of $130 (US dollars), it has indices similar to those of the industrialized nations. This particular experience could be useful for other less-developed countries that are still applying the paradigm of the deficiency diseases.
Bauger, Lars; Bongaardt, Rob
In response to the ever-increasing longevity in Western societies, old age has been divided into two different periods, labelled the third and fourth age. Where the third age, with its onset at retirement, mostly involves positive aspects of growing old, the fourth age involves functional decline and increased morbidity. This article focuses on the entry to the third age and its potential for health promotion initiatives. Well-being is an important factor to emphasize in such health promotion, and this article views the lifestyle of third agers as essential for their well-being. The structural developmental theory of Robert Kegan delineates how a person's way of knowing develops throughout the life course. This theory is an untapped and salient perspective for health promotion initiatives in the third age. This article outlines Kegan's approach as a tool for developing psychologically spacious health promotion, and suggests future directions for research on the topic.
Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E
Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.
Segurado, Ricardo; McAuliffe, Fionnuala M.; Kelleher, Cecily C.
Numerous studies have identified the effects of prematurity on the neonate’s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000–2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children’s general health and severity of behavior problems. The association between parent’s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32–36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%–6.2%), compared to 1% (0.2–2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048
Joska, J A; Sorsdahl, K R
Mental disorders are highly prevalent across all health settings. Where they are co-morbid with other chronic physical disorders, a complex bidirectional relationship exists between them. While mental disorders may result in an increase in adverse healthrelated outcomes, they are amenable to cost-effective treatments. In resource-limited settings, many barriers to the detection and treatment of mental disorders exist. One approach to the effective targeting of the available resources is to utilize a "risk-flag" approach, wherein individuals at-risk of treatment failure are identified and routed into more intensive mental health screening and intervention. This paper discusses how lessons from HIV services may inform how to improve mental health care and integration in HIV settings, as well as in other chronic diseases.
Marshall, Victor W; Altpeter, Mary
The rapid growth of the population of older adults and their concomitant physical status and health needs have captured the attention, collaboration, and funding support of an array of leaders in the fields of aging and health care. To help fill the void of literature available to social workers interested in health promotion and aging, the authors provide a conceptual clarification of the meaning of health and explain how health is a resource for optimal living and not merely the absence of disease. The authors analyze frameworks of health promotion and suggest that the ecological approach provides the ideal framework for devising successful strategies in the area of aging. Finally, using the example of promoting physical activity as a healthy aging strategy, they detail eight ways that social workers can provide leadership in promoting positive health in later life.
Zahner, G E; Daskalakis, C
OBJECTIVES: This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school. METHODS: Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression. RESULTS: Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8). CONCLUSIONS: Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children. PMID:9314794
Dominicans are one of the fastest growing Hispanic subgroups in the United States, and they are greatly affected by type 2 diabetes. Health literacy and general literacy are critical components in diabetes self-management given that type 2 diabetes is a disease that relies heavily on a person having the skills needed to actively participate in their diabetes care. Three PubMed searches were conducted using search words Dominicans, Hispanics, diabetes, type 2 diabetes, diabetes education, health literacy, and literacy. These searches were based on published articles completed from January 2000 to May 2012. There were 14 articles reviewed. Eight articles were eliminated from the 3 literature searches. These findings show a lack of data and research on Dominicans with diabetes and on health literacy and general literacy among this Hispanic subgroup. Qualitative and quantitative studies are urgently needed to examine diabetes in Dominicans and the impact health literacy and general literacy have on diabetes health outcomes in this Hispanic subgroup.
Becker, Craig M.; Johnson, Hans; Vail-Smith, Karen; Maahs-Fladung, Cathy; Tavasso, Debra; Elmore, Barry; Blumell, Charla
Revisions of general education curricula have been ongoing as universities strive to meet the general education goal of helping students succeed. The importance of health status with regard to the future health potential of college students and the impact the college years have on their health has been highlighted in the American College Health…
De Martinis, Massimo; Sirufo, Maria Maddalena; Ginaldi, Lia
Allergy reactions are the most common immunological diseases and represent one of the most widespread and fast growing chronic human health problems among people over 15 years of age in developed countries. As populations get older worldwide, allergy manifestations in aged persons will occur more often in the future. To date, there has been much more studies on allergies in children than in adults. As the population ages, clinicians must be prepared to meet all the elderly's health care needs, including these new and emerging health issue. Allergic diseases represent an old/new emerging health issue. Because many common illnesses masquerade as atopic disease, the differential diagnosis of suspected allergic diseases becomes more expanded in an aging population. Research in the field needs to focus on both human and animal model systems to investigate the impact of the aging process on the immunologic pathways underpinning allergy and its different facets.
Doi, Yuriko; Minowa, Masumi
The 12-item General Health Questionnaire (GHQ-12) has been extensively used in a variety of settings across countries. The main aim of the present study was to assess the factor structure of the GHQ-12 for the Japanese general adult population. Data came from a sample of 1808 Japanese aged 20 years or older who were randomly selected based on the 1995 census (897 men and 911 women). Cronbach's alpha coefficients were 0.83 for men and 0.85 for women. Overall, the corrected item-total correlation coefficients were >0.20 for both genders. The GHQ-12 yielded a two-factor solution of psychological distress (items 2, 5, 6, 9, 10 and 11) and social dysfunction (items 1, 3, 4, 7 and 8), which jointly accounted for 49.1% of the total variance, for women. Item 12 on happiness was not discernable. For men, item 12 was separated from a social dysfunction factor and yielded the third factor with item 3 on social role, and the three factors jointly accounted for 57.6%. The results of the present study suggest that the GHQ-12 can be used as an internally reliable and homogeneous scale that produces mainly the factors of psychological distress and social dysfunction. Item 12 may be structurally different in the case of Japanese adults.
Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H
Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health.
Katsoulis, Joannis; Huber, Sandra; Mericske-Stern, Regina
Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living
... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of the body such that it does not function properly (e.g., cardiovascular disease), or a state...
... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of the body such that it does not function properly (e.g., cardiovascular disease), or a state...
... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of the body such that it does not function properly (e.g., cardiovascular disease), or a state...
The 1986 "Le General de Sanidad" (Sanitary General Regulations) has been studied using the method of the "Topología del Discurso" in order to elucidate what are the thoughts of the lawmakers. The law protects not only the population of catastrophes as it happened with the choleric epidemic of the XIX century, but considers a new concept a sanitary wealth should be provided to the individuals. Together with this new concept there are new ones such as equality and universalization of the sanitary assistence that would be keys of the aim of the lawmakers: to coordinate all the State resources in the reform of the spanish sanity. This includes the integration of the Universities. This can help in the understanding of the dificulties in the development and aplication of the Law present reality.
Emami, Elham; de Souza, Raphael Freitas; Kabawat, Marla; Feine, Jocelyne S.
An adequate dentition is of importance for well-being and life quality. Despite advances in preventive dentistry, edentulism is still a major public health problem worldwide. In this narrative review, we provide a perspective on the pathways that link oral to general health. A better understanding of disease indicators is necessary for establishing a solid strategy through an organized oral health care system to prevent and treat this morbid chronic condition. PMID:23737789
Xu, Wei; Cai, Gong–Jie; Li, Guan–Nan; Cao, Jing–Jing; Shi, Qiong–Hua; Bai, Jie
Background The New Cooperative Medical Scheme (NCMS) for peasantries implemented in 2003 and the Urban Resident Basic Medical Insurance (URBMI) for the urban unemployed implemented in 2007 have many similarities. They both apply the financing mode of individual premiums plus government’s subsidies, and the voluntary enrollment. The Chinese government plans to integrate these two systems and build a unified basic medical insurance system for the unemployed in order to achieve the medical equity and increase the general health level. Thus, to analyze the main influencing factors of the enrollment of the urban unemployed and rural residents is very important for improving the system and securing the stability of the system during the transition. Methods The study uses data from the China Health and Nutrition Survey (CHNS) and adopts logistic regression models to test which factors influence the enrollment of the URBMI and the NCMS under the background of rather high enrollment rate of Chinese basic medical insurances and strong fiscal support of the Chinese government, especially whether health status or age influences enrollment of these two insurances greater. Results There is indeed some adverse selection in the URBMI and the NCMS. Whether the individual has chronic diseases have significant influence on enrollments of both the urban unemployed and rural residents, while whether the individual got ill in last four weeks just influences enrollments of the urban unemployed. Age influences enrollment greater than health status. The older the insured are, the larger the enrollment rates are. Conclusion Because of the active support for basic medical insurances of the Chinese government, the enrollment performance of the urban unemployed and rural residents has already changed. When implementing the new policy, the government should pay attention to the willingness to enroll in and the change of enrollment performance of the insured. Therefore, under the policy of
Schewe, C D; Spotts, H E
The health-care marketplace is aging by leaps and bounds and bringing with it new and different medical needs. As costs soar and public assistance programs dwindle in impact, health-care providers will need better marketing strategies to bring treatments to patients/consumers. This article looks at the research findings of behavioral scientists and offers guidelines for effective communication with aging audiences. Health-care providers can use these findings to design more effective advertising, promotional brochures, newsletters, and a host of other communication tools targeted at an older market. Health-care managers and other professionals should find the guidelines useful in their daily interactions with patients and colleagues.
Allegrini, Paolo; Aquino, Gerardo; Grigolini, Paolo; Palatella, Luigi; Rosa, Angelo
We discuss the problem of the equivalence between continuous-time random walk (CTRW) and generalized master equation (GME). The walker, making instantaneous jumps from one site of the lattice to another, resides in each site for extended times. The sojourn times have a distribution density psi(t) that is assumed to be an inverse power law with the power index micro. We assume that the Onsager principle is fulfilled, and we use this assumption to establish a complete equivalence between GME and the Montroll-Weiss CTRW. We prove that this equivalence is confined to the case where psi(t) is an exponential. We argue that is so because the Montroll-Weiss CTRW, as recently proved by Barkai [E. Barkai, Phys. Rev. Lett. 90, 104101 (2003)], is nonstationary, thereby implying aging, while the Onsager principle is valid only in the case of fully aged systems. The case of a Poisson distribution of sojourn times is the only one with no aging associated to it, and consequently with no need to establish special initial conditions to fulfill the Onsager principle. We consider the case of a dichotomous fluctuation, and we prove that the Onsager principle is fulfilled for any form of regression to equilibrium provided that the stationary condition holds true. We set the stationary condition on both the CTRW and the GME, thereby creating a condition of total equivalence, regardless of the nature of the waiting-time distribution. As a consequence of this procedure we create a GME that is a bona fide master equation, in spite of being non-Markov. We note that the memory kernel of the GME affords information on the interaction between system of interest and its bath. The Poisson case yields a bath with infinitely fast fluctuations. We argue that departing from the Poisson form has the effect of creating a condition of infinite memory and that these results might be useful to shed light on the problem of how to unravel non-Markov quantum master equations.
Raymo, James M.; Liang, Jersey; Kobayashi, Erika; Sugihara, Yoko; Fukaya, Taro
In this paper, we investigate ways in which the relationship between health and labor force exit at older ages is moderated by family characteristics. Using two waves of data from a national sample of older Japanese men collected 1999 and 2002, we estimate logistic regression models for labor force exit beyond age 63 as a function of health change, family characteristics, and their interactions. We confirm that poor health is strongly associated with labor force exit and find evidence that moderating influences of family context depend upon the level of health. However, results are only partially consistent with hypotheses that the relationship between health and the likelihood of labor force exit should be stronger for (a) those with good health and family incentives to exit the labor force and (b) those with poor health and family incentives to remain in the labor force. PMID:23082037
DeVan, Allison E.; Seals, Douglas R.
The demographics of ageing are changing dramatically such that there will be many more older adults in the near future. This setting likely will produce a new “boomer-driven” epidemic of physiological dysfunction, disability and risk of chronic degenerative disorders, including cardiovascular diseases (CVD). Standing out against this dreary biomedical forecast are Masters athletes, a group of middle-aged and older adults who engage in regular vigorous physical training and competitive sport. Compared with their sedentary/less active (untrained) peers, Masters athletes who perform endurance training-based activities demonstrate a more favorable arterial function-structure phenotype, including lower large elastic artery stiffness, enhanced vascular endothelial function and less arterial wall hypertrophy. As such, they may represent an exemplary model of healthy or “successful” vascular ageing. In contrast, Masters athletes engaged primarily/exclusively in intensive resistance training exhibit less favorable arterial function-structure than their endurance-trained peers and, in some instances, untrained adults. These different arterial properties likely are explained in large part by the different intravascular mechanical forces generated during endurance vs. resistance exercise-related training activities. The more favorable arterial function-structure profile of Masters endurance athletes may contribute to their low risk of clinical CVD. PMID:22266948
Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.
... as you age. Here's how to keep the flame burning. By Mayo Clinic Staff Sexual health is ... Accessed June 3, 2014. Cunningham GR, et al. Treatment of male sexual dysfunction. http://www.uptodate.com/ ...
Molavi, Razieh; Alavi, Mousa; Keshvari, Mahrokh
Background: Self-esteem is known to be one of the most important markers of successful aging. Older people's self-esteem is influenced by several factors that particularly may be health related. Therefore, this study aimed to explore some important general health-related predictors of the older people's self-esteem. Materials and Methods: In this study, 200 people, aged 65 years and older, who referred to health care centers were selected through stratified random sampling method. Data were collected by using Rosenberg's self-esteem scale and the 28-item Goldberg's general health questionnaire. Data were analyzed by Pearson's coefficient tests and multiple regression analysis. Results: Findings showed that the entered predictor variables accounted for 49% of the total variance (R2) of self-esteem in the model (P < 0.001, F4,195 = 46.717). Three out of the four predictor variables including somatic signs, anxiety/insomnia, and depression, significantly predicted the self-esteem. The results emphasized on the determinant role of both physical (somatic signs) and mental (anxiety/insomnia and depression) aspects of health in older patients’ self-esteem. Conclusions: The significant general health-related predictors found in the present study emphasize on some of the significant points that should be considered in planning for improving older patients’ self-esteem. PMID:26793259
Dogra, Shilpa; Al-Sahab, Ban; Manson, James; Tamim, Hala
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.
Park, Jungsun; Park, Jong-Tae; Kim, Soo Geun; Yoo, Cheol-In; Son, Junseok; Yim, Jun; Kim, Dae-Seong; Rhee, Kyung Young; Kim, Yangho
The rapid aging trend in South Korea will cause a growing shortage of labor and decreasing quality of the labor force. The purpose of this commentary is to recommend a health care strategy to maintain and promote the work ability of employees in an aging Korea. Strategies to promote the work ability require the collaboration of governmental agencies at the central and local levels. First, the common goal should be the reinforcement of follow-up measure in general medical examinations and the promotion of healthy lifestyles for workers. Second, collaborating activities should be performed among the Worker's Health Center, the Health Promotion Center, and community health centers. In conclusion, health care strategies for ensuring the work ability in an aging Korea require the collaboration of governmental agencies at the central and local levels.
Johnson, Simon C; Sangesland, Maya; Kaeberlein, Matt; Rabinovitch, Peter S
The physiological responses to nutrient availability play a central role in aging and disease. Genetic and pharmacological studies have identified highly conserved cellular signaling pathways that influence aging by regulating the interface between nutrient and hormone cues and cellular growth and maintenance. Among these pathways, the mechanistic target of rapamycin (mTOR) has been most reproducibly shown to modulate aging in evolutionarily diverse organisms as reduction in mTOR activity extends life span from yeast to rodents. mTOR has been shown to play a role in a broad range of diseases, and is of particular interest to human health and aging due to the availability of clinically approved pharmacological agents targeting the mTOR complexes and other components of the mTOR signaling network. Characterizing the role of mTOR in aging and health promises to provide new avenues for intervention in human aging and disease through modulation of this signaling pathway.
Babaei, Samaneh; Varandi, Shahryar Ranjbar; Hatami, Zohre; Gharechahi, Maryam
Objectives: The present study was conducted to investigate the role of metacognition beliefs and general health in alexithymia in Iranian students. Methods: This descriptive and correlational study included 200 participants of high schools students, selected randomly from students of two cities (Sari and Dargaz), Iran. Metacognitive Strategies Questionnaire (MCQ-30); the General Health Questionnaire (GHQ) and Farsi Version of the Toronto Alexithymia Scale (TAS-20) were used for gathering the data. Using the Pearson’s correlation method and regression, the data were analyzed. Results: The findings indicated significant positive relationships between alexithymia and all subscales of general health. The highest correlation was between alexithymia and anxiety subscale (r=0.36, P<0.01). Also, there was a significant negative relationship between alexithymia and some metacognitive strategies. The highest significant negative relationship was seen between alexithymia and the sub-scale of risk uncontrollability (r=-0.359, P < 0.01). Based on the results of multiple regressions, three predictors explained 21% of the variance (R2=0. 21, F=7.238, P<0.01). It was found that anxiety subscale of General Health significantly predicted 13% of the variance of alexithymia (β=0.36, P<0.01) and risk uncontrollability subscale of Metacognition beliefs predicted about 8% of the variance of alexithymia (β=-0.028, P<0.01). Conclusions: The findings demonstrated that metacognition beliefs and general health had important role in predicting of alexithymia in students. PMID:26383206
Douglass, Carolinda; Henry, Beverly W.; Kostiwa, Irene M.
The Aging Game, a simulation activity, has been used successfully with medical students in the development of empathetic attitudes toward older adults. To date, the Aging Game has not been used extensively with allied health students. It has been viewed as too costly, time-consuming and labor-intensive. The purpose of this study was to examine the…
The United States Commissioner on Aging describes challenges posed by the increasing size of the older adult population, outlines gaps in knowledge regarding aging and the elderly, and calls for greater collaboration between the elderly and existing mental health networks. (AOS)
Perry, Gloria R.
Classes on lifestyling for the promotion of health for the elderly were offered to a senior citizens' group in a community center setting. The objectives of the sessions were: (1) to teach the importance of health maintenance and primary prevention throughout the aging process; (2) to disseminate information relative to diet, exercise, and stress…
Koutsogeorgou, Eleni; Davies, John Kenneth; Aranda, Kay; Zissi, Anastasia; Chatzikou, Maria; Cerniauskaite, Milda; Quintas, Rui; Raggi, Alberto; Leonardi, Matilde
Objectives: This paper examines the context of health promotion actions that are focused on/contributing to strengthening social capital by increasing community participation, reciprocal trust and support as the means to achieve better health and more active ageing. Method: The methodology employed was a literature review/research synthesis, and a…
de Figueiredo, João Paulo; Cardoso, Salvador Massano
OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and
Brownell, Kelly D.
Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity. PMID:21233428
Pomeranz, Jennifer L; Brownell, Kelly D
Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity.
Fernandes Antunes, Adelio; Xu, Ke; James, Chris D; Saksena, Priyanka; Van de Maele, Nathalie; Carrin, Guy; Evans, David B
There has been recent controversy about whether aid directed specifically to health has caused recipient governments to reallocate their own funds to non-health areas. At the same time, general budget support (GBS) has been increasing. GBS allows governments to set their own priorities, but little is known about how these additional resources are subsequently used. This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources. Finally, increases in total government expenditure led to substantial increases in domestic government health expenditures.
Beard, John R; Officer, Alana; de Carvalho, Islene Araujo; Sadana, Ritu; Pot, Anne Margriet; Michel, Jean-Pierre; Lloyd-Sherlock, Peter; Epping-Jordan, JoAnne E; Peeters, G M E E Geeske; Mahanani, Wahyu Retno; Thiyagarajan, Jotheeswaran Amuthavalli; Chatterji, Somnath
Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. This Health Policy highlights key findings and recommendations from the report.
Joyce, Kelly; Loe, Meika
Abstract This special monograph issue builds on sociology of health and illness scholarship and expands the analytical lens to examine how old people, healthcare professionals, and technology designers create, use, and modify science and technology to negotiate and define health and illness. Far from passive consumers, elders are technogenarians, creatively utilising and adapting technological artefacts such as walking aids and medications to fit their needs. This publication adds theoretical and empirical depth to our understanding of the multiple and overlapping socio-historical contexts surrounding ageing bodies and ageing enterprises, including the biomedicalisation of ageing that includes the rise of anti-ageing or longevity medicine; and the rise of gerontechnology industries and professions -- fields that largely accept the ageing body as a given. This collection sociologically investigates how and where these two trends overlap and diverge in relation to a global context of ageing and ageism, and calls for further scholarship in this area. Combining science and technology studies and sociology of health and illness frameworks together provides an empirical basis from which to analyse technogenarians in action, as well as the stakeholders and institutions involved in the ageing, health, and technology matrix.
This document presents the text of health legislation approved in Mexico on December 23, 1986, setting forth ethical issues and professional responsibilities in the area of health research. Health research is conceptualized as activities that contribute to knowledge regarding biological and physiological processes in humans; knowledge of the links between the causes of disease, medical practice, and social structures; prevention and control of health problems; evaluation of the harmful effects of the environment on health; the study of techniques recommended or used for the delivery of health services; and the production of goods for the health sector. Title 1 of these regulations outlines responsibilities of the Secretariat of Health and calls for the establishment of an Inter-Institutional Commission on Health Research. Title II defines ethical aspects of research on human subjects, with separate provisions for research involving minors, incompetent persons, women of childbearing age, pregnant women, women during labor or childbirth, nursing mothers, embryos, stillborn fetuses, and cadavers. In general, research is permissible on human subjects only if it confers health benefits and carries minimal risks. Title III sets forth regulations on research on new prophylactic, diagnostic, therapeutic, and rehabilitative methods, while Title IV concerns the biosafety of research. Clinical research in the field of pharmacology must include 4 phases preceded by full preclinical studies. Finally, Title V of this legislation defines the duties of internal committees in health institutions.
A functional and socially acceptable level of oral health is an integral part of healthy ageing! More teeth, more sophisticated dental technology and increasing co-morbidities of an ageing Australian society will have significant impacts on oral health professionals and their capacities to work within expanded teams of health, education and social organizations. Society is adapting its perspective on the social role of older citizens; replacing its perception of the elderly as an economic social burden, to one of senior citizens as being a respected and active source of social and economic benefit. Maintaining general and oral health for older Australians will bring into sharp focus the need for recognizing and managing not only the biological markers associated with ageing and frailty, but also the potential mediators on health outcomes associated with changing health and social behaviours. Increasing social capital of older Australians through national policy initiatives such as the Living Longer Living Better reforms, and greater involvement of allied health and carers' organizations in oral health education and health promotion will set a new scene for the roles of dental professionals. Issues of equity will drive the service delivery agenda, and a socio-cultural shift to 'consumer-directed' health outcomes will shape the range of services, quality of care and support required by an older Australian population. Formal education and training modules for aged care workers, allied health practitioners and geriatricians will develop. The challenge for the dental profession is the coordination and integration of these changes into new models of dental and general health care.
Wurm, S; Wiest, M; Tesch-Römer, C
The present paper starts by introducing different perspectives of the aging process and includes biological, psychological, and sociological theories in its scope. The article addresses the issue of when "old age" begins and why a distinction is made between the third and fourth age. With increasing age, it becomes more and more difficult to differentiate between health-related losses due to illnesses or to aging. However, this can be important with respect to health behavior and health care. Having the best possible health in old age is an important factor for a good life in old age. Over their whole lives, from childhood to old age, people can actively contribute to their health in old age. But health is not the sole criterion for a good life in old age. Having interests and aims are just as important as being integrated in a social network. In old age, people often differ greatly and this is why there is such variety in what people consider to constitute a good life for themselves in old age.
Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang
The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries. PMID:26816664
Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang
The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries.
Hoy-Ellis, Charles P.; Ator, Michael; Kerr, Christopher; Milford, Jessica
LGBTQ older adults have higher levels of psychological distress as compared to older adults in general. They also experience multiple barriers to accessing equitable, culturally competent mental health and aging services because of their distinct histories and particular social contexts. This article discusses this lack of access to services, and highlights an innovative way mental health services are being delivered in LGBTQ communities. PMID:28366982
Verhaak, Peter F. M.; van Dijk, Christel E.; Nuijen, Jasper; Verheij, Robert A.; Schellevis, Francois G.
Objective In the field of mental health care, a major role for general practice is advocated. However, not much is known about the treatment and referral of mental health problems in general practice. This study aims at the volume and nature of treatment of mental health problems in general practice; the degree to which treatment varies according to patients’ gender, age, and social economic status; and trends in treatment and referral between 2004 and 2008. Design/setting Descriptive study with trends in time in general practice in the Netherlands. Subjects 350,000 patients enlisted in general practice, whose data from the Netherlands Information Network of General Practice were routinely collected from 1 January 2004 to 31 December 2008. Main outcome measures For all episodes of mental health problems recorded by the GP, the proportion of patients receiving prolonged attention, medication, and referral during each year have been calculated. Results More than 75% of patients with a recorded mental health problem received some kind of treatment, most often medication. In 15–20% of cases medication was accompanied by prolonged attention; 9–13% of these patients were referred (given referrals), the majority to specialized mental health care. Age is the most important variable associated with treatment received. During the period 2004–2008, treatment with medication declined slightly and referrals increased slightly. Conclusion Treatment for psychological disorders is mostly delivered in general practice. Although in recent years restraint has been advocated in prescribing medication and collaboration between primary and secondary care has been recommended, these recommendations are only partially reflected in the treatment provided. PMID:22794194
Web Feet, 2002
Presents an annotated list of Web site educational resources kindergarten through eighth grade. The Web sites this month cover the following subjects: countries (general); electricity; geography; health; children's literature; and plants. Includes a list of "Calendar Connections" to Web site sources of information on Earth Day in April…
Wong, Rebeca; Michaels-Obregón, Alejandra; Palloni, Alberto; Gutiérrez-Robledo, Luis Miguel; González-González, César; López-Ortega, Mariana; Téllez-Rojo, Martha María; Mendoza-Alvarado, Laura Rosario
Objective To describe the third wave of the Mexican Health and Aging Study (MHAS), completed in 2012, and present preliminary results. Materials and methods Descriptive analyses by gender and age group of demographic and socioeconomic characteristics, health conditions and health behaviors, as well as social support and life satisfaction measures are presented. In addition, external validations are presented by comparing MHAS 2012 indicators with other national data sources. Results For the panel of older adults in the sample, the rate of health care insurance coverage increased greatly between 2001 and 2012, a significantly higher change in rural compared to urban areas. The results for 2012 are consistent with the previous two waves for the main indicators of health and physical disability prevalence, risk factors, and behaviors. Conclusions The MHAS offers a unique opportunity to study aging in Mexico, as well as to complete cross-national comparisons. The cumulative number of deaths in the cohort should support the study of mortality and its association with health outcomes and behaviors over the life cycle. In addition, the sub-samples of objective markers will enable methodological research on self-reports and associations of biomarkers in old age with similar health outcomes and behaviors. PMID:26172238
Thompson, Hilaire J.; Voss, Joachim G.
This article focuses on a synthesis of knowledge about healthy aging research in human beings and then synthesized nurse-led research in gerontology and geriatrics that use biomarkers. Healthy aging research has attracted considerable attention in the biomedical and basic sciences within the context of four major areas: (a) genetic variations as an expression of successful or unsuccessful aging; (b) caloric restriction as an intervention to slow the progression of aging; (c) immunological aging; (d) neurobiology of the aging brain. A systematic review of the literature was performed to identify nurse-led geriatric-related biomarker research. Nurse researchers who have chosen to integrate biomarkers as part of their research studies have been working in six focal areas, which are reviewed: health promotion within risk populations, cancer, vascular disease, Alzheimer’s disease, caregiving, and complementary therapies. The article provides a discussion of contributions to date, identifying existing gaps and future research opportunities. PMID:20077975
Vvedenskaia, E S; Kobzeva, L F; Vvedenskaia, I I
The article presents a detailed analysis of health care provision to both general and retirement age population (RAP) in the Nizhny Novgorod region. For the past 10 years, the organization and use of different types of health care for RAP have not changed. The availability of inpatient health care for RAP is high whereas the availability of nursing and outpatient health care is low and palliative care service is not available. In order to enhance availability and ensure quality of medical services it is necessary to implement restructuring of health care for RAP at the municipal level herewith a key attention will be paid to out-patient types of health care expansion and palliative care development. The authors formulate some proposals aimed at improving the organization of medical and social care for RAP which should be included in the health care restructuring program at the municipal level.
Matzel, Louis D.; Grossman, Henya; Light, Kenneth; Townsend, David; Kolata, Stefan
A defining characteristic of age-related cognitive decline is a deficit in general cognitive performance. Here we use a testing and analysis regimen that allows us to characterize the general learning abilities of young (3-5 mo old) and aged (19-21 mo old) male and female Balb/C mice. Animals' performance was assessed on a battery of seven diverse…
Guralnik, Jack M.; Jackson, Richard J.; Marottoli, Richard A.; Phelan, Elizabeth A.; Prohaska, Thomas R.
Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms. PMID:22698013
Surgeon General Thomas Parran Jr was once viewed as a path-breaking leader, but his legacy is now highly contested. Scholars of national health insurance have viewed Parran as an impediment to government-backed insurance, and revelations about his role in the Tuskegee Study and in the Public Health Service's experiments in Guatemala have cast a shadow over his career. Surgeon General from 1936 to 1948, Parran led the Public Health Service during the development of key features of the modern American health system and was involved in critical debates over the role of the national government in health. I argue that Parran is best understood not as an opponent of insurance but as the proponent of an approach to health policy that sought to link public health and individual medicine. A pragmatic bureaucrat, Parran believed that effective policymaking required compromise with the American Medical Association.
Hou, Zheng-kun; Liu, Feng-bin; Yang, Yun-ying; Chen, Xin-lin; Li, Li-juan; Li, Pei-wu; Liu, Yuan-peng
Nowadays, the simple combination of Western medicine (WM) and complementary and alternative medicine (CAM) cannot resolve all the health problems and various requirements. This article proposed the general integral medicine (GIM) theoretical model, which declares the disease causes analysis, clinical intervention and outcomes assessment should be recognized, managed and evaluated both from physiological, psychological, and spiritual status, and all the four dimensions: orthodox medicine (WM, Chinese medicine, etc.), individual inherent characteristics (emotion, attitude, psychology, etc.), cultural influences (doctors, caregivers, groups care, etc.), and natural environment and social systems (economic status, social security system, environmental pollution, etc). As for health outcomes assessment, a more comprehensive system including biological, doctors, patients, health intimate, social and environmental evaluations were required. The GIM model has individualized, dynamic, standardized, objective, systematic inherent characteristics, and opening and compatible external characteristics. It aims to provide the new theoretical guidance and strategic development direction for complex health interventions, and solve various medical related psychological and social problems.
Papathanasiou, Ioanna V.; Kleisiaris, Christos F.; Tsaras, Konstantinos; Fradelos, Evangelos C.; Kourkouta, Lambrini
Background: General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. Aim: The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. Methods: The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values < 0.05 were defined as reflecting the acceptable level of statistical significance. Results: 457 healthcare workers completed the questionnaire. The mean age of the sample was 41.8 ± 7.9 years. The Cronbach alpha coefficient for GSQ was 0.79. The total mean score of general satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, p<0.01) and therefore the two groups of healthcare workers feel different general satisfaction. Conclusions: Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients. PMID:26543410
Ryan, Rob; Garlick, Robyn; Happell, Brenda
There is currently considerable discussion about the impact of the aging population on the demand for health care services, however there is considerably less attention paid to the impact of mental health issues on the needs of the aged population. Nurses comprise the largest professional group within the mental health workforce in Australia. The availability of a high quality mental health nursing workforce will therefore be crucial to meeting the health needs of aging clients in the future, accompanied by an increased pressure to increase the proportion of care delivered in the community. There is however, a paucity of literature on the role and contribution of community mental health nurses specialising in the aged care field. The aim of this paper is to present the findings of a project designed to examine the role of mental health nursing within aged persons' community mental health teams in Victoria, Australia, with particular emphasis on the biopsychosocial interventions used. Fifteen participants from three community mental health services in Victoria participated in a focus group interview to share their insights and experiences. Data analysis revealed two main themes, the role of the nurse, and the specific functions of the nurse. This data is presented as a beginning contribution to the paucity of literature currently available in this important area.
Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund; Bech, Bodil Hammer; Vestergaard, Mogens; Flarup, Kaare Rud; Fenger-Grøn, Morten
Background The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. Objectives To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. Materials and methods The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. Results The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18–34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. Conclusion We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research. PMID
Tansella, M; Bellantuono, C
The main features of the psychiatric system and of the general practice system in Italy since the psychiatric reform and the introduction of a national health service are briefly described. Research conducted in Italy confirms that a large proportion of patients seen by general practitioners have psychological disorders and that only some of those patients whose psychological problems are identified by general practitioners are referred to specialist psychiatric care. Thus, the need to identify the best model of collaboration between psychiatric services and general practice services is becoming increasingly urgent. The chances of improving links between the two services and of developing a satisfactory liaison model are probably greater in countries such as Italy where psychiatric services are highly decentralized and community-based, than in countries where the psychiatric services are hospital-based. PMID:1807308
The paper analyzes the situation of the psychiatric reform 25 years of the General Health Law. The author wonders what has been done and what has been left undone, on the degree of implementation of the Community model that adopts the law and its future sustainability. It highlights, among the strengths, the loss of hegemony of the psychiatric hospital and the great development of alternative resources, and seeks to explain the reason for the inadequacies of care, policy and training, as well as threats: the changes in the management of social and health services, increased privatization of services, the theoretical impoverishment and changing demands of the population.
Hanna, Gay Powell; Noelker, Linda S; Bienvenu, Beth
In advance of the White House Conference on Aging (WHCoA) in 1981, 1995, and 2005, the arts and aging communities held mini-conferences to ensure that arts, culture, and livability were part of larger public policy discussions. This article takes a historical look at recommendations from the 2005 WHCoA Mini-Conference on Creativity and Aging in America, including arts in health care, lifelong learning, and livability through universal design. Overarching recommendations in 2005 requested investments in research, including cost-benefit analyses; identification of best practices and model programs; program dissemination to broaden the availability of arts programs. The "Arts" is a broad term encompassing all forms of arts including music, theater, dance, visual arts, literature, multimedia and design, folk, and traditional arts to engage the participation of all older Americans; promotion of innovative public and private partnerships to support arts program development, including workforce development (e.g., artists, social workers, and health care providers); and public awareness of the importance of arts participation to healthy aging. Through the leadership of the National Endowment for the Arts and U.S. Department of Health and Human Services, thinking about the arts and aging has broadened to include greater emphasis on a whole-person approach to the health and well-being of older adults. This approach engages older adults in arts participation not only as audience members, but as vital members of their community through creative expression focusing on life stories for intergenerational as well as interprofessional collaboration. This article reviews progress made to date and identifies critical gaps in services for future consideration at a 2015 Mini-Conference on Creativity and Aging related to the WCHoA area of emphasis on healthy aging.
Habes, Mohamad; Erus, Guray; Toledo, Jon B; Zhang, Tianhao; Bryan, Nick; Launer, Lenore J; Rosseel, Yves; Janowitz, Deborah; Doshi, Jimit; Van der Auwera, Sandra; von Sarnowski, Bettina; Hegenscheid, Katrin; Hosten, Norbert; Homuth, Georg; Völzke, Henry; Schminke, Ulf; Hoffmann, Wolfgang; Grabe, Hans J; Davatzikos, Christos
White matter hyperintensities are associated with increased risk of dementia and cognitive decline. The current study investigates the relationship between white matter hyperintensities burden and patterns of brain atrophy associated with brain ageing and Alzheimer's disease in a large populatison-based sample (n = 2367) encompassing a wide age range (20-90 years), from the Study of Health in Pomerania. We quantified white matter hyperintensities using automated segmentation and summarized atrophy patterns using machine learning methods resulting in two indices: the SPARE-BA index (capturing age-related brain atrophy), and the SPARE-AD index (previously developed to capture patterns of atrophy found in patients with Alzheimer's disease). A characteristic pattern of age-related accumulation of white matter hyperintensities in both periventricular and deep white matter areas was found. Individuals with high white matter hyperintensities burden showed significantly (P < 0.0001) lower SPARE-BA and higher SPARE-AD values compared to those with low white matter hyperintensities burden, indicating that the former had more patterns of atrophy in brain regions typically affected by ageing and Alzheimer's disease dementia. To investigate a possibly causal role of white matter hyperintensities, structural equation modelling was used to quantify the effect of Framingham cardiovascular disease risk score and white matter hyperintensities burden on SPARE-BA, revealing a statistically significant (P < 0.0001) causal relationship between them. Structural equation modelling showed that the age effect on SPARE-BA was mediated by white matter hyperintensities and cardiovascular risk score each explaining 10.4% and 21.6% of the variance, respectively. The direct age effect explained 70.2% of the SPARE-BA variance. Only white matter hyperintensities significantly mediated the age effect on SPARE-AD explaining 32.8% of the variance. The direct age effect explained 66.0% of the SPARE
Madey, Scott F.; Chasteen, Alison L.
This experiment investigated how age-related health stereotypes affect people's judgments of younger and older patients' medical compliance. Previous research has shown that stereotypes of young adults include healthy components, but stereotypes of older adults include both healthy and unhealthy components (Hummert, 1990). We predicted that…
Ricciardi, Walter; Specchia, Maria Lucia; Marino, Marta
Population ageing is a major challenge for European Union (EU) society and economy, particularly for Italy, which is the oldest country in Europe. According to the World Health Organization, two-thirds of European citizens who have reached the retirement age suffer from at least two chronic conditions, with a strong pressure on healthcare systems. Moreover, EU countries already spend, on average, more than a quarter of their gross domestic product on social protection, above all pensions, health and long term care. The current financial crisis is putting a strain on this system. In this context, it becomes increasingly necessary to promote a healthy and independent ageing, by improving outcomes for patients and society while ensuring health systems sustainability. To this purpose a proactive approach to chronic diseases prevention (primary, secondary and tertiary) as well as an integrated healthcare approach and also patients' empowerment are required so as to make daily life more age-friendly. It is also necessary to share health and social best practices, adopt policies really effective against elderly social exclusion and strengthen older people participation in society. A joint effort of all key stakeholders is needed to create a society in which older people can play an active role.
Thompson, Azure B.; Tebes, Jacob K.; McKee, Sherry A.
Background It is generally accepted that smoking starts in adolescence and earlier initiation is associated with more negative health outcomes. Some research suggests that women initiate smoking at later ages and have more negative health outcomes than men. The purpose of this study was to examine gender differences in age of initiation and its association with health. Methods The sample included men (n=8,506) and women (n=8,479) with a history of smoking from the 2001-2002 National Epidemiological Survey of Alcohol Related Conditions. Logistic regression was used to examine gender differences in the effect of late smoking initiation on physical and mental health status after adjusting for covariates. Results At mostly all ages after 16, women exceeded men in rates of smoking initiation (59.8% vs. 50.3%, p<.001). Among late initiators (≥16), women were more likely than men to have hypertension (OR:1.24,CI:1.09-1.41), heart disease (OR:1.20,CI:1.00-1.45), major depressive disorder (OR:2.54,CI:2.22-2.92) and generalized anxiety disorder (OR:2.34,CI:1.84-2.99). Among early initiators (<16), women were more likely than men to have major depressive disorder (OR:2.42,CI:2.11-2.77) and generalized anxiety disorder (OR:2.01,CI:1.59-2.54) but there were no gender differences in the likelihood of having hypertension (OR:1.04,CI:0.89-1.22) and heart disease (OR:1.11,CI:0.90-1.36). Conclusions In late adolescence and adulthood, women exceed men in smoking initiation. Late initiation was associated with more significant physical health risks for women than men. Our findings raise questions about generally accepted notions on the age at which smoking initiation occurs and its association with health. PMID:27499723
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
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).
Wilcox, Sara; Altpeter, Mary; Anderson, Lynda A; Belza, Basia; Bryant, Lucinda; Jones, Dina L; Leith, Katherine H; Phelan, Elizabeth A; Satariano, William A
There is an urgent need to translate science into practice and help enhance the capacity of professionals to deliver evidence-based programming. We describe contributions of the Healthy Aging Research Network in building professional capacity through online modules, issue briefs, monographs, and tools focused on health promotion practice, physical activity, mental health, and environment and policy. We also describe practice partnerships and research activities that helped inform product development and ways these products have been incorporated into real-world practice to illustrate possibilities for future applications. Our work aims to bridge the research-to-practice gap to meet the demands of an aging population.
Hughes, Anne K; Lewinson, Terri D W
Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women's perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women's attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient-provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers.
This article deals with the concepts "renaissance" and "low water mark between 1925 and 1955" of general relativity suggested in the literature. By empirical data, it is shown that no such period did exist. Research on general relativity continued continuously since the 1920s interrupted only by the second world war. On a broad scale, research on general relativity started only after 1945.
Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L
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.
Helbostad, Jorunn L.; Vereijken, Beatrix; Becker, Clemens; Todd, Chris; Taraldsen, Kristin; Pijnappels, Mirjam; Aminian, Kamiar; Mellone, Sabato
The European population is ageing, and there is a need for health solutions that keep older adults independent longer. With increasing access to mobile technology, such as smartphones and smartwatches, the development and use of mobile health applications is rapidly growing. To meet the societal challenge of changing demography, mobile health solutions are warranted that support older adults to stay healthy and active and that can prevent or delay functional decline. This paper reviews the literature on mobile technology, in particular wearable technology, such as smartphones, smartwatches, and wristbands, presenting new ideas on how this technology can be used to encourage an active lifestyle, and discusses the way forward in order further to advance development and practice in the field of mobile technology for active, healthy ageing. PMID:28335475
Helbostad, Jorunn L; Vereijken, Beatrix; Becker, Clemens; Todd, Chris; Taraldsen, Kristin; Pijnappels, Mirjam; Aminian, Kamiar; Mellone, Sabato
The European population is ageing, and there is a need for health solutions that keep older adults independent longer. With increasing access to mobile technology, such as smartphones and smartwatches, the development and use of mobile health applications is rapidly growing. To meet the societal challenge of changing demography, mobile health solutions are warranted that support older adults to stay healthy and active and that can prevent or delay functional decline. This paper reviews the literature on mobile technology, in particular wearable technology, such as smartphones, smartwatches, and wristbands, presenting new ideas on how this technology can be used to encourage an active lifestyle, and discusses the way forward in order further to advance development and practice in the field of mobile technology for active, healthy ageing.
Bosma, Hans; van de Mheen, H Dike; Mackenbach, Johan P
Objective To determine the contribution of psychological attributes (personality characteristics and coping styles) to the association between social class in childhood and adult health among men and women. Design Partly retrospective, partly cross sectional study conducted in the framework of the Dutch GLOBE study. Subjects Sample of general population from south east Netherlands consisting of 2174 men and women aged 25-74 years. Baseline self reported data from 1991 provided information on childhood and adult social class, psychological attributes, and general health. Main outcome measure Self rated poor health. Results Independent of adult social class, low childhood social class was related to self rated poor health (odds ratio 1.67 (95% confidence interval 1.02 to 2.75) for subjects whose fathers were unskilled manual workers versus subjects whose fathers were higher grade professionals). Subjects whose fathers were manual workers generally had more unfavourable personality profiles and more negative coping styles. External locus of control, neuroticism, and the absence of active problem focused coping explained about half of the association between childhood social class and self rated poor health. The findings were independent of adult social class and height. Conclusions A higher prevalence of negative personality profiles and adverse coping styles in subjects who grew up in lower social classes explains part of the association between social class in childhood and adult health. This finding underlines the importance of psychological mechanisms in the examination of the negative effects of adverse socioeconomic conditions in childhood. Key messagesRegardless of adult social class, low social class in childhood is related to poor general health in adulthoodAdverse personality profiles and negative coping styles are more common in people who grew up in lower social classesPsychological attributes, such as low perceived control, explain a substantial part of
Bambra, Clare; Lunau, Thorsten; Van der Wel, Kjetil A; Eikemo, Terje A; Dragano, Nico
This article is the first to examine the association between self-reported general health and a wide range of working conditions at the European level and by type of welfare state regime. Data for 21,705 men and women ages 16 to 60 from 27 European countries were obtained from the 2010 European Working Conditions Survey. The influence of individual-level sociodemographic, physical, and psychosocial working conditions and of the organization of work were assessed in multilevel logistic regression analyses, with additional stratification by welfare state regime type (Anglo-Saxon, Bismarckian, Eastern European, Scandinavian, and Southern). At the European level, we found that "not good" general health was more likely to be reported by workers more exposed to hazardous working conditions. Most notably, tiring working positions, job strain, and temporary job contracts were strongly associated with a higher likelihood of reporting "not good" health. Analysis by welfare state regime found that only tiring or painful working conditions were consistently associated with worse self-reported health in all regimes. There was no evidence that the Scandinavian welfare regime protected against the adverse health effects of poor working conditions. The article concludes by examining the implications for comparative occupational health research.
Bernabé, Eduardo; Sabbah, Wael; Delgado-Angulo, Elsa K; Murasko, Jason E; Gansky, Stuart A
This study aimed to confirm whether the well-known income disparities in oral health seen over the life course are indeed absent in 9- to 11-yr-old children, and to explore the role of access to dental care in explaining the age-profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1-5, 6-8, 9-11, 12-14, and 15-17 yr), using survey logistic regression to control for family-, parental-, and child-level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9- to 11-yr-old children. Different age-patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9- to 11-yr-old children, was also seen in 15- to 17-, 12- to 14-, and 6- to 8-yr-old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9- to 11-yr-old children. Access to dental care could attenuate income gradients in oral health in other age groups.
Introduction Physicians’ attitudes towards health may influence the motivation of patients for constructive health behaviors. The purpose of this study was to evaluate general practitioners (GP) attitudes towards health and to determine factors affecting diagnosis of obesity in their patients. Material and methods We examined 250 GPs. The average age was 53.55 ±10.57 years. We used methods examining: health behaviors (IZZ), the sense of coherence (SOC-29), the individual meaning of health (LZK), and attitude toward obesity (own questionnaire). Results The predominance of pro-health behaviors was found in 31.9% and anti-health behavior was observed in 24.6% of the examined group. Health was most commonly defined as a state (74%). The most common criterion of health was “self-acceptance” (38%). A high level of coherence was seen in 39% of individuals. A relationship between the sense of coherence and seeing health as a process (p < 0.01) and target (p < 0.05) was found in this study. We also found a relationship between the doctor’s attitude towards obesity and his internship, area of residence, number of hours spent at work during the week and bodey mass index. It was found that taking the body weight and waist circumference measurements from patients depends significantly on the results from SOC-29 (p = 0.05) and IZZ (p = 0.05). Conclusions Polish GPs are a diverse group in terms of health behavior, defining health, sense of coherence and attitude towards obesity. High sense of coherence and the manifestation of healthy behavior are factors that favor the diagnosis of obesity in patients by the GP. PMID:28261299
Haider, Syed Imran; Ansari, Zahid; Vaughan, Loretta; Matters, Helen; Emerson, Eric
Multiple measures of health and wellbeing of people with intellectual disability (ID) and the general Victorian population were compared using representative population level data. The sample consisted of adults with ID (N=897) and the general Victorian population (N=34,168) living in the state of Victoria in Australia. Proxy respondents were interviewed on behalf of people with ID, while respondents from the general Victorian population were interviewed directly. The data were weighted to reflect the age/sex/geographic distribution of the population. Results revealed that adults with ID reported higher prevalence of poor social determinants of health, behavioural risk factors, depression, diabetes, poor or fair health. A higher proportion of people with ID reported blood pressure and blood glucose checks, while a lower proportion reported cervical and breast cancer screening, compared with the general Victorian population. The survey identified areas where targeted approaches may be undertaken to improve the health outcomes of people with ID and provide an important understanding of the health and wellbeing of these Victorians.
Hasselhorn, H M; Rauch, A
The German population is aging and shrinking. This will have a significant impact on the labor market, because labor supply will start to shrink. Consequently, there is a need to develop additional labor market resources. In this setting, a crucial issue is the health and employment of the older working population. This article discusses--on the basis of nine articles in this special issue--the health of the working population in the context of work, age, and labor participation. It shows the diversity of morbidity in the work force in general and particularly in older age, and it identifies older labor force groups with good health and those with bad health. The latter shows that "working while having a bad state of health" is today's reality. Labor market participation is less dependent on health than on the "work ability" and/or the "motivation to work" of older workers. The employment dynamics of an aging population will be a key issue in future political debate. A reliable knowledge base is needed for proper discussion, judgment, and action in the economic, political, and social fields. Current research is often focused on subtopics or on subgroups; however, a network of all the related scientific disciplines and the establishment of new comprehensive research approaches are needed in this area.
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.
Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E
The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.
Cohen, Seth M; Lee, Hui-Jie; Roy, Nelson; Misono, Stephanie
Objectives To examine voice-related health care utilization of patients in the general medical community without otolaryngology evaluation and explore factors associated with prolonged voice-related health care. Study Design Retrospective cohort analysis. Setting Large, national administrative US claims database. Subjects and Methods Patients with voice disorders per International Classification of Diseases, Ninth Revision, Clinical Modification ( ICD-9-CM) codes from January 1, 2010, to December 31, 2012, seen by a general medical physician, and who did not see an otolaryngologist in the subsequent year were included. Voice-related health care utilization, patient demographics, comorbid conditions, and index laryngeal diagnosis were collected. Logistic regression with variable selection was performed to evaluate the association between predictors and ≥30 days of voice-related health care use. Results In total, 46,205 unique voice-disordered patients met inclusion criteria. Of these patients, 8.5%, 10.0%, and 12.5% had voice-related health care use of ≥90, ≥60, and ≥30 days, respectively. Of the ≥30-day subset, 80.3% and 68.5%, respectively, had ≥60 and ≥90 days of voice-related health care utilization. The ≥30-day subset had more general medicine and nonotolaryngology specialty physician visits, more prescriptions and procedures, and 4 times the voice-related health care costs compared with those in the <30-day subset. Age, sex, employment status, initial voice disorder diagnosis, and comorbid conditions were related to ≥30 days of voice-related health care utilization. Conclusions Thirty days of nonotolaryngology-based care for a voice disorder may represent a threshold beyond which patients are more likely to experience prolonged voice-related health care utilization. Specific factors were associated with extended voice-related health care.
Depoorter, Pieter; Van Huffel, Xavier; Diricks, Herman; Imberechts, Hein; Dewulf, Jeroen; Berkvens, Dirk; Uyttendaele, Mieke
The development of an animal health barometer, an instrument to measure the general health of the Belgian livestock population on a yearly basis and to monitor its evolution over time, is described. The elaboration of a set of 13 animal health indicators (AHIs) as the basis for the animal health barometer is discussed. These indicators were weighted by experts - including scientists, policy makers and agro-industrial representatives - to determine their relative weight in the barometer. The result of the barometer is expressed as a comparison with a previous year. Based on the results of the 13 AHIs, it is concluded that general animal health in Belgium shows a positive evolution since 2008. The animal health barometer provides a composite view of the status of livestock health in Belgium and is a tool to communicate in an intelligible, comprehensible manner on aspects of animal health to consumers and professional stakeholders in the animal production and food chain. Together with the food safety barometer (Baert et al., 2011. Food Res. Int. 44, 940) and the plant health barometer (Wilmart et al., 2014. Eur. J. Plant Pathol. doi: 10.1007/s10658-014-0547-x), the animal health barometer is one of the three instruments to provide a holistic view on the overall status of the safety of the food chain in Belgium.
Collins, Sandra K; Collins, Kevin S
With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future.
Halcomb, Elizabeth J; Davidson, Patricia M; Brown, Nicola
The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and support to people with a chronic disease for and on behalf of a general practitioner (GP). The uptake of Medicare Item 100997 from 2007 to 2009, to monitor chronic disease interventions provided by general practice nurses has increased dramatically. The rate of uptake of Item 100997 has not been consistent across States and Territories, even allowing for population distributions. Exploring reasons for these regional variations and linking uptake of Medicare Item numbers to patient outcomes is important in developing the nursing role in Australian general practice.
Ogletree, Roberta, Ed.; Doyle, Kathy, Ed.
This monograph presents a collection of papers related to health issues and aging: "Introduction" (Paul Simon); "Memory, Aging, and Cognition" (Rita E. Arras); "Internet Resources for the Elderly and Their Caregivers" (Kathleen Doyle); "Unintentional Injuries in the Homes of the Elderly: A Look at Current…
Burt, Vicki L.; Harris, Tamara
Describes third National Health and Nutrition Examination Survey (NHANES III), noting that upper age limit was removed and that older black, Mexican American, and white populations were oversampled. Sees NHANES III component for older adults providing multidimensional overview of physical and functional health status (osteoporosis; arthritis;…
Ebener, M; Hasselhorn, H M
Working life in Germany is changing. The work force is ageing and the number of people available to the labour market will - from now on - shrink considerably. Prospectively, people will have to work longer; but still today, most people leave employment long before reaching official retirement age. What are the reasons for this? In this report, a conceptual framework and the German lidA Cohort Study are presented. The "lidA conceptual framework on work, age, health and work participation" visualises determinants of employment (11 "domains") in higher working age, e. g., "work", "health", "social status" and "life style". The framework reveals 4 key characteristics of withdrawal from work: leaving working life is the result of an interplay of different domains (complexity); (early) retirement is a process with in part early determinants in the life course (processual character); retirement has a strong individual component (individuality); retirement is embedded in a strong structural frame (structure). On the basis of this framework, the "lidA Cohort Study on work, age, health and work participation" (www.lida-studie.de) investigates long-term effects of work on health and work participation in the ageing work force in Germany. It is the only large study in Germany operationalising the concept of employability in a broad interdisciplinary approach. Employees subject to social security and born in 1959 or in 1965 will be interviewed (CAPI) every 3 years (N[wave 1]=6 585, N[wave 2]=4 244) and their data will be linked (where consented) with social security data covering employment history and with health insurance data. The study design ("Schaie's most efficient design") allows for a tri-factor model that isolates the impact of age, cohort and time. In 2014, the second wave was completed. In the coming years lidA will analyse the association of work, health and work participation, and identify age as well as generation differences. lidA will investigate the
Süss, Jochen; Kahl, Olaf; Aspöck, Horst; Hartelt, Kathrin; Vaheri, Antii; Oehme, Rainer; Hasle, Gunnar; Dautel, Hans; Kunz, Christian; Kupreviciene, Nerija; Randolph, Sarah; Zimmermann, Hans-Peter; Atkinson, Barry; Dobler, Gerhard; Kutsar, Kuulo; Heinz, Franz X; Steffen, Robert
The 11th meeting of the International Scientific Working Group on Tick-borne Encephalitis (ISW-TBE) was conducted under the title of, "From childhood to golden age: increased mobility - increased risk of contracting TBE?" Participants from 26 countries, including the United States of America and China, presented reports on the latest developments and trends in local TBE cases, vaccination coverage and risk factors. In particular, the situation of children and the elderly (the "golden agers") was discussed. As the current evidence suggests, the location and extension of endemic areas for TBE have changed over the last few years, along with global warming and the shift of infected ticks to higher altitudes. The increased mobility of the human population adds to the heightened exposure; outdoor activities and international travel are on the rise also, and especially, amongst the 50+ generation, who are already per se at higher risk of disease manifestation, complications and case fatality. Most Europeans travel within Europe, often without sufficient awareness of endemic areas. Only high immunization rates can ensure low disease rates in the long run. To achieve this goal, public education is the sole effective approach for raising the level of awareness. Overall, the risk of any given person to contract TBE should not be regarded as a fixed entity, but rather it must be estimated individually, on the basis of knowledge of the TBE virus endemic areas and risk factors.
Marshall, Stephen E; Cheng, Bin; Northridge, Mary E; Kunzel, Carol; Huang, Catherine; Lamster, Ira B
Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care-sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening.
Bugg, Julie M.; Zook, Nancy A.; DeLosh, Edward L.; Davalos, Deana B.; Davis, Hasker P.
The current study examined the contributions of general slowing and frontal decline to age differences in fluid intelligence. Participants aged 20-89 years completed Block Design, Matrix Reasoning, simple reaction time, choice reaction time, Wisconsin Card Sorting, and Tower of London tasks. Age-related declines in fluid intelligence, speed of…
Shen, Sijun; Neyens, David M
There are many studies that evaluate the effects of age, gender, and crash types on crash related injury severity. However, few studies investigate the effects of those crash factors on the crash related health care costs for drivers that are transported to hospital. The purpose of this study is to examine the relationships between drivers' age, gender, and the crash types, as well as other crash characteristics (e.g., not wearing a seatbelt, weather condition, and fatigued driving), on the crash related health care costs. The South Carolina Crash Outcome Data Evaluation System (SC CODES) from 2005 to 2007 was used to construct six separate hierarchical linear regression models based on drivers' age and gender. The results suggest that older drivers have higher health care costs than younger drivers and male drivers tend to have higher health care costs than female drivers in the same age group. Overall, single vehicle crashes had the highest health care costs for all drivers. For males older than 64-years old sideswipe crashes are as costly as single vehicle crashes. In general, not wearing a seatbelt, airbag deployment, and speeding were found to be associated with higher health care costs. Distraction-related crashes are more likely to be associated with lower health care costs in most cases. Furthermore this study highlights the value of considering drivers in subgroups, as some factors have different effects on health care costs in different driver groups. Developing an understanding of longer term outcomes of crashes and their characteristics can lead to improvements in vehicle technology, educational materials, and interventions to reduce crash-related health care costs.
Adlung, R.; Carzaniga, A.
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215
Klainin-Yobas, Piyanee; He, Hong-Gu
This study aimed to evaluate the psychometric properties of the General Health Questionnaire (GHQ-30) given conflicting findings in the literature. A cross-sectional, nonexperimental research was used with a convenience sample of 271 American female health care professionals. Data were collected by using self-reported questionnaires. A series of exploratory factor analyses (EFAs), confirmatory factor analyses (CFAs), and structural equation modeling (SEM) were performed to examine underlying dimensions of the GHQ-30. Results from EFAs and CFAs revealed the three-factor composition (positive affect, anxiety, and depressed mood). All factor loadings were statistically significant, and one pair of error variance was allowed to be correlated. All factors contained questionnaire items with acceptable face validity and demonstrated good internal consistency reliability. Results from SEM further confirmed underlying constructs of the scale. To our knowledge, this is the first study that extensively tested the psychometric properties of the GHQ-30, taking both statistical and substantive issues into consideration.
Biagi, Elena; Candela, Marco; Turroni, Silvia; Garagnani, Paolo; Franceschi, Claudio; Brigidi, Patrizia
The ageing process affects the human gut microbiota phylogenetic composition and its interaction with the immune system. Age-related gut microbiota modifications are associated with immunosenescence and inflamm-ageing in a sort of self-sustaining loop, which allows the placement of gut microbiota unbalances among both the causes and the effects of the inflamm-ageing process. Even if, up to now, the link between gut microbiota and the ageing process is only partially understood, the gut ecosystem shows the potential to become a promising target for strategies able to contribute to the health status of older people. In this context, the consumption of pro/prebiotics may be useful in both prevention and treatment of age-related pathophysiological conditions, such as recovery and promotion of immune functions, i.e. adjuvant effect for influenza vaccine, and prevention and/or alleviation of common "winter diseases", as well as constipation and Clostridium difficile-associated diarrhoea. Moreover, being involved in different mechanisms which concur in counteracting inflammation, such as down-regulation of inflammation-associated genes and improvement of colonic mucosa conditions, probiotics have the potentiality to be involved in the promotion of longevity.
Russell, Richard; Sweda, Jennifer R; Porcheron, Aurélie; Mauger, Emmanuelle
Redness or yellowness of the sclera (the light part of the eye) are known signs of illness, as is looking older than one's actual age. Here we report that the color of the sclera is related to age in a large sample of adult Caucasian females. Specifically, older faces have sclera that are more dark, red, and yellow than younger faces. A subset of these faces were manipulated to increase or decrease the darkness, redness, or yellowness of the sclera. Faces with decreased sclera darkness, redness, or yellowness were perceived to be younger than faces with increased sclera darkness, redness, or yellowness. Further, these manipulations also caused the faces to be perceived as more or less healthy, and more or less attractive. These findings show that sclera coloration is a cue for the perception of age, health, and attractiveness that is rooted in the physical changes that occur with age.
Kern, David W.; Wroblewski, Kristen E.; Chen, Rachel C.; Schumm, L. Philip; McClintock, Martha K.
Objectives. Sensory function, a critical component of quality of life, generally declines with age and influences health, physical activity, and social function. Sensory measures collected in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) survey focused on the personal impact of sensory function in the home environment and included: subjective assessment of vision, hearing, and touch, information on relevant home conditions and social sequelae as well as an improved objective assessment of odor detection. Method. Summary data were generated for each sensory category, stratified by age (62–90 years of age) and gender, with a focus on function in the home setting and the social consequences of sensory decrements in each modality. Results. Among both men and women, older age was associated with self-reported impairment of vision, hearing, and pleasantness of light touch. Compared with women, men reported significantly worse hearing and found light touch less appealing. There were no gender differences for vision. Overall, hearing loss seemed to have a greater impact on social function than did visual impairment. Discussion. Sensory function declines across age groups, with notable gender differences for hearing and light touch. Further analysis of sensory measures from NSHAP Wave 2 may provide important information on how sensory declines are related to health, social function, quality of life, morbidity, and mortality in this nationally representative sample of older adults. PMID:25360015
Spitzer, William J; Davidson, Kay W
Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.
Lee, Sing; Lam, Ivy M H; Kwok, Kathleen P S; Leung, Candi M C
This community-based study examined the frequency of worry about personal health in respondents with and without generalized anxiety disorder (GAD), and the impact of health anxiety on the disorder. A random community-based telephone survey of 5118 Chinese respondents aged 18-64 was conducted. A fully structured questionnaire covered the DSM-IV-TR criteria of GAD, major depressive episode (MDE), eight domains of worry, the seven-item Whiteley Index (WI-7), health service use, and socio-demographic information. Worry about personal health ranked fifth (75.6%) among eight domains of worries examined. GAD respondents with high level of health anxiety were significantly older, less educated, and had lower family income. High health anxiety significantly increased the occurrence of one-year MDE, previous persistent worry, previous persistent low mood, number of domains of worries, number of non-core DSM-IV-TR GAD symptoms, health service use, and mistrust of doctors. Health anxiety is common in GAD and may signify greater severity of the disorder.
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true General safety and health... Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY CONTRACTS General Safety and Health Standards § 50-204.2 General safety and health standards. (a)...
Marchal, Bruno; Van Dormael, Monique; Pirard, Marjan; Cavalli, Anna; Kegels, Guy; Polman, Katja
Disease control programmes are an intrinsic part of health systems. Neglected tropical disease (NTD) control is a clear case in point. While there is a growing consensus that NTD control and health services are linked, with important mutual impacts, little is known of what actually happens at the interface between the two entities. Here, we review the rationale, viewpoints and experiences of NTD control programmes regarding general health services, and vice versa, and compare their respective arguments. We discuss the interactions and interface between disease control and health systems, and present possible scenarios for health system strengthening by NTD- and other disease-specific programmes. Focusing on countries in sub-Saharan Africa, we suggest a number of principles that could pave the way for fruitful discussions and development of synergies.
Sigurdson, J F; Wallander, J; Sund, A M
The aim was to examine prospectively associations between bullying involvement at 14-15 years of age and self-reported general health and psychosocial adjustment in young adulthood, at 26-27 years of age. A large representative sample (N=2,464) was recruited and assessed in two counties in Mid-Norway in 1998 (T1) and 1999/2000 (T2) when the respondents had a mean age of 13.7 and 14.9, respectively, leading to classification as being bullied, bully-victim, being aggressive toward others or non-involved. Information about general health and psychosocial adjustment was gathered at a follow-up in 2012 (T4) (N=1,266) with a respondent mean age of 27.2. Logistic regression and ANOVA analyses showed that groups involved in bullying of any type in adolescence had increased risk for lower education as young adults compared to those non-involved. The group aggressive toward others also had a higher risk of being unemployed and receiving any kind of social help. Compared with the non-involved, those being bullied and bully-victims had increased risk of poor general health and high levels of pain. Bully-victims and those aggressive toward others during adolescence subsequently had increased risk of tobacco use and lower job functioning than non-involved. Further, those being bullied and aggressive toward others had increased risk of illegal drug use. Relations to live-in spouse/partner were poorer among those being bullied. Involvement in bullying, either as victim or perpetrator, has significant social costs even 12 years after the bullying experience. Accordingly, it will be important to provide early intervention for those involved in bullying in adolescence.
Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A
The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging.
Sakti, G M; Boldy, D P
This study assessed the usefulness and relevance of the information, which had been provided by the Ministry of Health for use in community health centers. Furthermore, this identified the needs of health professionals in terms of relevant information for providing health care to the elderly in the community health centers. A total of 105 questionnaires were administered to 35 doctors and 70 health care workers. The overall response rate of the 105 questionnaires sent out was 80%. Findings revealed that the overall opinion expressed by the health professionals was that the information leaflets, in general, were good. However, some gaps existed between the information provided by the Ministry of Health and the information needs perceived by health professionals working in community health centers for providing health care to the elderly. The majority commented that pertinent information on health problems related to hypertension, arthritis, and heart disease needed to be added. Furthermore, effective pre-testing of the prepared information materials with the target groups before their production and distribution may lessen such gaps or deficiencies. Recommendations to ensure appropriate information are also given and presented in this article.
Pati, Susmita; Siewert, Elizabeth; Wong, Angie T; Bhatt, Suraj K; Calixte, Rose E; Cnaan, Avital
The objective of this study is to determine the influence of maternal health literacy and child's age on participation in social welfare programs benefiting children. In a longitudinal prospective cohort study of 560 Medicaid-eligible mother-infant dyads recruited in Philadelphia, maternal health literacy was assessed using the test of functional health literacy in adults (short version). Participation in social welfare programs [Temporary Assistance to Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), child care subsidy, and public housing] was self-reported at child's birth, and at the 6, 12, 18, 24 month follow-up interviews. Generalized estimating equations quantified the strength of maternal health literacy as an estimator of program participation. The mothers were primarily African-Americans (83%), single (87%), with multiple children (62%). Nearly 24% of the mothers had inadequate or marginal health literacy. Children whose mothers had inadequate health literacy were less likely to receive child care subsidy (adjusted OR = 0.54, 95% CI 0.34-0.85) than children whose mothers had adequate health literacy. Health literacy was not a significant predictor for TANF, SNAP, WIC or housing assistance. The predicted probability for participation in all programs decreased from birth to 24 months. Most notably, predicted WIC participation declined rapidly after age one. During the first 24 months, mothers with inadequate health literacy could benefit from simplified or facilitated child care subsidy application processes. Targeted outreach and enrollment efforts conducted by social welfare programs need to take into account the changing needs of families as children age.
Background Heat shock proteins (Hsp) are ubiquitously synthesised in virtually all species and it is hypothesised that they might have beneficial health effects. Recent studies have identified circulating Hsp as an important mediator in inflammation - the effects of low-grade inflammation in the aging process are overwhelming. While much is known about intracellular Hsp70, scant data exist on circulating Hsp70 in the aging context. Therefore, the objectives of this study were to investigate the effect of age and disease on circulating Hsp70 and, in particular, to evaluate the association between circulating Hsp70 and inflammatory parameters. Results Serum Hsp70, Interleukin (IL) -10, IL-6 and Tumor Necrosis Factor (TNF) alpha concentrations were determined in 90 hospitalised geriatric patients (aged 83 ± 6 years) and in 200 community-dwelling control subjects (100 elderly, aged 74 ± 5 years, and 100 young, aged 23 ± 3 years). In the community-dwelling elderly, serum Hsp70 and IL-10 concentrations were significantly lower and IL-6 was significantly higher when compared to healthy young control subjects. Elderly patients presenting inflammation (CRP serum levels ≥5 mg/L) showed significantly (p = 0.007) higher Hsp70 values; and Hsp70 correlated positively (p < 0.001) with IL-6 and CRP, but not with TNF-alpha or IL-10. A significant association was also noted between Hsp70 levels and the degree of dependency and cognitive decline in geriatric patients. Conclusions The present data provide new evidence that serum concentration of Hsp70 decreases with age in a normal population. Our study also shows that higher levels of Hsp70 are associated with inflammation and frailty in elderly patients. PMID:21443787
Background Few studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies. We describe the health status of flight attendants and compare it to the U.S. population. In addition, we explore whether the prevalence of major health conditions in flight attendants is associated with length of exposure to the aircraft environment using job tenure as a proxy. Methods We surveyed flight attendants from two domestic U.S. airlines in 2007 and compared the prevalence of their health conditions to contemporaneous cohorts in the National Health and Nutrition Survey (NHANES), 2005-2006 and 2007-2008. We weighted the prevalence of flight attendant conditions to match the age distribution in the NHANES and compared the two populations stratified by gender using the Standardized Prevalence Ratio (SPR). For leading health conditions in flight attendants, we analyzed the association between job tenure and health outcomes in logistic regression models. Results Compared to the NHANES population (n =5,713), flight attendants (n = 4,011) had about a 3-fold increase in the age-adjusted prevalence of chronic bronchitis despite considerably lower levels of smoking. In addition, the prevalence of cardiac disease in female flight attendants was 3.5 times greater than the general population while their prevalence of hypertension and being overweight was significantly lower. Flight attendants reported 2 to 5.7 times more sleep disorders, depression, and fatigue, than the general population. Female flight attendants reported 34% more reproductive cancers. Health conditions that increased with longer job tenure as a flight attendant were chronic bronchitis, heart disease in females, skin cancer, hearing loss, depression and anxiety, even after adjusting for age, gender, body mass index (BMI), education, and smoking. Conclusions This study found higher rates of specific diseases in flight attendants
This study investigated the changes of general and oral health status of elderly patients who received home-visit dental services. The subjects were 51 patients (male: 19, female: 32, age: 83.0+/-9.1). The results of initial and re-examination (5.4 months later) by questionnaire survey, oral status and oral microbes were compared. The following results were obtained. 1. More than half of the subjects were bedridden and about 70% were affected by dementia. Three-quarters needed special care for daily activities. 2. The general health condition of the subjects became worse after 5.4 months. Moreover, 11 subjects died within 6 months after re-examination. However, oral health status, such as status of oral hygiene (p < 0.01), inflammation of gingiva (p < 0.01), tongue coating (p < 0.05) and oral malodor (p < 0.01) improved significantly. 3. There was a significant difference in the rate of people with dysphagic problems between the living and dead groups (p < 0.05). 4. The initial general and oral health status of the people with dysphagic problems was significantly worse than that of those without it. After receiving home-visit dental services, general condition became worse. However oral status, such as status of oral hygiene, inflammation of gingiva, oral malodor, and lactobacillus count significantly improved in both groups. These results suggest that dysphagic problems of elderly patients may affect their general health condition and might increase the risk of death. It is recommended to judge dysphagic problems accurately when performing certification of need for long-term care and to provide professional oral care periodically for the dependent elderly needing care.
Kotwal, Ashwin; Huisingh-Scheetz, Megan J.; Waite, Linda J.; McClintock, Martha K.; Dale, William
Objective. The goals of this paper were: (a) to promote research using the National Social Life, Health and Aging Project (NSHAP) Wave 2 data by providing relevant background information for a broad range of chronic conditions and (b) to provide a framework for combining these chronic conditions into informative comorbidity indices. Method. The chronic conditions measured in NSHAP Wave 2 were grouped across several health domains: cardiovascular, endocrine and metabolic, cancer, lung, inflammatory and bone, neurological, and sensorimotor. Prevalences for each condition were reported as percentages and were also estimated separately by age group and gender. Additionally, 2 comorbidity indices were created: a Modified Charlson Comorbidity Index (CCI) that included conditions associated with mortality risk and the NSHAP Comorbidity Index (NCI) that included conditions from the Modified CCI as well as additional conditions related to overall health and function. Results. Hypertension, incontinence, arthritis, heart conditions, cancer, and diabetes were the most prevalent conditions. In general, prevalences of most chronic conditions increased with age. Additionally, there were several notable gender differences in chronic condition prevalence. Due to the inclusion of highly prevalent conditions, such as hypertension and incontinence, the mean comorbidity index score of the NCI was higher than that of the Modified CCI. Discussion. Wave 2 of NSHAP included a variety of measures assessing the chronic conditions that are the most prevalent in older adults. These data are a valuable resource for the study of the impact of chronic conditions on overall health and aging. PMID:25360017
Hunt, R W
Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is little evidence to suggest that substantial economic savings could be achieved. Moreover, his argument raises serious moral objections. A policy of withholding treatments from members of a social group involves elements of compulsion and discrimination, both of which would intrude on the doctor-patient relationship, undermine the autonomy of elderly patients, and invoke the slippery slope towards involuntary forms of euthanasia. Life-death decisions should be based on more than the one criterion of age, and take account of more relevant factors such as the patient's usual state of well-being, her/his expressed wishes, informed consent and the type of illness. Any move to the implementation and enforcement of the policy Callahan recommends would be rejected by health professionals and the public. PMID:8459434
Kulkarni, Chetan S.; Celaya, Jose Ramon; Biswas, Gautam; Goebel, Kai
This paper discusses experimental setups for health monitoring and prognostics of electrolytic capacitors under nominal operation and accelerated aging conditions. Electrolytic capacitors have higher failure rates than other components in electronic systems like power drives, power converters etc. Our current work focuses on developing first-principles-based degradation models for electrolytic capacitors under varying electrical and thermal stress conditions. Prognostics and health management for electronic systems aims to predict the onset of faults, study causes for system degradation, and accurately compute remaining useful life. Accelerated life test methods are often used in prognostics research as a way to model multiple causes and assess the effects of the degradation process through time. It also allows for the identification and study of different failure mechanisms and their relationships under different operating conditions. Experiments are designed for aging of the capacitors such that the degradation pattern induced by the aging can be monitored and analyzed. Experimental setups and data collection methods are presented to demonstrate this approach.
Davis, Adrian; McMahon, Catherine M; Pichora-Fuller, Kathleen M; Russ, Shirley; Lin, Frank; Olusanya, Bolajoko O; Chadha, Shelly; Tremblay, Kelly L
Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice.
Both hip fracture incidence and life expectancy are known to have increased during the last decades. Seventeen studies of hip fracture incidence from Great Britain and Scandinavia were collected from the literature. It was found that there was a good correlation for both men and women between the incidence of cervical but not trochanteric fractures in the 75-79 year age group and the mean life expectancy at 70 years of age at the time in the country concerned. The increased incidence is probably accounted for partly by the increased lifespan of the infirm. It is, however, suggested that increases in life expectancy among a majority of the elderly also entail better general health at any particular age, and that this may lead to a higher level of physical mobility which raises the risk of falls and fractures. PMID:3065438
Souza, Luciane Albuquerque Sá de; Torres, Ana Raquel Rosas; Barbosa, Genário Alves; Lima, Tiago Jessé Souza de; Souza, Luana Elayne Cunha de
The objective of this study is to investigate the role of self-efficacy beliefs as a mediator of the relationship between the subjective well-being and general health of military cadets (police and firefighters). For this study, 228 cadets participated, the majority being Military Police officer candidates (65%), male (79%), between 17 and 34 years of age (99%), and unmarried (74%). They responded to questionnaires on general health (GHQ-12), perceived general self-efficacy, to the multiple scales that cover subjective well-being, and demographic questions. Initial regression analyses indicate the predictive power of subject well-being regarding general health. Subsequently, the mediation analyses provide satisfactory evidence for the role of perceived self-efficacy as a mediator of the relationship between the subjective well-being variables and the overall health of military cadets. The implications of these results for the professional training of the cadets are discussed.
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.
Lee, Ju-Mi; Lee, Won Joon; Kim, Hyeon Chang; Choi, Wungrak; Lee, Jina; Sung, Kiho; Chu, Sang Hui; Park, Yeong-Ran; Youm, Yoosik
The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr). PMID:24876995
Engelen, Lucien JLPG; Berben, Sivera AA; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette
Background Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. Objective To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. Methods A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. Results The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. Conclusions The Internet is the main source of health
Enns, Jennifer; Holmqvist, Maxine; Wener, Pamela; Halas, Gayle; Rothney, Janet; Schultz, Annette; Goertzen, Leah; Katz, Alan
Health policies and programs promoting mental health or preventing mental illness in the general public are under-recognized facets of primary prevention. Increasing awareness and adoption of such strategies could reduce the burden of mental illness in individuals, families, communities, and society as whole. We conducted a scoping review of reviews of interventions to promote mental health or prevent mental illness. We searched PubMed, PsycINFO, Scopus, Cochrane CENTRAL, CINAHL and ERIC from 2004 to 2014. Reviews were included if the authors indicated a systematic approach in their literature searches, and if they comprised interventions in Westernized countries targeting the general population. We identified 39 reviews that met the inclusion criteria. Mental health intervention approaches and outcomes varied across age groups and settings, and included functional, social, and cognitive measures. Most interventions aimed to prevent a specific mental illness or symptoms (depression, anxiety, burnout, or stress). Cognitive-behavioral therapy and educational components were common. School-based programs focused on outcomes involving social and academic development. Interventions for families, especially for young or disadvantaged parents, taught parenting skills to help improve the well-being of children and their care-givers. In the workplace, the focus was on managing stress, while programs for the elderly emphasized quality of life determinants. This review summarizes a wide variety of interventions to promote mental health or prevent mental illness, but the literature is primarily focused on the individual or family unit. More information is required about interventions at the community and societal levels.
Searby, Adam; Maude, Phil; McGrath, Ian
Oral administration of methadone has been used as a treatment strategy for opiate addiction for many years. The state of Victoria, Australia, has a long-running methadone program with a large number of participants. Accordingly, a growing number of adults have utilised methadone maintenance treatment for a number of years and are now moving into older age due to advances in medical treatment and harm reduction initiatives. The objective of this review is to examine the literature pertaining to co-occurring mental illness in older methadone treatment participants and to explore the future challenges this growing cohort of ageing adults pose to aged persons’ psychiatry services. As part of a broader study into dual diagnosis in older adults, a search of the Scopus, ProQuest, and CINAHL journal databases was performed. Twenty abstracts from literature published within the previous 15 years (1999–2014) were identified that explored methadone maintenance programs and the older adults maintained on them. A number of researchers have identified the ageing methadone population to have a high degree of comorbid mental illness and psychological distress. Studies also indicate that individuals enrolled in methadone maintenance programs may engage in a degree of continual substance use, potentially leading to deleterious effects on their psychosocial function. An ageing methadone population experiencing a high degree of comorbid mental illness is likely to challenge aged persons’ psychiatry services. These services are likely to be increasingly called on to manage these individuals, particularly within Victoria where few substance use services exist for those over the age of 65. It is essential that aged persons’ psychiatry services prepare to provide care for these individuals in a responsive manner that is inclusive of both their mental health and substitution pharmacotherapy.
Divsalar, Kouros; Nejadnaderi, Samira; Nakhaee, Nowzar; Rouhani, Saed
Background: Given the university students’ model role in the society and the importance of period of university education in selecting behavioral methods and lifestyles in the future have made it necessary to study the smoking pattern and its associated factors and complications among students. The aim of this study was to compare religious attitude and mental health between smoking and non-smoking students. Methods: In this research, religious attitude and mental health was studied in 1065 smoking and non-smoking students of Kerman University of Medical Sciences. In this study, three questionnaires were used (Demographic Questionnaire, General Health Questionnaire and Religious Attitude Scale Questionnaire) which were completed by the students voluntarily. The data were analyzed by descriptive statistic methods, multivariate analysis of variance (MANOVA), t-test, Pearson correlation, and regression coefficient. Findings: The mean age of smokers was 20 years and most of the smokers were male (78.9%), single (86.5%) and in BS or BA degree (52.5%). Most of them smoked a cigarette or more in the past month. The average age of start of smoking was 18 years. There was no significant difference between religious attitude and mental health in smoking students in terms of gender but in non-smoking students there was a significant difference in this regard. Smoking students had lower mental health status and religious attitude in comparison with non-smoking students. Between religious attitude and general health in smoking and non-smoking students was also a direct association. Conclusion: Due to psychological and physiological consequences of cigarette smoking, promoting smoking prevention by religious missionaries and university professors, and helping the students to quit smoking by counselors, psychologists and psychiatrics are necessary. PMID:24494094
Bialystok, Ellen; Abutalebi, Jubin; Bak, Thomas H; Burke, Deborah M; Kroll, Judith F
With the population aging and a dramatic increase in the number of senior citizens, public health systems will be increasingly burdened with the need to deal with the care and treatment of individuals with dementia. We review evidence demonstrating how a particular experience, bilingualism, has been shown to protect cognitive function in older age and delay onset of symptoms of dementia. This paper describes behavioral and brain studies that have compared monolingual and bilingual older adults on measures of cognitive function or brain structure and reviews evidence demonstrating a protective effect of bilingualism against symptoms of dementia. We conclude by presenting some data showing the potential savings in both human costs in terms of demented patients and economic considerations in terms of public money if symptoms of dementia could be postponed.
Background This study ascertain gender-specific determinants of outpatient mental health (MH) service use for depression to highlight gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour. Methods Data used in this study came from the Canadian Community Health Survey on Mental Health and Well Being, cycle 1.2 (CCHS 1.2) conducted by Statistics Canada in 2002 (N = 36,984). The sample was limited to respondents filling the criteria for a probable major depression in the 12 months prior to the interview (n = 1743). Gender-specific multivariate logistic regression analyses were carried out. Results The results showed that 54.3% of respondents meeting criteria for major depression had consulted for mental health reasons in the year prior to interview. When looking at type of outpatient mental health service use, males were more likely to consult a general practitioner and a mental health specialist in the past year as opposed to females. However, females were more likely to consult a general practitioner only as opposed to no service use than males. Gender specific differences in determinants associated with outpatient service use included for males, lower adjusted household income, and for females, a younger age, the presence of social support, self-reported availability barriers, the presence of self-reported suicidal thoughts or attempt and a poorer self- perceived mental health. Conclusions It is concluded that continued efforts to promote access to mental health care are needed for men and women affected by depression, and this, to target specific vulnerable populations and increase utilization rates. PMID:24884891
Nygaard, Egil; Jensen, Tine K.; Dyb, Grete
The aim of this study was to evaluate the structure of posttraumatic stress reaction factors and their relation to general mental health problems in Norwegian children exposed to the tsunami on December 26, 2004. A total of 133 children and adolescents (ages 6-17) were interviewed 10 months posttsunami using the UCLA PTSD Reaction Index, and 104…
Salthouse, Timothy A.
Both general (i.e., shared across different cognitive measures) and specific (i.e., unique to particular cognitive measures) influences can be postulated to contribute to the relations between adult age and measures of cognitive functioning. Estimates of general and specific influences on measures of memory, speed, reasoning, and spatial…
Sanjay, Venkataraam; Shetty, Sumanth M; Shetty, Rashmi G; Managoli, Noopur A; Gugawad, Sachin C; Hitesh, D
Background: This study was planned to assess the dental caries status among disabled children as dental health is an integral part of general body health and this group is deprived of health care needs. Materials & Methods: A sample of 310 disabled children was gathered including 195- Hearing impaired, 115 – blind. Of which 226 were males and 84 were females. A study questionnaire was prepared to include demographic information and WHO oral health assessment form (1997) to record dental caries status.Data was analysed using student’s test and ANOVA test was used at p≤0.05. Results: The overall mean for DMFT scores for males and females was 2.11 (1.753) and 1.75 (1.275) respectively. Similarly overall mean for dft was 0.31 (0.254) for males and 0.27 (0.143) for females. Mean DMFT of blind students was more as compared to hearing impaired ones as 2.16 (2.005) and 1.80 (1.264) respectively. Age factor showed a significant increase in the mean DMFT scores with advancing age at p ≤ 0.001. Conclusion: Overall mean scores of caries was very high and it increased with increasing age. Blind children experienced more caries then hearing impaired children in permanent, whereas it was opposite in primary dentition. So there is urgent need of both comprehensive and incremental dental care for this subgroup of population. How to cite the article: Sanjay V, Shetty SM, Shetty RG, Managoli NA, Gugawad SC, Hitesh D. Dental health status among sensory impaired and blind institutionalized children aged 6 to 20 years. J Int Oral Health 2014;6(1):55-8. PMID:24653604
Leoutsakos, Jeannie-Marie S.; Han, Dingfen; Mielke, Michelle M.; Forrester, Sarah N.; Tschanz, JoAnn T.; Corcoran, Chris D.; Green, Robert C.; Norton, Maria C.; Welsh-Bohmer, Kathleen A.; Lyketsos, Constantine G.
Background Several observational studies suggested a link between health status and rate of decline among individuals with Alzheimer’s disease (AD). We sought to quantify the relationship in a population-based study of incident AD, and to compare global comorbidity ratings to counts of comorbid conditions and medications as predictors of AD progression. Methods Design Case-only cohort study arising from population-based longitudinal study of memory and aging. Setting Cache County, Utah Participants 335 individuals with incident AD followed for up to 11 years. Measurements Patient descriptors included sex, age, education, dementia duration at baseline, and APOE genotype. Measures of health status made at each visit included the GMHR (General Medical Health Rating), number of comorbid medical conditions, and number of non-psychiatric medications. Dementia outcomes included the Mini-Mental State Exam (MMSE), Clinical Dementia Rating – sum of boxes (CDR-sb), and the Neuropsychiatric Inventory (NPI). Results Health Status tended to fluctuate over time within individuals. None of the baseline medical variables (GMHR, comorbidities, non-psychiatric medications) were associated with differences in rates of decline in longitudinal linear mixed effects models. Over time, low GMHR ratings, but not comorbidities or medications, were associated with poorer outcomes (MMSE: β=−1.07 p=0.01; CDR-sb: β=1.79 p<0.001; NPI: β=4.57 p=0.01) Conclusions Given that time-varying GMHR, but not baseline GMHR, was associated with the outcomes, there is likely a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications. Since health status is a potentially modifiable risk factor, further study is warranted. PMID:22687143
Fink, Bernhard; Hufschmidt, Carla; Hirn, Thomas; Will, Susanne; McKelvey, Graham; Lankhof, John
The social significance of physical appearance and beauty has been documented in many studies. It is known that even subtle manipulations of facial morphology and skin condition can alter people’s perception of a person’s age, health and attractiveness. While the variation in facial morphology and skin condition cues has been studied quite extensively, comparably little is known on the effect of hair on social perception. This has been partly caused by the technical difficulty of creating appropriate stimuli for investigations of people’s response to systematic variation of certain hair characteristics, such as color and style, while keeping other features constant. Here, we present a modeling approach to the investigation of human hair perception using computer-generated, virtual (rendered) human hair. In three experiments, we manipulated hair diameter (Experiment 1), hair density (Experiment 2), and hair style (Experiment 3) of human (female) head hair and studied perceptions of age, health and attractiveness. Our results show that even subtle changes in these features have an impact on hair perception. We discuss our findings with reference to previous studies on condition-dependent quality cues in women that influence human social perception, thereby suggesting that hair is a salient feature of human physical appearance, which contributes to the perception of beauty. PMID:28066276
Duncan, Sylvia H; Flint, Harry J
In healthy adults microbial communities that colonise different regions of the human colon contribute nutrients and energy to the host via the fermentation of non-digestible dietary components in the large intestine. A delicate balance of microbial species is required to maintain healthy metabolism and immune function. Disturbance in this microbial balance can have negative consequences for health resulting in elevated inflammation and infection, that are contributory factors in diabetes and cancer. There is a growing awareness that the microbial balance in the colon may become increasingly perturbed with aging and therefore hasten the onset of certain diseases. Societal and dietary factors influence microbial community composition both in the short and long term in the elderly (>65 years old) whilst immunosenescence may also be linked to a perturbed distal gut microbiota and frailty in the elderly. Significant progress has been made in defining some of the dominant members of the microbial community in the healthy large intestine and in identifying their roles in metabolism. There is therefore an urgent need for better awareness of the impact of diet, prebiotic and probiotic strategies in driving human colonic microbial composition in order to understand the possibilities for maintaining healthy gut function and well-being in an increasingly elderly population. Here we review gut microbial changes associated with aging and how diet, prebiotics and probiotics may modulate the gut microbiota to maintain health in the elderly.
Fink, Bernhard; Hufschmidt, Carla; Hirn, Thomas; Will, Susanne; McKelvey, Graham; Lankhof, John
The social significance of physical appearance and beauty has been documented in many studies. It is known that even subtle manipulations of facial morphology and skin condition can alter people's perception of a person's age, health and attractiveness. While the variation in facial morphology and skin condition cues has been studied quite extensively, comparably little is known on the effect of hair on social perception. This has been partly caused by the technical difficulty of creating appropriate stimuli for investigations of people's response to systematic variation of certain hair characteristics, such as color and style, while keeping other features constant. Here, we present a modeling approach to the investigation of human hair perception using computer-generated, virtual (rendered) human hair. In three experiments, we manipulated hair diameter (Experiment 1), hair density (Experiment 2), and hair style (Experiment 3) of human (female) head hair and studied perceptions of age, health and attractiveness. Our results show that even subtle changes in these features have an impact on hair perception. We discuss our findings with reference to previous studies on condition-dependent quality cues in women that influence human social perception, thereby suggesting that hair is a salient feature of human physical appearance, which contributes to the perception of beauty.
Background Missing data within the comprehensive geriatric assessment of the interRAI suite of assessment instruments potentially imply the under-detection of conditions that require care as well as the risk of biased statistical results. Impaired oral health in older individuals has to be registered accurately as it causes pain and discomfort and is related to the general health status. Objective This study was based on interRAI-Home Care (HC) baseline data from 7590 subjects (mean age 81.2 years, SD 6.9) in Belgium. It was investigated if missingness of the oral health-related items was associated with selected variables of general health. It was also determined if multiple imputation of missing data affected the associations between oral and general health. Materials and Methods Multivariable logistic regression was used to determine if the prevalence of missingness in the oral health-related variables was associated with activities of daily life (ADLH), cognitive performance (CPS2) and depression (DRS). Associations between oral health and ADLH, CPS2 and DRS were determined, with missing data treated by 1. the complete-case technique and 2. by multiple imputation, and results were compared. Results The individual oral health-related variables had a similar proportion of missing values, ranging from 16.3% to 17.2%. The prevalence of missing data in all oral health-related variables was significantly associated with symptoms of depression (dental prosthesis use OR 1.66, CI 1.41–1.95; damaged teeth OR 1.74, CI 1.48–2.04; chewing problems OR 1.74, CI 1.47–2.05; dry mouth OR 1.65, CI 1.40–1.94). Missingness in damaged teeth (OR 1.27, CI 1.08–1.48), chewing problems (OR 1.22, CI 1.04–1.44) and dry mouth (OR 1.23, CI 1.05–1.44) occurred more frequently in cognitively impaired subjects. ADLH was not associated with the prevalence of missing data. When comparing the complete-case technique with the multiple imputation approach, nearly identical odds ratios
Atlanta Regional Commission, GA.
The aging network has been slow to embrace health promotion activities as core services to the aging population. Therefore, advocates for business and aging partnerships in health promotion activities must first educate their colleagues about the value of health promotion programs before looking for partners in the business community. The goal of…
Introduction The gradual shift of general paediatric surgery (GPS) provision from district general hospitals (DGH) to specialised units is well recognised in the UK. The consequences of centralisation include a reduction in exposure to GPS for current surgical trainees. The GPS practice of a DGH is examined here. Methods All operations performed on children aged under 5 years over a 5-year period were identified using the local electronic operation database. Electronic hospital records and clinic letters were accessed to collect data on demographics, operations performed and outcome measures. Results 472 GPS operations were performed on children between the age of 22 days and 5 years between 2009 and 2014, of which 43 were on an emergency basis and 105 were performed on patients aged less than 1 year. Three patients were admitted following day case surgery. Six patients were readmitted within 30 days. Complication rates for all procedures and the four most common procedures were similar to those found in published literature. Conclusions GPS for patients aged less than 5 years is comparatively safe in the DGH setting. The training opportunities available at DGHs are invaluable to surgical trainees and vital for sustaining the future provision of GPS by such hospitals. PMID:27269243
Calnan, Michael; Almond, Stephen; Smith, Nick
One possible explanation for the positive relationship between age and public and user views of health care is that it reflects a generational effect and this relationship has changed over the last decade or so. The analysis carried out in this report examines the relationship between ageing and levels of satisfaction with the health service in the UK using pooled data from the British Social Attitudes Survey, 1983-99. At the descriptive level there is strong evidence of a positive trend between age and satisfaction with general practice and hospital services, and for how the NHS is run but not for NHS primary dental services. Also, when comparing 1983 with 1999 data, there is evidence of a shift down in satisfaction levels for all of these indicators with the widest gap in inpatient services. At the multivariate level there is some evidence to suggest that, over time, the older population value how the NHS is run and GP and dental services at a slightly higher rate compared with the younger population, but the effect is small. This 'age/cohort' interaction effect is, however, negative for inpatient and outpatient services. These findings show little evidence of marked changes in attitude among the elderly or that the elderly are becoming more critical and less positive in their attitude to health care in the UK. The theoretical and methodological implications of these findings are discussed.
There are complex reciprocal relationships between health and social, emotional and economic factors in aging populations. Social and affective neurosciences are rapidly developing an understanding of the mechanisms underlying these phenomena using sophisticated behavioural, neuroimaging and psychophysiological methods. These techniques are often complex and expensive, so are generally used in relatively small selected samples rather than in large-scale cohort studies. However, an understanding of the significance of these processes in health and well-being depends on integrating findings from social and affective neuroscience into population-level studies. The aim of this article is to describe how a population perspective on the determinants of health and well-being in old age articulates with the agenda of social, affective and economic neuroscience, particularly through the application of psychosocial biomarker research. Social and affective neuroscience and epidemiological approaches provide complementary research strategies for understanding the mechanisms linking social, emotional and economic factors with health risk. This will be illustrated primarily from findings from two studies conducted at University College London, the Whitehall II Study and the English Longitudinal Study of Ageing.
Abstract Objective Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH). Methods The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed. Results In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001). Conclusions Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth. PMID:28289473
Pitt-Catsouphes, Marcie; James, Jacquelyn Boone; Matz-Costa, Christina
Workplace-based health and wellness programs (HWPs) may be an obvious yet under-utilized strategy for promoting positive health-related behaviors among older workers and for increasing their ability to continue to work. Given the unprecedented number of older adults who extend their labor force attachment beyond traditional retirement ages, a new vision of older adults' economic security and overall quality-of-life should take into account the intersections of aging, work, and health. The purpose of this article is to: (a) discuss the workplace as an increasingly important setting that can expand the reach and effectiveness of health promotion efforts; (b) examine current knowledge of barriers and facilitators that can affect older workers' participation in workplace-based HWPs; and (c) suggest new incentive structures that may increase older workers' engagement in these programs. We develop a rationale for our proposition that sustained participation in HWPs may improve the health status of older workers and reduce health care costs. It is our conclusion that there is significant potential for workplace-based HWPs to support older adults who want to or need to work.
Lockhart, Samuel N.; Roach, Alexandra E.; Luck, Steven J.; Geng, Joy; Beckett, Laurel; Carmichael, Owen; DeCarli, Charles
A fundamental controversy is whether cognitive decline with advancing age can be entirely explained by decreased processing speed, or whether specific neural changes can elicit cognitive decline, independent of slowing. These hypotheses are anchored by studies of healthy older individuals where age is presumed the sole influence. Unfortunately, advancing age is also associated with asymptomatic brain white matter injury. We hypothesized that differences in white matter injury extent, manifest by MRI white matter hyperintensities (WMH), mediate differences in visual attentional control in healthy aging, beyond processing speed differences. We tested young and cognitively healthy older adults on search tasks indexing speed and attentional control. Increasing age was associated with generally slowed performance. WMH was also associated with slowed search times independent of processing speed differences. Consistent with evidence attributing reduced network connectivity to WMH, these results conclusively demonstrate that clinically silent white matter injury contributes to slower search performance indicative of compromised cognitive control, independent of generalized slowing of processing speed. PMID:24183716
Zhang, Chuanchuan; Lei, Xiaoyan; Strauss, John; Zhao, Yaohui
We document the recent profile of health insurance and health care among mid-aged and older Chinese using data from the China Health and Retirement Longitudinal Study conducted in 2011. Overall health insurance coverage is about 93%. Multivariate regressions show that respondents with lower income as measured by per capita expenditure have a lower chance of being insured, as do the less-educated, older, and divorced/widowed women and rural-registered people. Premiums and reimbursement rates of health insurance vary significantly by schemes. Inpatient reimbursement rates for urban people increase with total cost to a plateau of 60%; rural people receive much less. Demographic characteristics such as age, education, marriage status, per capita expenditure, and self-reported health status are not significantly associated with share of out-of-pocket cost after controlling community effects. For health service use, we find large gaps that vary across health insurance plans, especially for inpatient service. People with access to urban health insurance plans are more likely to use health services. In general, Chinese people have easy access to median low-level medical facilities. It is also not difficult to access general hospitals or specialized hospitals, but there exists better access to healthcare facilities in urban areas. Copyright © 2016 John Wiley & Sons, Ltd.
Background: Periodic general health examinations (GHEs) are gradually becoming more popular as they employ subclinical screenings, as a means of early detection. This study considers the effect of information technology (IT), health communications and the public's attitude towards GHEs in Vietnam. Methods: A total of 2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas. Results: In total, 42.12% of participants stated that they were willing to use IT applications to recognise illness symptoms, and nearly 2/3 of them rated the healthcare quality at average level or below. Discussion: The data, which was processed by the BCL model, showed that IT applications (apps) reduce hesitation toward GHEs; however, older people seem to have less confidence in using these apps. Health communications and government's subsidy also increased the likelihood of people attending periodic GHEs. The probability of early check-ups where there is a cash subsidy could reach approximately 80%.
Jaspers, Loes; Daan, Nadine M P; van Dijk, Gabriella M; Gazibara, Tatjana; Muka, Taulant; Wen, Ke-Xin; Meun, Cindy; Zillikens, M Carola; Roeters van Lennep, Jeanine E; Roos-Hesselink, Jolien W; Laan, Ellen; Rees, Margaret; Laven, Joop S E; Franco, Oscar H; Kavousi, Maryam
Middle-aged and elderly women constitute a large and growing proportion of the population. The peri and postmenopausal period constitutes a challenging transition time for women's health, and menopausal health is a crucial aspect in healthy and successful aging. Currently, no framework for the concept of healthy menopause exists, despite its recognized importance. Therefore, we aimed to: (i) characterize healthy menopause; (ii) identify aspects that contribute to it; and (iii) explore potential approaches to measure it. We propose healthy menopause as a dynamic state, following the permanent loss of ovarian function, which is characterized by self-perceived satisfactory physical, psychological and social functioning, incorporating disease and disability, allowing the attainment of a woman's desired ability to adapt and capacity to self-manage. The concept of healthy menopause applies to all women from the moment they enter the menopausal transition, up until they reach early and late postmenopause and includes women with spontaneous, iatrogenic, and premature menopause. This conceptualization can be considered as a further step in the maintenance and improvement of health in menopausal women from different perspectives, foremost the woman's own perspective, followed by the clinical, public health, and societal perspectives, and can be seen as a further step in delineating lines for future research. Furthermore, it could facilitate the improvement of adequate preventive and treatment strategies, guide scientific efforts, and aid education and communication to health care practitioners and the general public, allowing women the achievement of their potential and the fulfillment of their fundamental role in society.
Vogt, Dominique; Schaeffer, Doris; Messer, Melanie; Berens, Eva-Maria; Hurrelmann, Klaus
Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99-4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29-3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed.
Friborg, Oddgeir; Emaus, Nina; Rosenvinge, Jan H.; Bilden, Unni; Olsen, Jan Abel; Pettersen, Gunn
This general population-based study examined associations between violence and mental health, musculoskeletal pain, and early disability pension. The prevalence and consequences of good vs. poor adjustment (resilience vs. vulnerability) following encounters with violence were also examined. Data were based on the sixth wave of the “Tromsø Study” (N = 12,981; 65.7% response rate, 53.4% women, M-age = 57.5 years, SD-age = 12.7 years). Self-reported data on psychological (threats) and physical violence (beaten/kicked), mental health (anxiety/depression), musculoskeletal pain (MSP), and granting of disability pension (DP) were collected. Men suffered more violent events during childhood than women did, and vice versa during adulthood. Psychological violence implied poorer mental health and slightly more MSP than physical violence. The risk of MSP was highest for violence occurring during childhood in women and during the last year for men. A dose-response relationship between an increasing number of violent encounters and poorer health was observed. About 58% of individuals reported no negative impact of violence (hence, resilience group), whereas 42% considered themselves as more vulnerable following encounters with violence. Regression analyses indicated comparable mental health but slightly more MSP in the resilience group compared to the unexposed group, whereas the vulnerable group had significantly worse health overall and a higher risk of early granting of DP. Resilience is not an all-or-nothing matter, as physical ailments may characterize individuals adapting well following encounters with violence. PMID:26317970
Farrahi, Hassan; Kafi, Seyed Mousa; Karimi, Tamjid; Delazar, Robabeh
Background: Particularly, this concept has used for examination of its empact on health of various people groups. Given the importance of students' health, this study investigated the relationship between emotional intelligence and general health. Objectives: The concept of emotional intelligence has attracted growing interest from researchers working in various fields. This study investigated the relationship between emotional intelligence and general health. Materials and Methods: In this cross-sectional study, 136 students were selected from the University of Guilan, north of Iran, using simple random sampling. The subjects completed the Schutte self-report emotional intelligence test and general health questionnaire. Results: The results showed a significant correlation between emotional intelligence and general health. Also, results indicated that emotional perception and emotional utilization are predictors of general health. Conclusions: The findings reflect that emotional intelligence can play an important role in general health. PMID:26576167
Singletary, Joanne H.; Bartle, Craig L.; Svirydzenka, Nadzeya; Suter-Giorgini, Nicola M.; Cashmore, Annette M.; Dogra, Nisha
Objectives: Increased recognition of the need for health education in schools has seen advances in health literacy in recent years. Most of these have focussed on physical health, whereas education about mental health is generally lacking and focussed on tackling stigma rather than promoting good mental health. This study evaluated a pilot…
Fisher, William H.; Gershenson, Bernice; Grudzinskas, Albert J.; Banks, Steven M.
We compared arrest onset and frequency and types of charges between a statewide cohort of adolescent girls in the public mental health system and girls of the same age in the general population to investigate important differences that could have policy or intervention implications. Girls in the public mental health system were arrested at earlier ages more frequently and were charged with more serious offenses than were girls in the general population. Our results strongly argue for cooperation between the public mental health and justice systems to provide mental health and offender rehabilitation in their shared population. PMID:19059845
Hahn, Joan Earle; FitzGerald, Leah; Markham, Young Kee; Glassman, Paul; Guenther, Nancy
Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3. PMID:22619708
Violence against women has been recognized as both a major public health problem and a human rights violation worldwide. Research has documented the association between physical/sexual intimate partner violence (IPV) and mental health, measured by the 12-item General Health Questionnaire (GHQ-12) among women in reproductive age. This study…
Sivananthan, Saskia N; Chambers, Larry W
A rapid and feasible priority-setting method conducted within a limited budget was used to identify research topics that would have an influence on health services for older adults. Health and aging researchers, policy makers, and caregivers were recruited to complete Delphi surveys that generated and ranked topics and identified other potential researchers. An interdisciplinary team of researchers was selected to produce and submit a proposal to a peer-review-granting agency. This method can be adapted by organizations to determine the focus of their research agenda and to engage individuals for collaboration on future research projects.
The study investigated the role of immigration status on self-rated health, general health, and well-being among elderly persons by comparing two groups of elderly persons who immigrated from Eastern European countries to Israel-veterans and new immigrants. It also examined the factors that explain self-rated health in both groups. Data for this study (n = 784) were taken from a study based on structured home interviews of a random sample of Israeli Jewish elderly (70+) conducted in 1994. The results show that the new immigrants are younger and have higher education than the veterans, but their economic status is lower and they have a lower percentage of men and married persons. The new immigrants also rank themselves lower than the veterans on a variety of measures of health and psycho-social well-being. It is suggested that the stress caused by immigration and factors related to the standard of living and health services in the countries of origin outweigh the relative advantage that the new immigrants have, in terms of age and education, in influencing their health and well-being. Self-rated health among the new immigrants is explained mainly by objective measures of health, economic status and a feeling of control over life, while among the veterans it is explained by these variables as well as by other psycho-social variables such as self-esteem and social support. These findings suggest careful analyses of subjective evaluations of health in different socio-cultural subgroups in society for theoretical reasons and for purposes of planning interventions directed to promote health and psycho-social well-being of elderly persons on the community level.
van der Kluit, Maria Johanna; Goossens, Peter J J
An estimated 40% of patients in general health care settings suffer from a comorbid mental illness. A literature review was conducted to elucidate the factors underlying the different attitudes of nurses in general health care toward the nursing care of these patients. Although lack of knowledge, skills, and additional training with respect to dealing with patients with comorbid mental illness were frequently mentioned as a cause of negative attitudes, their exact relationships remained unclear. A holistic nursing vision, support, and older age were described as having a positive influence on a positive attitude, and workload was described as having a negative influence.
Dogra, Shilpa; Clarke, Janine; Roy, Joel; Fowles, Jonathon
Distribution of fat is important when considering health risk; however, the value added from skinfold measurements (SKF) when using body mass index (BMI) refined by waist circumference (WC) is not well understood. The purpose of this study was to assess the utility of SKF compared with WC in determination of health risk in the general population. Data from the Canadian Health Measures Survey (cycles 1 and 2; N = 5217) were used. Health outcomes included directly measured blood pressure, cholesterol, glycated haemoglobin, lung function, self-reported health, and chronic conditions. Technical errors of measurements (TEM), sensitivity, and specificity analysis and linear regressions were conducted. Data indicated that TEM for SKF was above the acceptable 5% in most age and sex categories. Sensitivity and specificity of chronic conditions was not improved with the inclusion of SKF in models containing WC (in those aged 45-69 years) and SKF did not explain any additional variance in regression models containing WC. Health outcomes for those in the normal weight and overweight BMI category were significantly worse in those classified as high risk based on WC, whereas SKF did not consistently discriminate risk. In conclusion, evidence-based WC cut-points were shown to identify health risk, particularly in normal weight and overweight individuals. Thus, BMI refined by WC appears to be more appropriate than SKF for assessment of body composition when determining health risk in the general population.
Poulose, Shibu M; Miller, Marshall G; Shukitt-Hale, Barbara
Because of the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden. Clinical manifestation of many of these disorders takes years, with the initiation of mild cognitive symptoms leading to behavioral problems, dementia and loss of motor functions, the need for assisted living, and eventual death. Lifestyle factors greatly affect the progression of cognitive decline, with high-risk behaviors including unhealthy diet, lack of exercise, smoking, and exposure to environmental toxins leading to enhanced oxidative stress and inflammation. Although there exists an urgent need to develop effective treatments for age-related cognitive decline and neurodegenerative disease, prevention strategies have been underdeveloped. Primary prevention in many of these neurodegenerative diseases could be achieved earlier in life by consuming a healthy diet, rich in antioxidant and anti-inflammatory phytochemicals, which offers one of the most effective and least expensive ways to address the crisis. English walnuts (Juglans regia L.) are rich in numerous phytochemicals, including high amounts of polyunsaturated fatty acids, and offer potential benefits to brain health. Polyphenolic compounds found in walnuts not only reduce the oxidant and inflammatory load on brain cells but also improve interneuronal signaling, increase neurogenesis, and enhance sequestration of insoluble toxic protein aggregates. Evidence for the beneficial effects of consuming a walnut-rich diet is reviewed in this article.
Michel, Jean-Pierre; Herrmann, François; Zekry, Dina
Analysis of prospective data collected between 1984 and 2008 by the CERN medical team (European Centre of Nuclear Research, Geneva) concerning 2040 former employees who were retired or had died stimulated our interest on the impact of inequalities in socioeconomic conditions, employment, lifestyle and classical risk factors on health and life expectancy. Such inequalities explain differences in life expectancy, potentially reaching several decades, between rich and poor countries (France vs Swaziland), but also within a given country (USA), a given city (Glasgow) or even a given enterprise (CERN) where all employees have the same level of healthcare insurance and access to treatment. Classical cardiovascular and neurovascular risk factors (smoking, arterial hypertension and lipid disorders) interact with socioeconomic status, intelligence, education, emotions and job responsibility/complexity, precipitating or preventing cardiovascular events. The same is true of dementia, for which midlife risk factors (obesity, arterial hypertension and hypercholesterolemia) should be considered in the psychosocioeconomic context, which influences cognitive reserves and thus affects the risk and severity of dementia in old age. Thus, in addition to lifestyle and classical risk factors, socioeconomic status appears as a major health determinant, by imposing behaviors and habits and by determining access to healthcare.
Houghton, Lesley A; Heitkemper, Margaret; Crowell, Michael; Emmanuel, Anton; Halpert, Albena; McRoberts, James A; Toner, Brenda
Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective. Although the majority of FGIDs, including globus, rumination syndrome, IBS, bloating, constipation, functional abdominal pain, sphincter of Oddi dyskinesia, pelvic floor dysfunction, and extra-intestinal manifestations, are more prevalent in women than men, functional chest pain, dyspepsia, vomiting, and anorectal pain do not appear to vary by gender. Studies suggest sex differences in somatic but not visceral pain perception, motility, and central processing of visceral pain; although further research is required in autonomic nervous system dysfunction, genetics and immunologic/microbiome. Gender differences in response to psychological treatments, antidepressants, fiber, probiotics, and anticholinergics have not been adequately studied. However, a greater clinical response to 5-HT3 antagonists but not 5-HT4 agonists has been reported in women compared with men.
Brandl, Caroline; Breinlich, Valentin; Stark, Klaus J.; Enzinger, Sabrina; Aßenmacher, Matthias; Olden, Matthias; Grassmann, Felix; Graw, Jochen; Heier, Margit; Peters, Annette; Helbig, Horst; Küchenhoff, Helmut; Weber, Bernhard H. F.; Heid, Iris M.
Age-related macular degeneration (AMD) is a vision impairing disease of the central retina characterized by early and late forms in individuals older than 50 years of age. However, there is little knowledge to what extent also younger adults are affected. We have thus set out to estimate the prevalence of early AMD features and late AMD in a general adult population by acquiring color fundus images in 2,840 individuals aged 25 to 74 years of the Cooperative Health Research in the Region of Augsburg project (KORA) in South Germany. Among the 2,546 participants with gradable images for each eye, 10.9% (n = 277) had early AMD features (applying the 9-step Age-Related Eye Disease Study Severity Scale), 0.2% (n = 6) had late AMD. Prevalence increased with age, reaching 26.3% for early AMD features and 1.9% for late AMD at the age 70+. However, signs of early AMD were found in subjects as young as 25 years, with the risk for early AMD features increasing linearly by years of age in men, and, less consistent with a linear increase, in women. Risk for early AMD features increased linearly by pack years of smoking in men, not in women, nor was there any association with other lifestyle or metabolic factors. By providing much sought-after prevalence estimates for AMD from Central Europe, our data underscores a substantial proportion of the adult population with signs of early AMD, including individuals younger than 50 years. This supports the notion that early AMD features in the young might be under-acknowledged. PMID:27893849
The classical indicators typically used to understand the consequences of population aging upon the ability to finance social services fail to consider the active participation of older individuals. But such participation and contribution is not negligible in countries where the financing of social programs is mainly assured through governments¿ general funds. This paper considers the actual and future importance of the participation of the elderly in funding public expenditures in Quebec, Canada. Specifically, the author attempts to determine the contribution of the elderly to the public financing of health and social expenditures taking into account overall government revenues, how that contribution will change over time and which related factors could be influenced, and up to what point can this contribution offset the projected growth in the financial burden of countries caused by an aging population. Governments¿ revenue sources and indexes related to people¿s contributions are discussed with regard to taxation on consumption and income. The contribution of the elderly to the financing of public expenditures is then considered, followed by sections on the contribution of the elderly to government revenues and the financing of social expenses, and future trends in the contribution. Demographic and health factors such as the population¿s health status and the aging of the active population also affect expenditure trends and the ability of a population to finance them.
Fischer, Benedikt; Ialomiteanu, Anca R; Aeby, Samantha; Rudzinski, Katherine; Kurdyak, Paul; Rehm, Jürgen
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.
Hill, Tom R; Aspray, Terence J; Francis, Roger M
The aim of this review is to summarise the evidence linking vitamin D to bone health outcomes in older adults. A plethora of scientific evidence globally suggests that large proportions of people have vitamin D deficiency and are not meeting recommended intakes. Older adults are at particular risk of the consequences of vitamin D deficiency owing to a combination of physiological and behavioural factors. Epidemiological studies show that low vitamin D status is associated with a variety of negative skeletal consequences in older adults including osteomalacia, reduced bone mineral density, impaired Ca absorption and secondary hyperparathyroidism. There seems to be inconsistent evidence for a protective role of vitamin D supplementation alone on bone mass. However, it is generally accepted that vitamin D (17·5 μg/d) in combination with Ca (1200 mg/d) reduces bone loss among older white subjects. Evidence for a benefit of vitamin D supplementation alone on reducing fracture risk is varied. According to a recent Agency for Healthcare Research and Quality review in the USA the evidence base shows mixed results for a beneficial effect of vitamin D on decreasing overall fracture risk. Limitations such as poor compliance with treatment, incomplete assessment of vitamin D status and large drop-out rates however, have been highlighted within some studies. In conclusion, it is generally accepted that vitamin D in combination with Ca reduces the risk of non-vertebral fractures particularly those in institutional care. The lack of data on vitamin D and bone health outcomes in certain population groups such as diverse racial groups warrants attention.
Sunderland, Matthew; Slade, Tim; Carragher, Natacha; Batterham, Philip; Buchan, Heather
Two methodological criticisms have limited the reliability and validity of findings from previous studies that seek to examine change across the life span in levels of internalizing psychopathology using general population surveys. The first criticism involves the potential influence of cohort effects that confound true age-related changes whereas the second criticism involves the use of a single form of assessment to measure and compare levels of internalizing psychopathology. This study seeks to address these criticisms by modeling age-related change using multiple measures and multiple surveys. Data from 2 epidemiological surveys conducted 10 years apart in the Australian general population were combined and used for the current study. The latent construct of internalizing psychopathology was modeled using a combination of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) depression and anxiety diagnoses as well as items from the Kessler Psychological Distress scale (K10; Kessler et al., 2002). Confirmatory factor analysis (CFA) indicated that a single internalizing dimension provided good model fit to the data. Multigroup CFA indicated that strict measurement invariance of the model can be assumed across survey administrations and age bands, justifying comparisons of mean differences in latent trait levels. Significant changes in mean levels of latent internalizing psychopathology were evident between respondents aged 30-39 years old in 1997 and respondents aged 40-49 years old in 2007, suggesting a minor but significant increase in psychopathology across middle age. By contrast, a minor but significant decrease in psychopathology was noted when transitioning from late middle age (50-59 years old) to old age (60-69 years old). The majority of individuals in the general population will experience constant levels of internalizing psychopathology as they age, suggesting that the construct is relatively
... health standards. 50-204.2 Section 50-204.2 Public Contracts and Property Management Other Provisions Relating to Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY CONTRACTS General Safety and Health Standards § 50-204.2 General safety and...
Tokuda, Y.; Okubo, T.; Yanai, H.; Jacobs, J.; Ohde, S.; Takahashi, O.; Omata, F.; Hinohara, S.; Fukui, T.
Objective: Health locus of control (HLC) is associated with health behaviours. We aimed to investigate the difference of HLC to understand the potential gap in health beliefs between physicians and the general public. Design and setting: Physicians and the general public were surveyed in Japan using a cross-sectional survey. Data on the Japanese…
Vogel, Ineke; van de Looij-Jansen, Petra M.; Mieloo, Cathelijne L.; Burdorf, Alex; de Waart, Frouwkje
Objective To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. Methods A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. Results About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. Conclusions Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people’s health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed. PMID:24897078
Roe, Brenda; Beynon, Caryl; Pickering, Lucy; Duffy, Paul
roe b., beynon c., pickering l. & duffy p. (2010)Experiences of drug use and ageing: health, quality of life, relationship and service implications. Journal of Advanced Nursing66(9), 1968–1979. Aim This paper is a report of an exploration of older people’s experiences of substance use in the context of ageing, and its impact on health, quality of life, relationships and service use. Background Use of illicit drugs by older people is a neglected policy, research and service provision and is generally perceived as a lifestyle of younger populations. Method A convenience sample of 11 people aged 49–61 years (mean 57 years) in contact with voluntary sector drug treatment services participated in qualitative semi-structured tape-recorded interviews and thematic content analysis was performed. The data were collected in 2008. Findings Drug use can have negative impacts on health status, quality of life, family relationships and social networks that accrue with age. Participants were identified as early or later onset users of drugs due to the impact of life events and relationships. A range of substances had been used currently and throughout their lives, with no single gateway drug identified as a prelude to personal drug careers. Life review and reflection were common, in keeping with ageing populations, along with regret of ever having started to use drugs. Living alone and their accommodation made them more susceptible to social isolation, and they reported experiences of death and dying of their contemporaries and family members earlier than usual in the life course. Conclusion Older people who continue to use drugs and require the support of services for treatment and care are an important emerging population and their specific needs should recognized. PMID:20626477
Kim, Min Jeong; Lee, Chul Won
The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women. PMID:27389818
Bartels, Stephen J.; Pratt, Sarah I.; Mueser, Kim T.; Naslund, John A.; Wolfe, Rosemarie S.; Santos, Meghan; Xie, Haiyi; Riera, Erik G.
Objectives Self-management is promoted as a strategy for improving outcomes for serious mental illness as well as for chronic general medical conditions. This study evaluated the feasibility and effectiveness of an eight-month program combining training in self-management for both psychiatric and general medical illness, including embedded nurse care management. Methods Participants were 71 middle-aged and older adults (mean age=60.3±6.5) with serious mental illness and chronic general medical conditions who were randomly assigned to receive integrated Illness Management and Recovery (I-IMR) (N=36) or usual care (N=35). Feasibility was determined by attendance at I-IMR and nurse sessions. Effectiveness outcomes were measured two and six months after the intervention (ten- and 14-month follow-ups) and included self-management of psychiatric and general medical illness, participation in psychiatric and general medical encounters, and self-reported acute health care utilization. Results I-IMR participants attended 15.8±9.5 I-IMR and 8.2±5.9 nurse sessions, with 75% attending at least ten I-IMR and five nurse sessions. Compared with usual care, I-IMR was associated with greater improvements in participant and clinician ratings for psychiatric illness self-management, greater diabetes self-management, and an increased preference for detailed diagnosis and treatment information during primary care encounters. The proportion of I-IMR participants with at least one psychiatric or general medical hospitalization decreased significantly between baseline and ten- and 14-month follow-ups. Conclusions I-IMR is a feasible intervention for this at-risk group and demonstrated potential effectiveness by improving self-management of psychiatric illness and diabetes and by reducing the proportion of participants requiring psychi atric or general medical hospitalizations. PMID:24292559
Nesami, Masoumeh Bagheri; Goudarzian, Amir Hossein; Zarei, Houman; Esameili, Pedram; Pour, Milad Dehghan; Mirani, Hesam
Aim: This research organized to determine the relationship between Emotional Intelligence (EI) with Religious Coping and Mental Health of students at Mazandaran University of Medical Sciences. Method: This descriptive and analytical study was conducted in 2014 on 335 students at Mazandaran University of Medical Sciences. Students were selected by stratified random sampling method. The instruments to gather data were Bradberry and Greaves Standard Emotional Intelligence Questionnaire, the 12-item General Health Questionnaire, and the Pargament’s Religious Coping. Data was analyzed by SPSS 21 via descriptive and inferential statistics (Pearson and Spearman’s correlation). Results: Among 335 students under investigation, 144 students were male (43%) and 191 ones were female (57%). Their ages were ranging from 17 to 34 years old (21.02±2.014). Average EI scores, positive religious coping, negative religious coping, and mental health were 91.27, 14.91, 4.86, 5.34, respectively. Moreover, there was a direct and significant relationship between EI and positive religious coping (r=0.282, P<0.001). Conclusions: According to the results of this study, there is a direct correlation between positive religious coping and emotional intelligence. So Strengthening religious coping can promote emotional intelligence that is one component of mental health. PMID:26889101
Appukuttan, DP; Vinayagavel, M; Balasundaram, A; Damodaran, LK; Shivaraman, P; Gunasshegaran, K
Background: Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population. Aim: In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI-Tml). Subjects and Methods: Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test-retest, Cronbach alpha, and split half reliability. Inter-item and item-total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20–70 years attending the outpatient department were recruited. Subjects were requested to fill a self-reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self-perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure. Results: Mean GOHAI-Tml was 52.7 (6.8, range 22–60, median 54). The mean number of negative impacts was 2 (2.4, range 0–11, median 1). The Spearman rank correlation for test-retest ranged from 0.8 to 0.9 (P < 0.001) for all the 12 items between visits. The Cronbach alpha for 265 samples was 0.8 suggesting good internal consistency and homogeneity between items. Item scale correlation ranged from 0.4 to 0.8 (P < 0.001). Concurrent and discriminant validity was established. Principal component analysis resulted in extraction of four factors which together accounted for 66.4% (7.9/12) variance. Conclusion: GOHAI-Tml has shown acceptable
Krijgsman, Johan W; Brabers, Anne E; Jong, Judith D De; Friele, Roland D
Background Policy makers promote the use of eHealth to widen access to health care services and to improve the quality and safety of care. Nevertheless, the enthusiasm among policy makers for eHealth does not match its uptake and use. eHealth is defined in this study as “health services delivered or enhanced through the Internet and related information and communication technologies.” Objective The objective of this study was to investigate (1) the current use of eHealth in the Netherlands by general practitioners (GPs) and health care users, (2) the future plans of GPs to provide eHealth and the willingness of health care users to use eHealth services, and (3) the perceived positive effects and barriers from the perspective of GPs and health care users. Methods A cross-sectional survey of a sample of Dutch GPs and members of the Dutch Health Care Consumer Panel was conducted in April 2014. A pre-structured questionnaire was completed by 171 GPs (12% response) and by 754 health care users (50% response). In addition, two focus groups were conducted in June 2014: one group with GPs (8 participants) and one with health care users (10 participants). Results Three-quarters of Dutch GPs that responded to the questionnaire (67.3%, 115/171) offered patients the possibility of requesting a prescription via the Internet, and half of them offered patients the possibility of asking a question via the Internet (49.1%, 84/171). In general, they did intend to provide future eHealth services. Nonetheless, many of the GPs perceived barriers, especially concerning its innovation (eg, insufficient reliable, secure systems) and the sociopolitical context (eg, lack of financial compensation for the time spent on implementation). By contrast, health care users were generally not aware of existing eHealth services offered by their GPs. Nevertheless, half of them were willing to use eHealth services when offered by their GP. In general, health care users have positive attitudes
Bausell, R. Barker; Soeken, Karen L.
Although considerable data exist linking individual lifestyle variables to health outcomes, little is known about how the elderly differ from younger adults with respect to both their health seeking behavior and their beliefs about health. A national survey contrasted 155 persons aged 65 years of age or older with 1100 younger adults in order to…
Damron-Rodriguez, JoAnn; Effros, Rita
The University of California-Los Angeles (UCLA) General Education "Clusters" are innovations in student-centered undergraduate education focused on complex phenomena that require an interdisciplinary perspective. UCLA gerontology and geriatric faculty recognized the opportunity to introduce freshmen to the field of aging through this new…
GIURGIUTIU,VICTOR; REDMOND,JAMES M.; ROACH,DENNIS P.; RACKOW,KIRK A.
A project to develop non-intrusive active sensors that can be applied on existing aging aerospace structures for monitoring the onset and progress of structural damage (fatigue cracks and corrosion) is presented. The state of the art in active sensors structural health monitoring and damage detection is reviewed. Methods based on (a) elastic wave propagation and (b) electro-mechanical (NM) impedance technique are sighted and briefly discussed. The instrumentation of these specimens with piezoelectric active sensors is illustrated. The main detection strategies (E/M impedance for local area detection and wave propagation for wide area interrogation) are discussed. The signal processing and damage interpretation algorithms are tuned to the specific structural interrogation method used. In the high-frequency EIM impedance approach, pattern recognition methods are used to compare impedance signatures taken at various time intervals and to identify damage presence and progression from the change in these signatures. In the wave propagation approach, the acoustic-ultrasonic methods identifying additional reflection generated from the damage site and changes in transmission velocity and phase are used. Both approaches benefit from the use of artificial intelligence neural networks algorithms that can extract damage features based on a learning process. Design and fabrication of a set of structural specimens representative of aging aerospace structures is presented. Three built-up specimens, (pristine, with cracks, and with corrosion damage) are used. The specimen instrumentation with active sensors fabricated at the University of South Carolina is illustrated. Preliminary results obtained with the E/M impedance method on pristine and cracked specimens are presented.
GIURGIUTIU,VICTOR; REDMOND,JAMES M.; ROACH,DENNIS P.; RACKOW,KIRK A.
A project to develop non-intrusive active sensors that can be applied on existing aging aerospace structures for monitoring the onset and progress of structural damage (fatigue cracks and corrosion) is presented. The state of the art in active sensors structural health monitoring and damage detection is reviewed. Methods based on (a) elastic wave propagation and (b) electro-mechanical (E/M) impedance technique are cited and briefly discussed. The instrumentation of these specimens with piezoelectric active sensors is illustrated. The main detection strategies (E/M impedance for local area detection and wave propagation for wide area interrogation) are discussed. The signal processing and damage interpretation algorithms are tuned to the specific structural interrogation method used. In the high-frequency E/M impedance approach, pattern recognition methods are used to compare impedance signatures taken at various time intervals and to identify damage presence and progression from the change in these signatures. In the wave propagation approach, the acousto-ultrasonic methods identifying additional reflection generated from the damage site and changes in transmission velocity and phase are used. Both approaches benefit from the use of artificial intelligence neural networks algorithms that can extract damage features based on a learning process. Design and fabrication of a set of structural specimens representative of aging aerospace structures is presented. Three built-up specimens (pristine, with cracks, and with corrosion damage) are used. The specimen instrumentation with active sensors fabricated at the University of South Carolina is illustrated. Preliminary results obtained with the E/M impedance method on pristine and cracked specimens are presented.
Wilson, Robert S; Yu, Lei; James, Bryan D; Bennett, David A; Boyle, Patricia A
We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer's disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.
De Luca d'Alessandro, E; Bonacci, S; Giraldi, G
The progressive tendency for the age structure of the population to shift towards the elderly has been observed in all developed countries and this has important implications for health, society, economics and epidemiology. According to the most recent estimates for the world, the number of persons aged over 60 years will double from the present number, 756 to 1400 millions by 2030. In Italy, by the year 2050, 34.6% of the population will be aged more than 65 years. This will have important implications for health. There are medical conditions that occur almost exclusively among the elderly and these are sometimes referred to as syndromes or geriatric pathologies; other conditions that can occur at younger ages, may present with different symptoms, and cause complications in the elderly. More than just the single pathologies, the presence of two or more conditions simultaneously may have a critical impact on the health status of the elderly. As their ages increase, the elderly may be considered "frail"; factors, not only physical but also psychological cognitive and social, contribute to this syndrome and all must be considered together in the diagnosis and treatment of the elderly patient. These subjects are at greater risk of physical and cognitive decline, disability and death. As the elderly are an increasing fraction of the total patient load, their problems require that the structure and organization of health services be accordingly adjusted and also that the cultural and professional training of doctors and other medical personnel is appropriate. As a consequence, the objective of governments should be to promote the health and the quality of life of the elderly and this would include primary secondary and tertiary prevention applied in a variety of different settings. The choice of the preventive measures should be determined by the general health status of the elderly individuals, of whom 60-75% are classified as healthy, 20-30% are diagnosed as suffering
... 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...
... 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...
... 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...
Mustafa, Ammar A; Raad, Kais; Mustafa, Nazih S
Key Clinical Message Here, we aimed to assess whether postoperative oral rehabilitation for mandibulectomy patients is necessary to improve patients’ general health in terms of health-related quality of life. PMID:26576270
Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.
This supplement to "Mental Health: A Report of the Surgeon General" (1999) documents the existence of striking disparities for minorities in mental health services and the underlying knowledge base. Racial and ethnic minorities have less access to mental health services than whites, and they are less likely to receive needed care. When they…
Oliveira, Albertina L; Silva, José T; Lima, Margarida P
ABSTRACT OBJECTIVE To validate the Escala de Autoeficácia para a Autodireção na Saúde (EAAS – Self-efficacy for Self-direction in Health Scale). METHODS Non-experimental quantitative study of EAAS validation, by confirmatory factorial analyses, evaluating a sample of 508 older adults from the north and the center of Portugal with mean age of 71.67 (from 51 to 96 years), to whom the Self-efficacy for Self-direction in Health Scale, the Rosenberg Self-esteem Scale, the Positive and Negative Affect Schedule, the Satisfaction with Life Scale, and the Instrumental Activities of Daily Living Scale were applied. The EAAS was developed from the theoretical constructs of self-efficacy and from self-directed learning within the PALADIN European project framework, aiming to develop an instrument able to assess the extent to which older adults take good care of their health. RESULTS The internal consistency was 0.87 (Cronbach’s alpha) and confirmatory factorial analyses enabled to find a model near the one theoretically proposed, indicating a structure consisting of four dimensions: physical exercise, healthy diet, engaging in health-related learning, and visits to health professionals. From the psychometric point of view, the model in four factors showed quite satisfactory fit indicators. CONCLUSIONS The Self-efficacy for Self-direction in Health Scale, with 16 items, is adequate to evaluate to what extent older adults have confidence in their ability to take care of their own health, with high degree of autonomy. PMID:27384970
Teranishi, Kristen; Hayes, Donald K; Iwaishi, Louise K; Fuddy, Loretta J
Obesity is a widespread national issue that affects the health and well-being of millions of people; particular attention has been focused on the burden among children. The National Survey of Children's Health data from 2007 was used to examine the relationship of child health status and unhealthy weight (overweight/obese defined as body mass index in ≥ 85 th percentile) among 874 children aged 10 to 17 years of age in Hawai'i. In particular, the parentally reported child's general health status was assessed comparing those with a poorer health status (defined as "good/fair/poor") to those with a better one (defined as "excellent/very good"). Descriptive analysis and multiple logistic regression analysis examined risk for overweight/obese with child's general health status, accounting for gender, race, and socioeconomic factors. More children with a poorer health status (46.5%; 95%CI=33.2-60.2) were overweight/obese compared to those of better health status (25.8%; 95%CI=21.9-30.2). Estimates of overweight/obese were high in Native Hawaiian/Pacific Islander (38.6%; 95%CI: 28.9-49.4), multiracial (30.9%; 95%CI=24.2-38.6) children, and children whose parents had less than 12 years education (56.8%; 95%CI=32.8-78.0). Multivariate logistic regression modeling showed a 2.92 (95%CI=1.52-5.61) greater odds for overweight/obese status in children with a poorer health status compared to those of better health status after accounting for age, race, gender, and parental education. Gender, race, and parental education were also significant factors associated with overweight/obese in the final adjusted model. It is important that children that are overweight or obese receive appropriate health screenings including assessments of general health status. Children in high risk socioeconomic groups should be a particular focus of prevention efforts to promote health equity and provide opportunities for children to reach their potential.
Bartone, Paul T.; Hoover, Elizabeth
A soldier's occupation is a very stressful one, especially for junior enlisted soldiers who have little control over their highly-regimented work lives. This prospective study examined the relationship between soldier occupational stress and health and well-being 8 to 10 months later. Through an ongoing, longitudinal study of attitudes, health,…
Public Health Service (DHEW), Rockville, MD.
The purpose of this report is to enhance both individual and national perspectives on prevention of ill health and premature death through identification of priorities and specification of measureable goals. Health problems for every age group from infancy through old age are discussed with suggestions for prevention and improvement of…
Background: Periodic general health examinations (GHEs) are gradually becoming more popular as they employ subclinical screenings, as a means of early detection. This study considers the effect of information technology (IT), health communications and the public’s attitude towards GHEs in Vietnam. Methods: A total of 2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas. Results: In total, 42.12% of participants stated that they were willing to use IT applications to recognise illness symptoms, and nearly 2/3 of them rated the healthcare quality at average level or below. Discussion: The data, which was processed by the BCL model, showed that IT applications (apps) reduce hesitation toward GHEs; however, older people seem to have less confidence in using these apps. Health communications and government’s subsidy also increased the likelihood of people attending periodic GHEs. The probability of early check-ups where there is a cash subsidy could reach approximately 80%. PMID:28163904
Background There is limited evidence about the ways in which maternal age and mode of conception interact with psychological, sociodemographic, health and health service factors in governing pregnancy health. The aim of this study was to establish in what ways maternal age and mode of conception are associated with, health behaviours, health service use and self-rated physical and mental health during pregnancy. Method A prospective cohort study was conducted in a collaboration between universities, infertility treatment services and public and private obstetric hospitals in Melbourne and Sydney, Australia,. Consecutive cohorts of nulliparous English-literate women at least 28 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age-groups: 20–30; 31–36 and at least 37 years were recruited. Data were obtained via structured individual telephone interviews and self-report postal questionnaires at recruitment and four months postpartum. Study-specific questions assessed: sociodemographic characteristics; reproductive health; health behaviours and health service use. Standardized instruments assessed physical health: SF 12 Physical Component Score (PCS) and mental health: SF12 Mental Component Score (MCS); State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale. The main outcome measures were the SF 12 PCS, SF12 MCS scores and pregnancy-related hospital admissions. Results Of 1179 eligible women 791 (67%) participated, 27 had fertility treatment without oocyte retrieval and were excluded and 592/764 (78%) completed all pregnancy assessments. When other factors were controlled speaking a language other than English, having private health insurance and multiple gestation were associated with worse physical health and having private health insurance and better physical health were associated with better mental health. Pregnancy-related hospital admissions were associated with worse physical health and multiple gestation
Chatterjee, Anirban; Saluja, Mini; Agarwal, Gunjan; Alam, Mahtab
Green tea is particularly rich in health-promoting flavonoids (which account for 30% of the dry weight of a leaf), including catechins and their derivatives. The most abundant catechin in green tea is epigallocatechin-3-gallate, which is thought to play a pivotal role in the green tea's anticancer and antioxidant effects. Catechins should be considered right alongside of the better-known antioxidants like vitamins E and C as potent free radical scavengers and health-supportive for this reason. It has been suggested that green tea also promotes periodontal health by reducing inflammation, preventing bone resorption and limiting the growth of certain bacteria associated with periodontal diseases. PMID:23055579
Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek
Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.
... National Park Service Draft General Management Plan/Environmental Impact Statement for the Ice Age Complex... Statement for the Ice Age Complex at Cross Plains, Wisconsin DATES: The draft General Management Plan... Internet through the Web site above. You may also send comments to Superintendent, Ice Age National...
Gajdos, Csaba; Kile, Deidre; Hawn, Mary T.; Finlayson, Emily; Henderson, William G.; Robinson, Thomas N.
Background While some single center studies have demonstrated that major surgical operations are safe to perform in older adults, most multicenter database studies find advancing age to independently predict adverse postoperative outcomes. We hypothesized that thirty-day postoperative mortality, complications, failure to rescue rates and postoperative length of stay will increase with advancing age. Design Retrospective cohort study. Setting Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participants Patients undergoing non-emergent major general surgical operations between 2005 and 2008 were studied. Measures Postoperative outcomes of interest were complications occurring within 30 days of the index operation, return to OR within 30 days, failure to rescue after a postoperative complication, post-surgical length of stay and 30 day mortality. Results A total of 165,600 patients were studied. The rates of postoperative mortality, overall morbidity, and each type of postoperative complication increased as age increased. The rates of failure to rescue after each type of postoperative complication also increased with age. Mortality rates in patients ≥80 following renal insufficiency (43.3%), stroke (36.5%), myocardial infarction (35.6%), and pulmonary complications (25-39%) were particularly high. Median postoperative length of stay increased with age following surgical site infection, UTI, pneumonia, return to OR, and overall morbidity, but not after venous thromboembolism, stroke, myocardial infarction, renal insufficiency, failure to wean from the ventilator or reintubations. Conclusion Thirty-day mortality, complications and failure to rescue rates increase with advancing age following non-emergent general surgical operations. Patients over 80 years of age have especially high mortality following renal, cardiovascular, and pulmonary complications. As patient age advances, surgeons need to be
Background This study aimed to determine the relationship of health behaviors with the health locus of control and the sense of self-efficacy against the background of socio-economic factors and self-rated health among students of the Universities of the Third Age (U3As). Material/Methods The study included 320 U3A students, with mean age of 67.5 years. The following research tools were used: Health Behavior Inventory (HBI), Multidimensional Health Locus of Control Scale (MHLC), Generalized Self-Efficacy Scale (GSES), and an original survey of the author’s own design. Results Mean total HBI and GSES scores were 90.63 and 30.12, respectively. These results are satisfactory. A slight predominance of internal health locus of control was documented. A number of significant correlations were found between the HBI, GSES, and MHLC scores, except for the MHLC subscale expressing the influence of chance. Educational attainment was shown to have a significant impact on the scores for the positive attitude and proper dietary habits subscales of HBI, as well as on the GSES scores. Economic status of the participants influenced the levels of positive attitude, internal health locus of control, and self-efficacy. Furthermore, internal health locus of control was found to be modulated by subjective health of the respondents. The scores for external health locus of control and the influence of chance increased significantly with age. Conclusions The currently noticeable emphasis placed on lifelong education should serve as a good prognostic factor for health behaviors and personal health resources for years to come. PMID:26879981
BACKGROUND This study aimed to determine the relationship of health behaviors with the health locus of control and the sense of self-efficacy against the background of socio-economic factors and self-rated health among students of the Universities of the Third Age (U3As). MATERIAL AND METHODS The study included 320 U3A students, with mean age of 67.5 years. The following research tools were used: Health Behavior Inventory (HBI), Multidimensional Health Locus of Control Scale (MHLC), Generalized Self-Efficacy Scale (GSES), and an original survey of the author's own design. RESULTS Mean total HBI and GSES scores were 90.63 and 30.12, respectively. These results are satisfactory. A slight predominance of internal health locus of control was documented. A number of significant correlations were found between the HBI, GSES, and MHLC scores, except for the MHLC subscale expressing the influence of chance. Educational attainment was shown to have a significant impact on the scores for the positive attitude and proper dietary habits subscales of HBI, as well as on the GSES scores. Economic status of the participants influenced the levels of positive attitude, internal health locus of control, and self-efficacy. Furthermore, internal health locus of control was found to be modulated by subjective health of the respondents. The scores for external health locus of control and the influence of chance increased significantly with age. CONCLUSIONS The currently noticeable emphasis placed on lifelong education should serve as a good prognostic factor for health behaviors and personal health resources for years to come.
Khurana, Sandhya; Venkataraman, Krishnan; Hollingsworth, Amanda; Piche, Matthew; Tai, T C
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging.
Nguyen, Ha; Knowles, James
Many developing countries are trying to expand health insurance to achieve universal coverage, yet enrolling informal sector workers and the rural population remains a challenge. A good knowledge of factors driving demand for health insurance among these groups is therefore important. The current study contributes to this body of knowledge by analyzing demand for school-age children and adolescent student (aged 6-20) health insurance, a major voluntary health insurance scheme in Vietnam. Data were drawn form the Vietnam National Health Survey (2001-2002). We found that demand increases significantly with the expected benefits of insurance as measured by proximity to and quality of a tertiary hospital. There is a strong socio-economic gradient both at the household and commune levels, with wealthier, more educated households in better-off communes significantly more likely to purchase insurance for their children. No clear evidence of adverse selection is observed whether health status is assessed objectively or subjectively. Finally, while female heads of household are generally more prone to purchase health insurance for their children, households prioritize young children, male children, and those children with more schooling in their purchase decision. Findings emphasize the need to understand the effects of both health system factors and intra-household dynamics in resource allocation to explain the demand for health insurance in developing countries.
Laumann, Edward O.; Waite, Linda J.; McClintock, Martha K.; Tiedt, Andrew
Objectives. Provide recommendations for researchers on the use of the Big Five personality battery in the National Social Life, Health, and Aging Project (NSHAP), and ensure that the battery does proxy the Big Five. Also, describe the levels of Big Five traits across gender and age. Method. We used an Exploratory Structural Equation Model (ESEM) to analyze NHSAP’s personality battery, comparing NSHAP with the National Longitudinal Study of Midlife in the United States (MIDUS) and the Health and Retirement Study (HRS). Results. ESEM revealed a 5-factor structure in the NSHAP battery, but with considerable cross-loadings. When these cross-loadings were not included in the model, model fit notably worsened. Reliabilities of Big Five scales were comparable to the HRS and MIDUS, even though NSHAP’s battery is shorter. Women were considerably more Agreeable than men, although this gender gap closed among the oldest in the sample (80 years or older). Discussion. Researchers will be able to make use of NSHAP’s personality battery to examine a range of social, biological, and psychological factors at older ages, in light of individuals’ general traits. We recommend models which allow for cross-loadings. PMID:25360012
In the Netherlands and a number of other European countries general practitioners are the gatekeepers for specialist and hospital care. European health care systems with gatekeeping general practitioners, i.e. those with comprehensive, strong primary care, perform better on a number of health indicators and on equity. However, it is less clear if gatekeeping health care systems have lower health expenditure. There is ongoing debate on whether gatekeeping plays a role in diagnostic delay of cancers. At health care system level research is being hampered by small numbers and should be combined with in-depth research into health care mechanisms.
... April 18, 2012 Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over ... and Roberto Valverde, M.P.H., Division of Health Care Statistics Abstract Objective —This report presents national estimates ...
O'Neil, E H; Seifer, S D
The transformation of U.S. health care is driven by underlying principles. The tensions between what exists now and what will emerge over the next 15 years pervade health care delivery and financing, the doctor-patient relationship, the provider-payer relationship, and the atmosphere within educational institutions for the health professions. The institutions that early on develop the capacity to forge and sustain strategic partnerships will be well positioned to take advantage of the opportunities of a rapidly changing system, but those that do not will risk being isolated without the diversity of resources needed to make meaningful contributions to health care. The tensions also drive major changes in the way health professionals are educated, trained, and deployed. Health care reforms will dramatically change the culture of the medical school in areas of patient care, research, and education programs. These institutions face external pressures to change and internal barriers to change, not the least of which are the lack of sustained leadership and collective vision. Academic medical centers must take active steps now to assess their strengths and weaknesses objectively, look realistically at options, and construct new, mutually beneficial partnerships that will be the keys to success.
Dale, Ann Marie; Ryan, Daniel; Welch, Laura; Olsen, Margaret A.; Buchholz, Bryan; Evanoff, Bradley
Objectives Compare rates of medical insurance claims for musculoskeletal disorders (MSD) between workers in a construction trade and a general worker population to determine if higher physical exposures in construction lead to higher rates of claims on personal medical insurance. Methods Health insurance claims between 2006 and 2010 from floor layers were frequency matched by age, gender, eligibility time, and geographic location to claims from insured workers in general industry obtained from MarketScan. We extracted MSD claims and dates of service from six regions of the body: neck, low back, knee, lower extremity, shoulder, and distal arm, and evaluated differences in claim rates. Results Fifty-one percent of floor layers (n=1,475) experienced musculoskeletal claims compared to 39% of MarketScan members (p<0.001). Claim rates were higher for floor layers across all body regions with nearly double the rate ratios for the knee and neck regions (RR: 2.10 and 2.07). The excess risk was greatest for the neck and low back regions; younger workers had disproportionately higher rates in the knee, neck, low back, and distal arm. A larger proportion of floor layers (22%) filed MSD claims in more than one body region compared to general workers (10%; p<0.001). Conclusions Floor layers have markedly higher rates of MSD claims compared to a general worker population, suggesting shifting of medical costs for work-related MSD to personal health insurance. The occurrence of disorders in multiple body regions and among the youngest workers highlights the need for improved work methods and tools for construction workers. PMID:25224720
Albala, Cecilia; Lebrão, Maria Lúcia; León Díaz, Esther María; Ham-Chande, Roberto; Hennis, Anselm J; Palloni, Alberto; Peláez, Martha; Pratts, Omar
This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.
Lee, B.S.; Travis, R.; Grove, E.; DiBiasio, A.
A study was performed to assess the effects of aging on the Containment Isolation (CI) functions of Westinghouse Pressurized Water Reactors and General Electric Boiling Water Reactors. This study is part of the Nuclear Plant Aging Research (NPAR) program, sponsored by the U.S. Nuclear Regulatory Commission. The objectives of this program are to provide an understanding of the aging process and how it affects plant safety so that it can be properly managed. This is one of a number of studies performed under the NPAR program which provide a technical basis for the identification and evaluation of degradation caused by age. Failure data from two national databases, Nuclear Plant Reliability Data System (NPRDS) and Licensee Event Reports (LERs), as well as plant specific data were reviewed and analyzed to understand the effects of aging on the CI functions. This study provided information on the effects of aging on component failure frequency, failure modes, and failure causes. Current inspection, surveillance, and monitoring practices were also reviewed.
Blagosklonny, Mikhail V.
Making headlines, a thought-provocative paper by Neff, Ehninger and coworkers claims that rapamycin extends life span but has limited effects on aging. How is that possibly possible? And what is aging if not an increase of the probability of death with age. I discuss that the JCI paper actually shows that rapamycin slows aging and also extends lifespan regardless of its direct anti-cancer activities. Aging is, in part, MTOR-driven: a purposeless continuation of developmental growth. Rapamycin affects the same processes in young and old animals: young animals' traits and phenotypes, which continuations become hyperfunctional, harmful and lethal later in life. PMID:23934728
Blagosklonny, Mikhail V
Making headlines, a thought-provocative paper by Neff, Ehninger and coworkers claims that rapamycin extends life span but has limited effects on aging. How is that possibly possible? And what is aging if not an increase of the probability of death with age. I discuss that the JCI paper actually shows that rapamycin slows aging and also extends lifespan regardless of its direct anti-cancer activities. Aging is, in part, MTOR-driven: a purposeless continuation of developmental growth. Rapamycin affects the same processes in young and old animals: young animals' traits and phenotypes, which continuations become hyperfunctional, harmful and lethal later in life.
Wang, Shibin; Ungvari, Gabor S; Forester, Brent P; Chiu, Helen F K; Wu, Yanhua; Kou, Changgui; Fu, Yingli; Qi, Yue; Liu, Yawen; Tao, Yuchun; Yu, Yaqin; Li, Bo; Xiang, Yu-Tao
There is little information on gender differences in general mental health, smoking, drinking and chronic diseases in Chinese elderly. We examined the gender differences in general mental health, smoking, drinking and a number of chronic diseases in a large Chinese old population. Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people (2198 women; 1917 men) aged between 60 and 79 years were included and their general mental health, smoking, drinking and chronic diseases were recorded with standardized assessment tools. Multivariate analyses revealed that women were less likely to be current smokers and frequent drinkers, but had higher prevalence of poor mental health compared with their male counterparts. In addition, the prevalence rate of chronic diseases and multi-morbidities were higher in women than that in men (both p values <0.05). Health professionals and policy makers need to pay special attention to the common chronic diseases and poor mental health in older women and higher prevalence of smoking and drinking in men.
Lustig, Daniel C.; Strauser, David R.
Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…
Wang, Chengfang; Liu, Chunqing; Gao, Hanboya; Liu, Hui
To determine the functional age of an individual, a quantitative system for the assessment of aging status was developed in the present study. A total of 1579 subjects were selected randomly from patients undergoing physical examination. The index of organic mild impairment (IOMI) and IOMI corrected for age (COMI) were calculated. By receiver operating characteristic (ROC) curve analysis of the IOMIs of younger and elderly subjects, a cutoff value for COMI of 30% was obtained. About 95% of <30-year-old subjects were healthy. These data suggest that organs and systems reflect the aging status of an individual and may be a useful tool for evaluating health status.
Al Saif, Amer; Al Senany, Samira
[Purpose] The purpose of this study was to determine the validity, demographic features of the newly developed Amer Dizziness Diagnostic Scale (ADDS), provide differential diagnosis of the vestibular disorders, assist in the clinical research and practice activities of health workers as well as to understand the probability of the utilization of the ADDS as a first-line evaluation tool in general clinical practice. [Subjects and Methods] Two hundred subjects of various ages including both male and female patients with a history of vertigo and/or dizziness were included in the study and evaluated once using the ADDS. [Results] There were more female (59.5%) than male (49.5) patients in this study. Additionally, we found that most patients (64.4%) had a central mediated problem. In addition, the Amer Dizziness Diagnostic Scale has been found to have both a sensitivity and specificity of 96% that can adequately determine the possible diagnosis of vestibular disorders. [Conclusion] This study has demonstrated the validity of the ADDS scale, the predominance of female involvement related to supplementary medication, vitamin D deficiency, general lifestyle factors, and fluid retention, high sensitivity and specificity, provide differential diagnosis of vestibular disorders that could be used as a first-line evaluation tool in general clinics. PMID:26644673
FSPH is based on the foundations of the 45-year-old National School of Public Health Administration (ENSP), located in Rennes (Brittany) on a 22-acre campus. The annual budget is 55 milion euros, which is only partly adequate for FSPH missions and objectives. What is currently needed, in addition to ENSP is a high-level academic establishment. It has been argued that France lacks the research resources and funding necessary to hold a leading international position in public health research and expertise. About 85% of international scientific papers published by French teams in the field of public health are produced by Inserm (the French equivalent of NIH) and university hospitals, which are mainly located in Paris. It is proposed to initially network and reinforce existing forces, in close collaboration with top-level institutions in the French capital. This series of three papers proposes to establish a dynamic in two domains: (i) risk analysis and regulation, and (ii) prevention and screening in public health. FSPH will be grounded on scientific excellence, French-English bilingual training, openness to Europe and North America, worldwide notoriety, and collaboration with top-flight academic and research institutions, hospitals, and the private sector.
O'Neil, Edward H.; Seifer, Sarena D.
Health care reforms will dramatically change the culture of medical schools in areas of patient care, research, and education programs. Academic medical centers must construct mutually beneficial partnerships that will position them to take advantage of the opportunities rather than leave them without the diversity of resources needed to make…
Cherstvy, Andrey G.; Metzler, Ralf
We study generalized anomalous diffusion processes whose diffusion coefficient D(x, t) ∼ D0|x|αtβ depends on both the position x of the test particle and the process time t. This process thus combines the features of scaled Brownian motion and heterogeneous diffusion parent processes. We compute the ensemble and time averaged mean squared displacements of this generalized diffusion process. The scaling exponent of the ensemble averaged mean squared displacement is shown to be the product of the critical exponents of the parent processes, and describes both subdiffusive and superdiffusive systems. We quantify the amplitude fluctuations of the time averaged mean squared displacement as function of the length of the time series and the lag time. In particular, we observe a weak ergodicity breaking of this generalized diffusion process: even in the long time limit the ensemble and time averaged mean squared displacements are strictly disparate. When we start to observe this process some time after its initiation we observe distinct features of ageing. We derive a universal ageing factor for the time averaged mean squared displacement containing all information on the ageing time and the measurement time. External confinement is shown to alter the magnitudes and statistics of the ensemble and time averaged mean squared displacements.
Wardle, Jane; Wolf, Michael S.; von Wagner, Christian
Objectives: To review the evidence on the association between age and limited health literacy, overall and by health literacy test, and to investigate the mediating role of cognitive function. Method: The Embase, MEDLINE, and PsycINFO databases were searched. Eligible studies were conducted in any country or language, included participants aged ≥50 years, presented a measure of association between age and health literacy, and were published through September 2013. Results: Seventy analyses in 60 studies were included in the systematic review; 29 of these were included in the meta-analysis. Older age was strongly associated with limited health literacy in analyses that measured health literacy as reading comprehension, reasoning, and numeracy skills (random-effects odds ratio [OR] = 4.20; 95% confidence interval [CI]: 3.13–5.64). By contrast, older age was weakly associated with limited health literacy in studies that measured health literacy as medical vocabulary (random-effects OR = 1.19; 95% CI: 1.03–1.37). Evidence on the mediating role of cognitive function was limited. Discussion: Health literacy tests that utilize a range of fluid cognitive abilities and mirror everyday health tasks frequently observe skill limitations among older adults. Vocabulary-based health literacy skills appear more stable with age. Researchers should select measurement tests wisely when assessing health literacy of older adults. PMID:25504637
Lam, Carolyn S. P.; Borlaug, Barry A.; Kane, Garvan C.; Enders, Felicity T.; Rodeheffer, Richard J.; Redfield, Margaret M.
Background In contrast to the wealth of data on isolated systolic hypertension involving the systemic circulation in the elderly, much less is known about age-related change in pulmonary artery systolic pressure (PASP) and its prognostic impact in the general population. We sought to define the relationship between PASP and age, evaluate which factors influence PASP and determine if PASP is independently predictive of mortality in the community. Methods and Results A random sample of Olmsted County, MN general population (N=2042) underwent echocardiography and spirometry and was followed for a median of 9 years. PASP was measured from the tricuspid regurgitation velocity. Left ventricular diastolic pressure was estimated using Doppler echocardiography (E/e' ratio) and arterial stiffening was assessed using the brachial artery pulse pressure. Among 1413 (69%) subjects with measurable PASP (63±11y; 43% male), PASP (median, 25th-75th percentile) was 26 (24-30) mmHg and increased with age (r=0.31; p<0.001). Independent predictors of PASP were age, pulse pressure and mitral E/e' (all p≤0.003). Increasing PASP was associated with higher mortality (hazard ratio 2.73 per 10 mmHg; p<0.001). In subjects without cardiopulmonary disease (any heart failure, coronary artery disease, hypertension, diabetes mellitus or chronic obstructive lung disease), the age-adjusted hazard ratio was 2.74 per 10 mmHg (p=0.016). Conclusions We provide the first population-based evidence of age-related increase in pulmonary artery pressure, its association with increasing left heart diastolic pressures and systemic vascular stiffening, as well as its negative impact on survival. Pulmonary artery pressure may serve as a novel cardiovascular risk factor and potential therapeutic target. PMID:19433755
Briggs, Andrew M; Cross, Marita J; Hoy, Damian G; Sànchez-Riera, Lídia; Blyth, Fiona M; Woolf, Anthony D; March, Lyn
Persistent pain, impaired mobility and function, and reduced quality of life and mental well-being are the most common experiences associated with musculoskeletal conditions, of which there are more than 150 types. The prevalence and impact of musculoskeletal conditions increase with aging. A profound burden of musculoskeletal disease exists in developed and developing nations. Notably, this burden far exceeds service capacity. Population growth, aging, and sedentary lifestyles, particularly in developing countries, will create a crisis for population health that requires a multisystem response with musculoskeletal health services as a critical component. Globally, there is an emphasis on maintaining an active lifestyle to reduce the impacts of obesity, cardiovascular conditions, cancer, osteoporosis, and diabetes in older people. Painful musculoskeletal conditions, however, profoundly limit the ability of people to make these lifestyle changes. A strong relationship exists between painful musculoskeletal conditions and a reduced capacity to engage in physical activity resulting in functional decline, frailty, reduced well-being, and loss of independence. Multilevel strategies and approaches to care that adopt a whole person approach are needed to address the impact of impaired musculoskeletal health and its sequelae. Effective strategies are available to address the impact of musculoskeletal conditions; some are of low cost (e.g., primary care-based interventions) but others are expensive and, as such, are usually only feasible for developed nations. In developing nations, it is crucial that any reform or development initiatives, including research, must adhere to the principles of development effectiveness to avoid doing harm to the health systems in these settings.
Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar
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…
...-care resources, consisting of commercial services or the use of medical equipment or space, utilizing... acquisition of health-care resources. 873.109 Section 873.109 Federal Acquisition Regulations System... HEALTH-CARE RESOURCES 873.109 General requirements for acquisition of health-care resources. (a)...
... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true General safety and health... Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY... adequately protect the safety and health of employees as required by the Walsh-Healey Public Contracts Act....
Rapp, Stephen R.; Hogan, Patricia E.; Driscoll, Ira; Tindle, Hilary A.; Smith, J. Carson; Kesler, Shelli R.; Zaslavsky, Oleg; Rossom, Rebecca C.; Ockene, Judith K.; Yaffe, Kristine; Manson, JoAnn E.; Resnick, Susan M.; Espeland, Mark A.
Background. Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥80 years remain elusive. Methods. Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women’s Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. Results. Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. Conclusions. Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old. PMID:26858326
Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P
This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.
Objectives The aim of the present study was to examine the health and well being of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people, the health issues that concern them, the services they use and challenges accessing services.Methods This study comprised a survey of the health and well being of 312 LGBTI people aged 50 years and over in New South Wales. The survey included the Short-Form 12 (SF-12) measure of health-related quality of life, the Kessler 10 (K10) measure of psychological distress, and the three-item Loneliness Scale.Results Higher levels of psychological distress, lower mental health and greater loneliness were found among this sample than is typically found in the general population. Mental health was lower among carers and those not in a relationship, while psychological distress was greater among those living alone and those experiencing higher rates of loneliness. The most commonly accessed health service was a general practitioner (GP), with most respondents reporting that they were open about their sexuality to their GP and that they had a regular GP. Some reported difficulties accessing health services because of their gender or sexual diversity.Conclusions Although many older LGBTI people are well, both physically and mentally, they do appear to face increased risk of certain health issues compared with the general population.What is known about the topic? Overseas research indicates that older LGBTI people may be at greater risk of certain physical and mental health conditions than the general population.What does this paper add? This paper provides Australian data, using well-validated instruments, on the health and well being of older LGBTI people. It provides evidence of the health issues that older LGBTI people are most concerned about and the barriers they face in accessing services.What are the implications for practitioners? It is important for health practitioners to be aware that older LGBTI people appear to be
Advances in technology are transforming the way that health data is collected and used. This includes improvements in existing technology as well as innovations in mobile technology such as smartphone apps and wearables. Health data is strictly regulated under the EU Data Protection Directive 95/46/EC. Under current data protection rules, health data is broadly interpreted and will, in most circumstances not connected to the provision of healthcare, require organisations to obtain explicit consent from individuals for its collection and use. Further data protection compliance issues arise such as identifying who is a controller, ensuring transparency, using health data for research purposes and keeping health data secure. As the EU data protection landscape is due to change in the next few years and will affect the collection and use of health data, the forthcoming Data Protection Regulation also deserves attention.
An example about the use of everyday phenomena in teaching general chemistry is given. Students have a greater appreciation of the principles of chemistry if they can see the relevance to their lives. Fluorine compounds in dental applications (as topical or as systemic use) provide an excellent context in which to review core content of general…
Ozair, Fouzia F.; Jamshed, Nayer; Sharma, Amit; Aggarwal, Praveen
Electronic health record (EHR) is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions. PMID:25878950
Introduction Generally, men and women of higher socioeconomic status (SES) have better health. Little is known about how socioeconomic factors are associated with changes in health as women progress through mid-life. This study uses data from six survey waves (1996 to 2010) of the Australian Longitudinal Study on Women’s Health (ALSWH) to examine associations between SES and changes in the general health and mental health of a cohort of women progressing in years from 45–50 to 59–64. Methods Participants were 12,709 women (born 1946–51) in the ALSWH. Outcome measures were the general health and mental health subscales of the Medical Outcomes Study Short Form 36 Questionnaire (SF-36). The measure of SES was derived from factor analysis of responses to questions in the ALSWH baseline survey (1996) on school leaving age, highest qualifications, and current or last occupation. Multi-level random coefficient models, adjusted for socio-demographic factors and health behaviors, were used to analyze repeated measures of general health and mental health. Survey year accounted for changes in factors across time. In the first set of analyses we investigated associations between the SES index, used as a “continuous” variable, and general health and mental health changes over time. To illuminate the impact of different levels of SES on health, a second analysis was conducted in which SES scores were grouped into three approximately equal sized categories or “tertiles” as reported in an earlier ALSWH study. The least square means of general and mental health scores from the longitudinal models were plotted for the three SES tertiles. Results The longitudinal analysis showed that, after adjusting for the effects of time and possible confounders, the general (mental) health of this cohort of mid-aged women declined (increased) over time. Higher SES women reported better health than lower SES women, and SES significantly modified the effects of time on both general
MacNee, William; Rabinovich, Roberto A; Choudhury, Gourab
Ageing is associated with a progressive degeneration of the tissues, which has a negative impact on the structure and function of vital organs and is among the most important known risk factors for most chronic diseases. Since the proportion of the world's population aged >60 years will double in the next four decades, this will be accompanied by an increased incidence of chronic age-related diseases that will place a huge burden on healthcare resources. There is increasing evidence that many chronic inflammatory diseases represent an acceleration of the ageing process. Chronic pulmonary diseases represents an important component of the increasingly prevalent multiple chronic debilitating diseases, which are a major cause of morbidity and mortality, particularly in the elderly. The lungs age and it has been suggested that chronic obstructive pulmonary disease (COPD) is a condition of accelerated lung ageing and that ageing may provide a mechanistic link between COPD and many of its extrapulmonary effects and comorbidities. In this article we will describe the physiological changes and mechanisms of ageing, with particular focus on the pulmonary effects of ageing and how these may be relevant to the development of COPD and its major extrapulmonary manifestations.
Plach, Sandra K.; Napholz, Linda; Kelber, Sheryl T.
Depression in women with rheumatoid arthritis (RA) may be related to social role experiences, physical health, and age. The purpose of this study was to examine the social and health factors contributing to depression in two age groups of women with RA. One-hundred and thirty-eight midlife and late-life women with a diagnosis of RA participated in…
McCarron, M.; Gill, M.; McCallion, P.; Begley, C.
Consideration of the relationship between physical and mental health co-morbidities in ageing persons with Down syndrome (DS) and Alzheimer's dementia (AD) is of clinical importance both from a care and resource perspective. To investigate and measure health co-morbidities in ageing persons with Down syndrome with and without AD. Recorded physical…
Makai, Alexandra; Prémusz, Viktória; Füge, Kata; Figler, Mária; Lampek, Kinga
In this study we examined the health of the ageing population of East-Central Europe. Data derived from the 6th round of the European Social Survey. The aim of our research was to examine the most important factors that determine ageing people's health status. We paid particular attention to the social ties of our target group.
Lai, Daniel W. L.; Surood, Shireen
This study examined the relationships between service barriers and health status of aging South Asian immigrants. Data were obtained through a structured telephone survey with a random sample of 220 South Asians 55 years of age and older. The effect of the different types of service barriers on the physical and mental health of participants was…
At the 2003 World Health Forum conference, experts from around the world gathered to examine the issues surrounding global aging trends and to develop recommendations for the economic, health, and policy consequences of an aging population. The recommendations address a wide range of issues, but acknowledge the importance of community-based care, including long-term home care.
Khiavi, Farzad Faraji; Dashti, Rezvan; Zergani, Nadia
Introduction Job satisfaction is one of the most challenging organizational concepts, and it is the basis of management policies to increase productivity and efficiency of the organization. The general health rate may affect job satisfaction in several ways. This study aimed to determine the association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran. Methods The study population of this cross-sectional research included 100 employees of Golestan Hospital in Ahvaz, Iran. The data collection instruments were the General Health Questionnaire (28-GHQ) and the Job Descriptive Index (JDI) questionnaire. The data were analyzed using Pearson’s product-moment correlation coefficient, independent samples t-test, and ANOVA statistical tests in SPSS software. Results The mean general health was calculated as 26.19 ± 11.04, which indicated a positive psychiatric condition. Job satisfaction with a mean score of 89.67 ± 23.3 was deemed to be relatively dissatisfied. A medium negative and significant association was observed between job satisfaction and general health and its subscales (physical health, anxiety, social, and depression). Conclusions General health subscales and job satisfaction are associated. Some actions must be planned to cope with the negative factors in general health in order to increase employees’ satisfaction in university educational hospitals. PMID:27280002
Byrne, Jacqueline H; Ware, Robert S; Lennox, Nicholas G
People with intellectual disability experience inadequate health care and have unmet health needs that can go unidentified or be poorly managed. Health assessments have been shown to significantly increase short-term clinical activity for people with intellectual disability. The aim of this study was to more accurately quantify the effect of health assessments for people with intellectual disability by comparing health actions recorded in health assessment booklets to actions recorded in general practitioners' (GPs) records in the 12-month period following the health assessment. Participants were people with intellectual disability who had received a Comprehensive Health Assessment Program (CHAP), living in the community. The CHAP is a health assessment that is demonstrated to significantly increase health actions, compared with usual care, for people with intellectual disability. Data collected from three randomised controlled trials conducted in South-East Queensland, Australia, from 2000 to 2010 were pooled and analysed. The health assessment booklet contained significantly more information on health actions than GPs' records. Notably, hearing tests (risk ratio (RR) = 5.9; 95% confidence interval (CI) = 4.7-7.4), breast checks (RR = 3.9; 95% CI = 2.7-5.7), and skin examinations (RR = 7.9; 95% CI = 5.9-10.7) were more likely to be recorded in the CHAP booklet. Health assessments increase health actions for people with intellectual disability to a significantly greater extent than previously demonstrated.
Ahr, Emmanuel; Houdé, Olivier; Borst, Grégoire
A striking error in reading is the early and sometimes persistent confusion of mirror letters such as b and d. These mirror errors are likely a result of the mirror generalization process that allows one to identify a visual stimulus regardless of its presentation side. A previous study demonstrated that preventing mirror errors in reading requires the inhibition of the mirror generalization process in expert adult readers (Borst et al., 2015). Using the same experimental paradigm, the current study aimed at replicating this result in school-aged children. Three age groups-1st, 3rd, and 5th graders-performed a negative priming study in which they were asked to determine on the primes whether two letters were identical and on the probes whether two animals facing opposite directions were identical. All three groups of children required more time to discriminate two letters that were lateral mirror images of one another (e.g., b/d) than two letters that were not (e.g., f/t). Crucially, children required more time to determine that two animals facing opposite directions were identical when preceded by two letters that were lateral mirror images of one another (b/d) than when preceded by letters that were not mirror images of one another (f/t). Importantly, the amplitude of the negative priming effect did not vary with age. Our results suggest that overcoming mirror errors in reading, regardless of the reading proficiency of school-aged children, is rooted in the ability to inhibit the mirror generalization process.
Eslava-Castañeda, Juan C
This article takes stock of how promoting health (PH) (promoción de la salud - PS) has been understood within an international setting and gives three meanings for promotion: as general policy orientation, as a set of actions and as a special dimension of sanitary work. Interest expressed in giving it a specific basis distinguishing it from prevention, transcending educational work, has emerged from the subtle differences established from such different ways of coming to terms with PH. After recognising the challenge posed by PH in the field of health, the text succinctly describes how discourse regarding PH has been introduced in Colombia and discusses how an attempt has been made to be more precise regarding its place in the general health-related social security system. Efforts currently being made in Colombia regarding making PH become a reality within the Colombian health system are then mentioned.
Atella, Vincenzo; Kopinska, Joanna; Medea, Gerardo; Belotti, Federico; Tosti, Valeria; Mortari, Andrea Piano; Cricelli, Claudio; Fontana, Luigi
Aging and excessive adiposity are both associated with an increased risk of developing multiple chronic diseases, which drive ever increasing health costs. The main aim of this study was to determine the net (non‐estimated) health costs of excessive adiposity and associated age‐related chronic diseases. We used a prevalence‐based approach that combines accurate data from the Health Search CSD‐LPD, an observational dataset with patient records collected by Italian general practitioners and up‐to‐date health care expenditures data from the SiSSI Project. In this very large study, 557,145 men and women older than 18 years were observed at different points in time between 2004 and 2010. The proportion of younger and older adults reporting no chronic disease decreased with increasing BMI. After adjustment for age, sex, geographic residence, and GPs heterogeneity, a strong J‐shaped association was found between BMI and total health care costs, more pronounced in middle‐aged and older adults. Relative to normal weight, in the 45‐64 age group, the per‐capita total cost was 10% higher in overweight individuals, and 27 to 68% greater in patients with obesity and very severe obesity, respectively. The association between BMI and diabetes, hypertension and cardiovascular disease largely explained these elevated costs. PMID:26540605
Angelini, Viola; Cavapozzi, Danilo; Corazzini, Luca; Paccagnella, Omar
In this paper we investigate how age affects the self-reported level of life satisfaction among the elderly in Europe. By using a vignette approach, we find evidence that age influences life satisfaction through two counterbalancing channels. On the one hand, controlling for the effects of all other variables, the own perceived level of life…
Yadava, K N; Yadava, S S; Vajpeyi, D K
This article examines the prevalence of age-related diseases in different socioeconomic and demographic groups. The study is based on a sample of 267 aged persons (> 60 years) collected through a survey entitled "Aging and Health Conditions in Rural Area-A Sample Survey, 1990" conducted in the rural areas of the Varanasi district of Uttar Pradesh, a northern province of India. Various socio-behavioral factors are found to play a significant role in determining the health conditions of aged people. Also, illiteracy and poverty are found to have their own impact on health during aging. It is also noted that due to adverse familial relationships, many stress-related disorders occur which may result in the poor health of the elderly. Demands for old age pensions were made by most of the elderly people in the sample.
Shanahan, Michael J.; Hill, Patrick L.; Roberts, Brent W.; Eccles, Jacquelynne; Friedman, Howard S.
The Conscientiousness (C) of the self and significant others influences health by way of mediational chains involving socioeconomic attainment, the avoidance and neutralization of stressors, the promotion of health behaviors and the minimization of risk behaviors, and the management of symptoms and diseases. Yet, meta-analyses reveal that these…
Salzman, Stephanie A.; Girvan, James T.
A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…
Brody, Elaine M.; And Others
Examined 331 adult children with parents in nursing homes. Predictors of depression were poor health, time pressures, viewing parent as demanding, and lack of involvement with instrumental activities of daily living tasks. Emotional effects specific to parent's situation were predicted by poor health, negative perceptions of nursing home staff,…
SHAMSAEI, Farshid; CHERAGHI, Fatemeh; ZAMANI, Gholamreza
Objective Mental health problems frequently occur in children with epilepsy but the diagnosis is frequently missed and therapeutic opportunities are often lost. The aim of this study was to compare mental health statues between school-aged children with epilepsy and the healthy group. Materials & Methods In this case, control study, 120 children aged 6 to 12 years with idiopathic epilepsy and 240 healthy control groups were followed up. Children with epilepsy were enrolled from Iranian Epilepsy Association in 2014. The parent version of Child Symptom Inventory-4 questionnaire was used. Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. The Chi-Square test was used to assess the difference between frequency distribution of demographic variables in both groups. The significance level was considered less than 0.05. Results There were statistically significant differences between children with epilepsy and control group as for attention deficit hyperactivity disorder, generalized anxiety disorder, major depression, separation anxiety, social phobia, motor and vocal tics and oppositional defiant disorder. Conclusion The carefully evaluating and prospectively following the psychopathology symptom of children with epilepsy are critical for early identification, prevention and treatment. PMID:27375754
Lynch, D B; Jeffery, I B; Cusack, S; O'Connor, E M; O'Toole, P W
With modern medicine and an awareness of healthy lifestyle practices, people are living longer and generally healthier lives than their ancestors. These successes of modern medicine have resulted in an increasing proportion of elderly in society. Research groups around the world have investigated the contribution of gut microbial communities to human health and well-being. It was established that the microbiota composition of the human gut is modulated by lifestyle factors, especially diet. The microbiota composition and function, acting in concert with direct and indirect effects of habitual diet, is of great importance in remaining healthy and active. This is not a new concept, but until now the scale of the potential microbiota contribution was not appreciated. There are an estimated ten times more bacteria in an individual than human cells. The bacterial population is relatively stable in adults, but the age-related changes that occur later in life can have a negative impact on host health. This loss of the adult-associated microbiota correlates with measures of markers of inflammation, frailty, co-morbidity and nutritional status. This effect may be greater than that of diet or in some cases genetics alone. Collectively, the recent studies show the importance of the microbiota and associated metabolites in healthy aging and the importance of diet in its modulation.
Shetterly, S M; Baxter, J; Mason, L D; Hamman, R F
OBJECTIVES: This study investigated whether objective health indicators explained lower self-rated health among Hispanics compared with non-Hispanic Whites. It also considered socioeconomic and cultural explanations. METHODS: Health ratings of 429 Hispanics and 583 non-Hispanic Whites aged 20 through 74 were analyzed with logistic regression. RESULTS: Illness indicators were found to be strongly correlated with self-rated health in both ethnic groups, but after such markers were controlled for, Hispanics remained 3.6 times more likely to report fair or poor health (95% confidence interval = 2.4, 5.3). Adjustment for socioeconomic factors accounted for a portion of Hispanics' lower health rating, but the strongest explanatory factor was acculturation. CONCLUSIONS: Because of cultural and economic influences on definitions of health, ethnic differences in self-assessed health may not accurately reflected patterns resulting from objective health measurements. PMID:9003141
Chambers, Lori A; Wilson, Michael G; Rueda, Sergio; Gogolishvili, David; Shi, Maggie Qiyun; Rourke, Sean B
The growing number of people over age 50 with HIV requires research, policy, and practice to develop a more comprehensive understanding of the health consequences of HIV in older individuals. We conducted a scoping review of peer-reviewed and grey literature published since 1996 to explore the impacts of aging on the health of older people with HIV (50 years or older). We included 209 studies (two systematic reviews, 174 quantitative studies, 28 qualitative studies, and five mixed methods studies). Health topics addressed include: HIV- and aging-related comorbidities, disease progression, neurocognitive functioning, mental health conditions, psychological well-being, social supports, stigma, antiretroviral adherence, health care utilization/access, and sexual risk behaviour. We recommend that future research takes a broader view of health, looks at aging from a strength-based perspective and examines the issue using diverse perspectives (i.e., geographic location, multiple methods, time of diagnosis, time on antiretroviral therapy (ART), demographic diversity).
Wong, Albert; Wouterse, Bram; Slobbe, Laurentius C J; Boshuizen, Hendriek C; Polder, Johan J
Health care utilization is expected to rise in the coming decades. Not only will the aggregate need for health care grow by changing demographics, so too will per capita utilization. It has been suggested that trends in health care utilization may be age-specific. In this paper, age-specific trends in health care utilization are presented for different health care sectors in the Netherlands, for the period 1981-2009. For the hospital sector we also explore the link between these trends and the state of medical technology. Using aggregated data from a Dutch health survey and a nationwide hospital register, regression analysis was used to examine age-specific trends in the probability of utilizing health care. To determine the influence of medical technology, the growth in age-specific probabilities of hospital care was regressed on the number of medical patents while adjusting for confounders related to demographics, health status, supply and institutional factors. The findings suggest that for most health care sectors, the trend in the probability of health care utilization is highest for ages 65 and up. Larger advances in medical technology are found to be significantly associated with a higher growth of hospitalization probability, particularly for the higher ages. Age-specific trends will raise questions on the sustainability of intergenerational solidarity in health care, as solidarity will not only be strained by the ageing population, but also might find itself under additional pressure as the gap in health care utilization between elderly and non-elderly grows over time. For hospital care utilization, this process might well be accelerated by advances in medical technology.
Salas, C; Raftery, J P
A recent study by Zweifel et al. (Zweifel P, Felder S, Meiers M. Ageing of the population and health care expenditure: a red herring? Health Economics 1999; 8: 485-496) suggests that age is not related to health care expenditure among the elderly once 'closeness to death' is controlled for. If correct, this finding has major policy implications, but flaws in the econometric analysis undermine its credibility. We highlight two in particular, and propose methods to deal with them.
Hazell, Michelle L; Morris, Julie A; Linehan, Mary F; Frank, Timothy L
Background In order to assess and plan for changing healthcare needs, the lack of available information regarding temporal changes in the health-related quality of life of a population must be addressed. Aim This paper aims to describe such changes over 5 years in a general population. Design of study Longitudinal postal questionnaire study. Setting UK general practice. Method This was a longitudinal postal questionnaire study in two general practice populations, using the generic instrument EQ-5D to measure health-related quality of life. Individuals were included if they responded to three postal surveys in 1999, 2001, and 2004 and there were three consecutive values of EQ-5Dindex available between 1999 and 2004. Results A total of 2498 subjects were included in the study. After adjustment for potential confounders (including ageing), health-related quality of life declined significantly over the observation period. The change in EQ-5Dindex was from 0.79 to 0.74 and for EQ-5Dvas 76.8 to 73.3 (P for both trends <0.001). Conclusion Health-related quality of life deteriorated in these populations over 5 years. In an era of improvements in mortality, this has important implications for the use of health-related quality of life data in healthcare planning and resource allocation. PMID:19861028
Gladyshev, G P
Thermodynamic theory of aging explains changes of the functions of states of cells and tissues during aging. The rates of aging depend on the genetic factors, the nature of habitat, nutrition and external influences. These rates can be different. Aging of organs, functional systems and tissues, as theirs diseases, lead decrease of adaptational ability of organism and its death.
Todorova, Irina L G; Guzzardo, Mariana T; Adams, Wallis E; Falcón, Luis M
Puerto Rican adults in the United States mainland live with socioeconomic and health disparities. To understand their contextual experience of aging, we interviewed participants in the Boston Puerto Rican Health Study. Through a Thematic Analysis we identify themes and tensions: normalization and acceptance of aging; gratitude; the importance of aging within social networks; longing to return to Puerto Rico at older age. We address the tensions between 'acceptance' and fatalismo as a cultural belief, and a function of structural barriers. The experience of aging is discussed in the context of Puerto Rico's history and continued dependence on the United States.
Abrams, Alan P; Thompson, Lisa A
This article reviews the concepts of physiologic reserve, the principles of the normative aging process as exemplified by the cardiovascular, neurologic, and musculoskeletal systems. How these principles apply to oral health, and age-related changes in the oral cavity itself, is reviewed and suggests how they may affect disease management by oral health care providers. It does not focus on diseases related to aging, but rather aims to explore the normal physiologic changes associated with aging dentition and systemic changes related to age, thus enabling clinicians to obtain a better understanding of the presentation of older adults and how it may change their approach to diagnosis and treatment.
Westerhof, Gerben J; Miche, Martina; Brothers, Allyson F; Barrett, Anne E; Diehl, Manfred; Montepare, Joann M; Wahl, Hans-Werner; Wurm, Susanne
Evidence is accumulating on the effects of subjective aging-that is, how individuals perceive their own aging process-on health and survival in later life. The goal of this article is to synthesize findings of existing longitudinal studies through a meta-analysis. A systematic search in PsycInfo, Web of Science, Scopus, and Pubmed resulted in 19 longitudinal studies reporting effects of subjective aging on health, health behaviors, and longevity. The authors combine the outcomes reported in these studies using a random effects meta-analysis, assuming that there would be differences in effect sizes across studies. The meta-analysis resulted in an overall significant effect of subjective aging (likelihood ratio = 1.429; 95% confidence interval = 1.273-1.604; p < .001). The analyses revealed heterogeneity, with stronger effects for studies with a shorter period of follow-up, for studies of health versus survival, for studies with younger participants (average age of the studies varies between 57 and 85 years with a median of 63 years), and for studies in welfare systems where state provisions of welfare are minimal. However, effects did not vary either across different operationalizations of subjective aging or by study quality. Subjective aging has a small significant effect on health, health behaviors, and survival. Further theoretical conceptualizations and empirical studies are needed to determine how subjective aging contributes to health and survival.
Burris, Scott; Hitchcock, Laura; Ibrahim, Jennifer; Penn, Matthew; Ramanathan, Tara
Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in public health research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of public health significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the public health workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead.
Peterson, Candida C.
Administered quiz about positive and negative aspects of mental health in old age to 250 Australian adults (ages 17-81). Retirees scored lowest, with no significant differences among younger students versus nonstudents. Age was more important mediator of retirees' low scores than was gender, living with older person, or self-definition as retired.…
Feinberg, David R.
There is strong support for the idea that healthy vocal chords are able to produce fundamental frequencies (F0) with minimal perturbation. Measures of F0 perturbation have been shown to discriminate pathological versus healthy populations. In addition to measuring vocal chord health, F0 perturbation is a correlate of real and perceived age. Here, the role of jitter (periodic variation in F0) and shimmer (periodic variation in amplitude of F0) in perceived health and age in a young adult (males aged 18-33, females aged 18-26), nondysphonic population was investigated. Voices were assessed for health and age by peer aged, opposite-sex raters. Jitter and shimmer were measured with Praat software (www.praat.org) using various algorithms (jitter: DDP, local, local absolute, PPQ5, and RAP; shimmer: DDA, local, local absolute, APQ3, APQ5, APQ11) to reduce measurement error, and to ascertain the robustness of the findings. Male and female voices were analyzed separately. In both sexes, ratings of health and age were significantly correlated. Measures of jitter and shimmer correlated negatively with perceived health, and positively with perceived age. Further analysis revealed that these effects were independent in male voices. Implications of this finding are that attributions of vocal health and age may reflect actual underlying condition.
Sadeghi, Azam; Sirati-Nir, Masoud; Ebadi, Abbas; Aliasgari, Matin; Hajiamini, Zahra
Background: Pregnancy may be accompanied by serious physiological and psychological changes as it is a stressful period in a woman's life. So, this study was conducted to determine the effect of progressive muscle relaxation on pregnant women's general health. Materials and Methods: In this clinical trial, 60 primigravida women admitted to the prenatal clinic of selected hospitals in Iran constituted the study population. Using purposive sampling method, the level of general health of the women was measured with General Health Questionnaire-28 (GHQ-28). Then, the samples were randomly divided into control and experimental groups. Three 1.5–2 h relaxation training sessions were held for the experimental group. After 8 weeks, the level of general health of both groups was measured again. Finally, the collected data were analyzed using Chi-square and paired t-test (P < 0.05). Results: Total mean score of general health of the experimental group and the control group before the intervention was 35.83 (6.92) and 29.46 (8.3), respectively, and after the intervention, the respective scores were 20.2 (5.61) and 27.85 (8.24). Although after the intervention both groups showed an increased level of general health, the difference in general health between before and after intervention was significant in the experimental group (P < 0.001). Furthermore, comparison of variations in mean scores of general health level before and after intervention in the two groups showed a significant difference (P < 0.001). Conclusions: Given that the results showed the effectiveness of progressive muscle relaxation on pregnant women's general health, the prenatal clinics can include a training program for progressive muscle relaxation in the routine training programs for pregnant women. PMID:26793248
Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri
This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes.
Bodnar, Lisa M; Wisner, Katherine L
Adequate nutrition is needed for countless aspects of brain functioning. Poor diet quality, ubiquitous in the United States, may be a modifiable risk factor for depression. The objective was to review and synthesize the current knowledge of the role of nutrition in depression, and address implications for childbearing-aged women. Poor omega-3 fatty acid status increases the risk of depression. Fish oil and folic acid supplements each have been used to treat depression successfully. Folate deficiency reduces the response to antidepressants. Deficiencies of folate, vitamin B12, iron, zinc, and selenium tend to be more common among depressed than nondepressed persons. Dietary antioxidants have not been studied rigorously in relation to depression. Childbearing-aged women are particularly vulnerable to the adverse effects of poor nutrition on mood because pregnancy and lactation are major nutritional stressors to the body. The depletion of nutrient reserves throughout pregnancy and a lack of recovery postpartum may increase a woman's risk of depression. Prospective research studies are needed to clarify the role of nutrition in the pathophysiology of depression among childbearing-aged women. Greater attention to nutritional factors in mental health is warranted given that nutrition interventions can be inexpensive, safe, easy to administer, and generally acceptable to patients.
Calvo, Mona S; Uribarri, Jaime
This review explores the potential adverse impact of the increasing phosphorus content in the American diet on renal, cardiovascular, and bone health of the general population. Increasingly, studies show that phosphorus intakes in excess of the nutrient needs of a healthy population may significantly disrupt the hormonal regulation of phosphate, calcium, and vitamin D, which contributes to disordered mineral metabolism, vascular calcification, impaired kidney function, and bone loss. Moreover, large epidemiologic studies suggest that mild elevations of serum phosphate within the normal range are associated with cardiovascular disease (CVD) risk in healthy populations without evidence of kidney disease. However, few studies linked high dietary phosphorus intake to mild changes in serum phosphate because of the nature of the study design and inaccuracies in the nutrient composition databases. Although phosphorus is an essential nutrient, in excess it could be linked to tissue damage by a variety of mechanisms involved in the endocrine regulation of extracellular phosphate, specifically the secretion and action of fibroblast growth factor 23 and parathyroid hormone. Disordered regulation of these hormones by high dietary phosphorus may be key factors contributing to renal failure, CVD, and osteoporosis. Although systematically underestimated in national surveys, phosphorus intake seemingly continues to increase as a result of the growing consumption of highly processed foods, especially restaurant meals, fast foods, and convenience foods. The increased cumulative use of ingredients containing phosphorus in food processing merits further study given what is now being shown about the potential toxicity of phosphorus intake when it exceeds nutrient needs.
Milojevich, Helen M.; Lukowski, Angela F.
Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning. PMID:27280714
... Everyone forgets things from time to time. Modest memory problems are a fairly common part of aging, ... medication side effects or underlying conditions contribute to memory loss. There's a difference, though, between normal changes ...
Lowe, Sarah R; Joshi, Spruha; Pietrzak, Robert H; Galea, Sandro; Cerdá, Magdalena
Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across
Currin, James B.; Hayslip, Bert, Jr.; Temple, Jeff R.
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…
Schöllgen, Ina; Morack, Jennifer; Infurna, Frank J.; Ram, Nilam; Gerstorf, Denis
Well-being and physical health are central indicators of quality of life in old age. Research from a between-person difference perspective finds that people in better health than their peers also report higher well-being than their peers. However, we know very little about whether changes in one domain are accompanied by changes in the other…
Proust-Lima, Cécile; Amieva, Hélène; Letenneur, Luc; Orgogozo, Jean-Marc; Jacqmin-Gadda, Hélène; Dartigues, Jean-François
In cognitive aging research, the study of a general cognitive factor has been shown to have a substantial explanatory power over the study of isolated tests. The authors aimed at differentiating the impact of gender and education on global cognitive change with age from their differential impact on 4 psychometric tests using a new latent process approach, which intermediates between a single-factor longitudinal model for sum scores and an item-response theory approach for longitudinal data. The analysis was conducted on a sample of 2,228 subjects from PAQUID, a population-based cohort of older adults followed for 13 years with repeated measures of cognition. Adjusted for vascular factors, the analysis confirmed that women performed better in tests involving verbal components, while men performed better in tests involving visuospatial skills. In addition, the model suggested that women had a slightly steeper global cognitive decline with oldest age than men, even after excluding incident dementia or death. Subjects with higher education exhibited a better mean score for the 4 tests, but this difference tended to attenuate with age for tests involving a speed component.
Nandrino, Jean-Louis; Baracca, Margaret; Antoine, Pascal; Paget, Virginie; Bydlowski, Sarah; Carton, Solange
The Levels of Emotional Awareness Scale (LEAS) developed by Lane et al. (1990) measures the ability of a subject to discriminate his or her own emotional state and that of others. The scale is based on a cognitive-developmental model in which emotional awareness increases in a similar fashion to intellectual functions. Because studies performed using North American and German populations have demonstrated an effect of age, gender, and level of education on the ability to differentiate emotional states, our study attempts to evaluate whether these factors have the same effects in a general French population. 750 volunteers (506 female, 244 male), who were recruited from three regions of France (Lille, Montpellier, Paris), completed the LEAS. The sample was divided into five age groups and three education levels. The results of the LEAS scores for self and others and the total score showed a difference in the level of emotional awareness for different age groups, by gender and education level. A higher emotional level was observed for younger age groups, suggesting that emotional awareness depends on the cultural context and generational societal teachings. Additionally, the level of emotional awareness was higher in women than in men and lower in individuals with less education. This result might be explained by an educational bias linked to gender and higher education whereby expressive ability is reinforced. In addition, given the high degree of variability in previously observed scores in the French population, we propose a standard based on our French sample.
Bazargan, Massoud; Guzhva, Vitaly S
General aviation (GA) accounts for more than 82% of all air transport-related accidents and air transport-related fatalities in the U.S. In this study, we conduct a series of statistical analyses to investigate the significance of a pilot's gender, age and experience in influencing the risk for pilot errors and fatalities in GA accidents. There is no evidence from the Chi-square tests and logistic regression models that support the likelihood of an accident caused by pilot error to be related to pilot gender. However, evidence is found that male pilots, those older than 60 years of age, and with more experience, are more likely to be involved in a fatal accident.
Seo, Ji-Yun; Park, Yoon-Jung; Yi, Young-Ah; Hwang, Ji-Yun; Lee, In-Bog; Cho, Byeong-Hoon; Son, Ho-Hyun; Seo, Deog-Gyu
Genetic information such as DNA sequences has been limited to fully explain mechanisms of gene regulation and disease process. Epigenetic mechanisms, which include DNA methylation, histone modification and non-coding RNAs, can regulate gene expression and affect progression of disease. Although studies focused on epigenetics are being actively investigated in the field of medicine and biology, epigenetics in dental research is at the early stages. However, studies on epigenetics in dentistry deserve attention because epigenetic mechanisms play important roles in gene expression during tooth development and may affect oral diseases. In addition, understanding of epigenetic alteration is important for developing new therapeutic methods. This review article aims to outline the general features of epigenetic mechanisms and describe its future implications in the field of dentistry.
Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder
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
Kulishova, T V; Tabashnikova, N A; Akker, L V
Sixty women of the reproductive age with uterine myoma were divided into two groups. Thirty patients of the study group received combined therapy plus general magnetotherapy (GMT). Patients of the control group received only combined treatment. Ultrasound investigation registered a reduction in the size of myoma nodes by 16.7% in the study group, while in the controls myoma size did not change (p < 0.05). 1-year follow-up data for the study group demonstrated no cases of the myoma growth while 16.6% of the controls showed growth of myoma nodes, in 6.6% of them supravaginal myoma amputation was made for rapidly growing myoma.
Whitley, Elise; Popham, Frank; Benzeval, Michaela
Purpose of the Study: With increasing longevity in industrialized populations, there is growing interest in what defines “successful aging” (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe–Kahn SA model captures older individual’s perceptions of their own health and aging. Methods: Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe–Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life). Results: Respondents’ self-rated health and satisfaction was generally good but few had all six Rowe–Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions. Implications: The Rowe–Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe–Kahn dimensions and consider SA as a continuum. PMID:26970606
Lau, Robin S; Johnson, Shanthi; Kamalanabhan, T J
This study examines life expectancy (LE) and healthy life expectancy (HLE) in India longitudinally over the period 2007 to 2020, providing projections into the future. Specifically, the Indian Healthy Life Expectancy Projection model was developed based on epidemiological data (mortality, disability rates) obtained from the World Health Organization and the Government of India. The current model contributed to 4 key findings: decreases in mortality but not in all age and gender groups; increasing disability in the Indian population over time; increase in LE and HLE into the future in all age and gender groups; and the largest gains in LE and HLE are in the older age bands starting from the 70+ age band in women and 65+ age band in men. This study sheds some light on the population health measures needed to improve the understanding of the determinants of health for the efficient allocation of resources and to inform policy in the planning of health and social services.
Sauer, Mark V
Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction.
Pati, Susmita; Siewert, Elizabeth; Wong, Angie T.; Bhatt, Suraj K.; Calixte, Rose E.; Cnaan, Avital
Objective To determine the influence of maternal health literacy and child’s age on participation in social welfare programs benefiting children. Methods In a longitudinal prospective cohort study of 560 Medicaid-eligible mother-infant dyads recruited in Philadelphia, maternal health literacy was assessed using the Test of Functional Health Literacy in Adults (short version). Participation in social welfare programs (Temporary Assistance to Needy Families [TANF], Supplemental Nutrition Assistance Program [SNAP], Special Supplemental Nutrition Program for Women, Infants, and Children [WIC], child care subsidy, and public housing) was self-reported at child’s birth, and at the 6, 12, 18, 24 month follow-up interviews. Generalized estimating equations quantified the strength of maternal health literacy as an estimator of program participation. Results The mothers were primarily African-Americans (83%), single (87%), with multiple children (62%). Nearly 24% of the mothers had inadequate or marginal health literacy. Children whose mothers had inadequate health literacy were less likely to receive child care subsidy (adjusted OR= 0.54, 95% CI: 0.34–0.85) than children whose mothers had adequate health literacy. Health literacy was not a significant predictor for TANF, SNAP, WIC or housing assistance. The predicted probability for participation in all programs decreased from birth to 24 months. Most notably, predicted WIC participation declined rapidly after age one. Conclusions During the first 24 months, mothers with inadequate health literacy could benefit from simplified or facilitated child care subsidy application processes. Targeted outreach and enrollment efforts conducted by social welfare programs need to take into account the changing needs of families as children age. PMID:23990157
Shanahan, Michael J; Hill, Patrick L; Roberts, Brent W; Eccles, Jacquelynne; Friedman, Howard S
The Conscientiousness (C) of the self and significant others influences health by way of mediational chains involving socioeconomic attainment, the avoidance and neutralization of stressors, the promotion of health behaviors and the minimization of risk behaviors, and the management of symptoms and diseases. Yet, meta-analyses reveal that these associations are moderated by factors that are not well understood. We propose the Life Course of Personality Model (LCP Model), which comprises a series of hypotheses that suggest how such mediational chains are subject to 2 sources of contingency. First, the mechanisms by which C translates into health and the avoidance of risk change from early childhood to late adulthood, involving processes that are specific to phases of the life course; also, however, C influences health by way of continuous processes extending over many decades of life. Second, C may be more consequential in some social contexts than in others, and when accompanied by some constellations of personality characteristics than by others. That is, the mediational processes by which C translates into health and the avoidance of disease are likely moderated by timing, social context (including the C of others), and other aspects of the individual's personality. We consider methodological implications of the LCP Model.
Sueyoshi, Ted; Emoto, Gen; Yuasa, Tomoki
Background: Generalized joint laxity has been linked to ligamentous injuries such as anterior cruciate ligament tear and ankle sprain. Purpose/Hypothesis: The purpose of this study was to investigate generalized joint laxity and incidence of ligament injuries in high school–aged female volleyball players. It was hypothesized that volleyball players with a past history of sprains would have increased generalized joint laxity compared with those without any history and that athletes with multiple sprains would demonstrate with a higher generalized joint laxity score than those who had only 1 sprain. Study Design: Case-control study; Level of evidence, 3. Methods: Forty-seven subjects were tested for generalized joint laxity using the Beighton and Horan Joint Mobility Index (BHJMI). They were categorized into 2 groups based on the presence of past ligament injury: injury group (IG) and noninjury group (NG). The IG group was further divided into 2 groups based on whether they had a single ligamentous injury (IGS) or multiple injuries (IGM) in the past to study whether there was any difference in scores between the subgroups. The collected data were analyzed statistically with 1-way analysis of variance. Results: Subjects in the IG group scored significantly higher on the BHJMI than those in the NG group. The mean score for the IG group was 2.40 ± 1.42, as opposed to 1.24 ± 1.09 for the NG group (P = .006). Eleven subjects in the IG group had suffered multiple injuries or recurrent injuries (IGM) and scored significantly higher than the remaining 19 individuals in the IG group, who had only sustained a single injury (IGS). The mean BHJMI scores were 3.18 ± 1.47 and 1.95 ± 1.22 for IGM and IGS, respectively (P = .02). Conclusion: Female athletes with a high generalized joint laxity score may be more prone to ligament injury and potentially to recurrent ligament injuries. PMID:27761474
Jung, Hee-Won; Jang, Il-Young; Lee, Young Soo; Lee, Chang Ki; Cho, Eun-Il; Kang, Woo Young; Chae, Jeoung Hee; Lee, Eun Ju; Kim, Dae Hyun
Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.
Macdowall, W.; Copas, A. J.; Tanton, C.; Keevil, B. G.; Lee, D. M.; Mitchell, K. R.; Field, N.; Sonnenberg, P.; Bancroft, J.; Mercer, C. H.; Wallace, A. M.; Johnson, A. M.; Wellings, K.; Wu, F. C. W.
Context: Salivary T (Sal-T) measurement by liquid chromatography–tandem mass spectroscopy resents the opportunity to examine health correlates of Sal-T in a large-scale population survey. Objective: This study sought to examine associations between Sal-T and health-related factors in men and women age 18–74 years. Design and Setting: Morning saliva samples were obtained from participants in a cross-sectional probability-sample survey of the general British population (Natsal-3). Self-reported health and lifestyle questions were administered as part of a wider sexual health interview. Participants: Study participants included 1599 men and 2123 women. Methods: Sal-T was measured using liquid chromatography–tandem mass spectroscopy. Linear regression was used to examine associations between health factors and mean Sal-T. Results: In men, mean Sal-T was associated with a range of health factors after age adjustment, and showed a strong independent negative association with body mass index (BMI) in multivariable analysis. Men reporting cardiovascular disease or currently taking medication for depression had lower age-adjusted Sal-T, although there was no association with cardiovascular disease after adjustment for BMI. The decline in Sal-T with increasing age remained after adjustment for health-related factors. In women, Sal-T declined with increasing age; however, there were no age-independent associations with health-related factors or specific heath conditions with the exception of higher Sal-T in smokers. Conclusions: Sal-T levels were associated, independently of age, with a range of self-reported health markers, particularly BMI, in men but not women. The findings support the view that there is an age-related decline in Sal-T in men and women, which cannot be explained by an increase in ill health. Our results demonstrate the potential of Sal-T as a convenient measure of tissue androgen exposure for population research. PMID:27552539
Background Internet-delivered intervention programs are an effective way of changing health behavior in an aging population. The same population has an increasing number of people with cognitive decline or cognitive impairments. Modifiable lifestyle risk factors such as physical activity, nutrition, smoking, alcohol consumption, sleep, and stress all influence the probability of developing neurodegenerative diseases such as Alzheimer’s disease. Objective This study aims to answer two questions: (1) Is the use of a self-motivated, complex eHealth intervention effective in changing multiple health behaviors related to cognitive aging in Dutch adults in the work force, especially those aged 40 and over? and (2) Does this health behavior change result in healthier cognitive aging patterns and contribute to preventing or delaying future onset of neurodegenerative syndromes? Methods The Brain Aging Monitor study uses a quasi-experimental 2-year pre-posttest design. The Brain Aging Monitor is an online, self-motivated lifestyle intervention program. Recruitment is done both in medium to large organizations and in the Dutch general population over the age of 40. The main outcome measure is the relationship between lifestyle change and cognitive aging. The program uses different strategies and modalities such as Web content, email, online newsletters, and online games to aid its users in behavior change. To build self-regulatory skills, the Brain Aging Monitor offers its users goal-setting activities, skill-building activities, and self-monitoring. Results Study results are expected to be published in early 2016. Conclusions This study will add to the body of evidence on the effectiveness of eHealth intervention programs with the combined use of state-of-the-art applied games and established behavior change techniques. This will lead to new insights on how to use behavior change techniques and theory in multidimensional lifestyle eHealth research, and how these techniques
Delaruelle, Katrijn; Buffel, Veerle; Bracke, Piet
Researchers have recently been investigating the temporal variation in the educational gradient in health. While there is abundant literature concerning age trajectories, theoretical knowledge about cohort differences is relatively limited. Therefore, in analogy with the life course perspective, we introduce two contrasting cohort-specific hypotheses. The diminishing health returns hypothesis predicts a decrease in educational disparities in health across cohorts. By contrast, the cohort accretion hypothesis suggests that the education-health gap will be more pronounced among younger cohorts. To shed light on this, we perform a hierarchical age-period-cohort analysis (HAPC), using data from a subsample of individuals between 25 and 85 years of age (N = 232,573) from 32 countries in the European Social Survey (six waves: 2002-2012). The analysis leads to three important conclusions. First, we observe a widening health gap between different educational levels over the life course. Second, we find that these educational differences in the age trajectories of health seem to strengthen with each successive birth cohort. However, the two age-related effects disappear when we control for employment status, household income, and family characteristics. Last, when adjusting for these mediators, we reveal evidence to support the diminishing health returns hypothesis, implying that it is primarily the direct association between education and health that decreases across cohorts. This finding raises concerns about potential barriers to education being a vehicle for empowerment and the promotion of health.
Do socioeconomic differences in health status increase as people age, reflecting cumulative advantage or disadvantage in health trajectories? Life course research hypothesises that cumulative advantage/disadvantage (CAD) is an important underlying social process that shape inequalities as people age. The objective of this study is to examine whether health trajectories are diverging as people age across socioeconomic positions (education, employment status and income). In a random sample of 3,665 respondents living in Switzerland (Swiss Household Panel 2004-2011), trajectories of self-rated health, body mass index, depression and medicated functioning were examined with multilevel regression models. The results showed that employment status and income were associated with diverging health trajectories among men; however, only a few associations supported the CAD hypothesis. Education was rarely associated with diverging health trajectories. In conclusion, little evidence was found to support the CAD model.
Casado Marín, D
Over the last 30 years, the elderly population of developed countries has shown an unprecedented increase. This process has raised alarm about the future affordability of health care systems. In this context, we consider the effects of population aging on health care expenditure within a process involving several elements: the increasing number of elderly persons, variations in the health status of the elderly and the evolution of the cost of medical treatment. The main conclusion is that only a small part of the increase in expenditure is due to population aging. Furthermore, because the average health status of the elderly has improved with greater longevity, we suggest that most of the increase in health care expenditure can be attributed to the evolution of non-demographic factors. Such as health services utilization, treatment cost and the development of new medical technology. Unlike populations aging, these factors can be subjected to future regulation and consequently, can to a large extent be controlled.
Traver, M; Basagoiti, I; Martinez-Millana, A; Fernandez-Llatas, C; Traver, V
Digital Health Literacy (DHL) is a key element to promote patient empowerment. This position paper presents the lessons learnt from the daily activities of a General Practitioner interacting with patients. General Practitioners have a main role in each stage on individual digital health literacy process. They are the first meeting point between patients and the medical knowledge; in the search phase, they are who can prescribe and validate health information; in the comprehension phase, they lead to a full understanding; and in the adoption phase, they assist in the own personal application. Major conclusions are that General Practitioners need a set of tools, organizational resources and knowledge to acquire Digital Health Literacy skills to help patients on their way from the information to the empowerment. Some of these tools and knowledge are identified to draw the future roadmap to get people with Digital Health Literacy skills.
Müller, Juliana dos Santos; Falcão, Ila Rocha; Couto, Maria Carolina Barreto Moreira; Viana, Wendel da Silva; Alves, Ivone Batista; Viola, Denise Nunes; Woods, Courtney Georgette; Rêgo, Rita Franco
Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the “Physical Health” domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen’s work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil’s economy and food system. PMID:27164118
Khurana, Sandhya; Venkataraman, Krishnan; Hollingsworth, Amanda; Piche, Matthew; Tai, T. C.
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging. PMID:24077237
GONZÁLEZ-GONZÁLEZ, César; WONG, Rebeca
We use longitudinal data from the Mexican Health and Aging Study to analyze the relationship between health and labor force participation of population aged 50 years and older in Mexico. The results confirm that health, measured through chronic diseases and difficulty to perform activities of daily living, has a powerful influence on labor force participation. We also find important differences by gender; hypertension and diabetes have effects in both, men and women; heart disease and stroke only in men. We provide concrete evidence on economic participation and highlight the importance of public policies to create adequate jobs for the population at middle and old age. PMID:25722646
Garry, P J; Wayne, S J; Vellas, B
In 1979, Dr. James S. Goodwin, M.D., assisted by Philip J. Garry, Ph.D., submitted a grant proposal to the United States Public Health Service/ National Institute on Aging (NIA) entitled, "A prospective study of nutrition in the elderly". This study was approved and funded by the NIA beginning in 1979. Initially, approximately 300 men and women over 65 years of age with no known medical illnesses and no prescription medications were selected for this study. The primary purpose of this multi disciplinary study, known in the literature as the New Mexico Aging Process Study (NMAPS), was to examine the role of nutrition and resultant changes in body composition and organ function in relation to the aging process and health status of the elderly. This was accomplished by following prospectively healthy elderly volunteers, obtaining in-depth information about dietary habits, lifestyle, body composition, organ function, cognitive status, vitamin metabolism, genetic markers, and biochemical measures of nutritional status and then examining these data in relationship to age and health status and changes in health status. Some of the specific aims of the study were modified over the course of this longitudinal study because of availability of University of New Mexico School of Medicine faculty with expertise in different areas of aging research. In 1988, Dr. Bruno Vellas from the University Hospital in Toulouse, France became an on-going visiting professor at the University of New Mexico School of Medicine. From 1988, until the study was terminated in 2003, Dr. Vellas has collaborated with the faculty involved in the NMAPS on a number of research projects. In this article, we provide information about the studies overall design and briefly describe some of the major finding of the NMAPS.
Due to the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden. Clinical manifestation of many of these disorders takes years...
Percheski, Christine; Hargittai, Eszter
Objective: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. Participants: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study.…
Grady, Sally C.; Maynard, Charles L.
Describes Building Ties Project, a program that provides comprehensive assistance to local interagency planning committees addressing mental health service needs of older adults, including training program development materials and consultation. Notes that in two years, project activities in 23 counties increased services, improved interagency…
German, Pearl S.
Reports that the elderly appear most influenced in health attitudes and behaviors by various factors within the setting so those who identify a major source of care tend to be higher utilizers, do less "shopping-around," and exhibit less negative behaviors such as needing care without seeking it. Discussion of the article follows. (Author)
Sharifi, Nasibeh; Jalili, Lida; Khazaeian, Somayeh; nia, Anvar-sadat Nayebi
Introduction Most women experience significant changes in their general health status during menopause, which negatively affects their quality of life. Physical activity has also been shown to enhance quality of life. However, little is known about the effect of physical activity on women’s health during the menopausal transition. This study aimed to determine the relationship between physical activity and general health among menopausal women in Ahvaz, Iran. Methods This cross sectional study was carried out on 600 menopausal women using cluster random sampling during 2013–2014. Data collection tools were three questionnaires; women’s demographic characteristics, the Goldenberg’s questionnaire, and International physical activity questionnaire (IPAQ). Data were analyzed using descriptive and inferential statistics through SPSS version 19. The statistical tests were performed at the 95% confidence interval. Results There was a significant relationship between the total score of physical activity and physical health, social functioning, anxiety and depression (p<0.05), but no significant relationship was found between subscales related to physical activity and general health (p>0.05). Conclusion Physical activity is effective in improving general health in menopausal women. Proper training and effective interventions for regular physical activity can be important steps to promote the general health of menopausal women. PMID:28243418
Jørgensen, Jeanette Therming; Andersen, John Sahl; Tjønneland, Anne; Andersen, Zorana Jovanovic
Objective This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50–65 years. Design Cohort-based cross-sectional study. Setting Danish general practice. Subjects Totally, 54,849 participants of the Danish Diet, Cancer and Health cohort (50–65 years). Main outcome measures The sum of cohort members’ face-to-face consultations with general practitioner (GP) at the cohort baseline year (1993–1997). We obtained data on GP visits from the Danish National Health Service Register at the cohort baseline (1993–1997), when information on lifestyle (smoking, body mass index (BMI), alcohol use, physical activity), medical conditions (somatic and mental), employment, education, gravidity, and hormone therapy (HT) use was collected by questionnaire. Results Women had on average 4.1 and men 2.8 consultations per year. In a crude model, women had 47% higher rate of GP visits than men (incidence rate ratio: 1.47; 95% Confidence Interval: 1.45–1.50), which remained unchanged after adjustment for lifestyle, socio-demographic and medical factors, but attenuated to 18% (1.18; 1.13–1.24) after adjustment for female factors (gravidity and post-menopausal HT. In a fully adjusted model, subjects with hypertension (1.63; 1.59–1.67), mental illness (1.63; 1.61–1.66), diabetes (1.56; 1.47–1.65), angina pectoris (1.28; 1.21–1.34), and unemployed persons (1.19; 1.18–1.21) had highest rates of GP visits. Conclusions Gravidity and HT use explain a large proportion, but not all of the gender difference in GP utilization. Medical conditions (somatic and mental) and unemployment are the main determinants of GP utilization in men and women, while lifestyle has minor effect. Key Points Female gender remained a dominant determinant of GP utilization, after adjustment for lifestyle, socio-demography, medical and gender specific factors, with females consulting their GP 18% more often than males
Bershteyn, Anna; Klein, Daniel J.; Eckhoff, Philip A.
Background Generalized HIV epidemics propagate to future generations according to the age patterns of transmission. We hypothesized that future generations could be protected from infection using age-targeted prevention, analogous to the ring-fencing strategies used to control the spread of smallpox. Methods We modeled age-targeted or cohort-targeted outreach with HIV treatment and/or prevention using EMOD-HIV v0·8, an individual-based network model of HIV transmission in South Africa. Results Targeting ages 20 to 30 with intensified outreach, linkage, and eligibility for antiretroviral therapy (ART) averted 45% as many infections as universal outreach for approximately one-fifth the cost beyond existing HIV services. Though cost-effective, targeting failed to eliminate all infections to those under 20 due to vertical and inter-generational transmission. Cost-effectiveness of optimal prevention strategies included US$6238 per infection averted targeting ages 10–30, US$5031 targeting 20–30, US$4279 targeting 22–27, and US$3967 targeting 25–27, compared to US$10 812 for full-population test-and-treat. Minimizing burden (disability-adjusted life years [DALYs]) rather than infections resulted in older target age ranges because older adults were more likely to receive a direct health benefit from treatment. Conclusions Age-targeted treatment for HIV prevention is unlikely to eliminate HIV epidemics, but is an efficient strategy for reducing new infections in generalized epidemics settings. PMID:27008897
Mazor, Kathleen M; Agunwamba, Amenah A; Valluri, Sruthi; Wilson, Patrick M; Sadasivam, Rajani S; Finney Rutten, Lila J
Background Health information exchanged between friends or family members can influence decision making, both for routine health questions and for serious health issues. A health information broker is a person to whom friends and family turn for advice or information on health-related topics. Characteristics and online behaviors of health information brokers have not previously been studied in a national population. Objective The objective of this study was to examine sociodemographic characteristics, health information seeking behaviors, and other online behaviors among health information brokers. Methods Data from the Health Information National Trends Survey (2013-2014; n=3142) were used to compare brokers with nonbrokers. Modified Poisson regression was used to examine the relationship between broker status and sociodemographics and online information seeking. Results Over half (54.8%) of the respondents were consulted by family or friends for advice or information on health topics (ie, they acted as health information brokers). Brokers represented 54.1% of respondents earning <$20,000 yearly and 56.5% of respondents born outside the United States. Women were more likely to be brokers (PR 1.34, 95% CI 1.23-1.47) as were those with education past high school (PR 1.42, CI 1.22-1.65). People aged ≥75 were less likely to be brokers as compared to respondents aged 35-49 (PR 0.81, CI 0.67-0.99). Brokers used the Internet more frequently for a variety of online behaviors such as seeking health information, creating and sharing online content, and downloading health information onto a mobile device; and also reported greater confidence in obtaining health information online. Conclusions More than 50% of adults who responded to this national survey, including those with low income and those born abroad, were providing health information or advice to friends and family. These individuals may prove to be effective targets for initiatives supporting patient engagement
Parkin, D; Rice, N; Sutton, M
Patterns of self-reported morbidity and general practitioner (GP) utilization exhibit complex age, sex and time heterogeneity. Underlying patterns are often obscured by data which are overly 'rough' because of noise associated with adjacent year fluctuations. In this paper we describe methods to obtain smoothed estimates of age, time and birth-cohort effects using data from the General Household Survey (GHS), covering the period 1984-1995/6 inclusive. The methods outlined offer powerful analytic tools to research complex profiles or trends, particularly over age or time. The relationships of the morbidity and GP utilization measures with age, sex and survey year characteristics are estimated non-parametrically using roughness penalized least squares (RPLS). A semi-parametric extension of this model is used to estimate the effect of the morbidity variables on GP utilization. Tests are employed for various forms of age and time heterogeneity including birth-cohort effects. Linear age specifications are rejected for all variables and evidence is found of time heterogeneity in one of the morbidity measures--limiting long-standing illness (LS)--and GP utilization. The advantages of employing non- and semi-parametric estimations in the presence of complex relationships such as those observed for age and time profiles are discussed. Adoption of these techniques by applied econometricians working in health economics is encouraged.
Khalaila, Rabia; Litwin, Howard
Objective To examine the longitudinal association between changes in health behaviors and depression, and to determine the mediating effect of health characteristics on this association. Method Based on the first and second waves of the Survey of Health, Aging and Retirement in Europe (SHARE)-Israel, depressive symptoms of 1,524 Israelis aged 50 or older were analyzed using logistic regression. Results Changes in physical activity and body weight are associated with depressive symptoms after adjusting for confounders. However, after adding measures of health, the respective correlations of weight gain and commenced physical activity with depression disappear, and the correlation between continued activity and depression is reduced. Discussion Changes in health behaviors are related to mental health in late life, but their effect is mediated by physical and functional health. Future interventions should nevertheless target older individuals who stop physical activity and those who remain inactive to lessen the risk of depression. PMID:24401321
Forbes, Scott C; Little, Jonathan P; Candow, Darren G
Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.
Stewart, Tara L; Chipperfield, Judith G; Perry, Raymond P; Hamm, Jeremy M
This study assessed the extent to which older adults attribute a recent heart attack/stroke to "old age," and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73-98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of "old age" as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering "old age" attributions in the context of cardiovascular health events.
Rodrigues, Ana Paula; Fonseca, Rita Carvalho; Matias-Dias, Carlos
Current strategies of European health advocate the strengthening of the role of public health, requiring from decision-makers the ability to defend and enhance the health of individuals and populations in all policies. In the pursuit of this objective, public health should be evidence-based and so public health surveillance, seen as an important tool of public health since the nineteenth century, plays a central role in public health practice through the production and dissemination of the health information necessary for health planning and for evaluation of public health actions. Within the practice of public health estimations of disease frequency are important for outbreak control, health assessment, health needs assessment and estimation of health gains, but unfortunately these estimations are not always available for the entire population. In those cases and for diseases with high prevalence sentinel surveillance based in sentinel networks have some advantages for specific groups, namely needed of scarce resources and obtainment of quick results.The central role of family doctors in chronic disease management, their knowledge on individuals and families and their responsibilities in the management of a clear defined patients list are characteristics that make general practice an appropriate context to develop a sentinel network. In fact, in Portugal there is a general practitioner sentinel network named Rede Médicos-Sentinela working since 1989 which estimated, for the last 25 years, incidence rates of several chronic diseases, some of them targeted on national priority health programs. Thus, we consider that Rede Médicos-Sentinela can be integrated in a national surveillance system for chronic diseases in Portugal.
Kaplan, R M
There is near consensus that the US health care system requires reform. Only a quarter of the American public has faith in the current system. Health care was one of the major issues considered in the 1992 US presidential election and the search for innovative solutions has transcended administrations.
Kaplan, R M
There is near consensus that the US health care system requires reform. Only a quarter of the American public has faith in the current system. Health care was one of the major issues considered in the 1992 US presidential election and the search for innovative solutions has transcended administrations. PMID:8505751
Pham-Kanter, Genevieve; Leitsch, Sara A.
Objectives This paper presents a description of the methods used in the National Social Life, Health, and Aging Project to detect the presence of chronic conditions and diseases associated with aging. It also discusses the validity and distribution of these measures. Methods Markers associated with common chronic diseases and conditions of aging were collected from 3,005 community-dwelling older adults living in the United States, aged 57–85 years, during 2006. Dried blood spots, physical function tests, anthropometric measurements, self-reported history, and self-rated assessments were used to detect the presence of chronic conditions associated with aging or of risk factors associated with the development of chronic diseases. Results The distribution of each measure, disaggregated by age group and gender, is presented. Conclusions This paper describes the methodology used as well as the distribution of each of these measures. In addition, we discuss how the measures used in the study relate to specific chronic diseases and conditions associated with aging and how these measures might be used in social science analyses. PMID:19204070
Zapata, Heidi J; Quagliarello, Vincent J
Advances in bacterial deoxyribonucleic acid sequencing allow for characterization of the human commensal bacterial community (microbiota) and its corresponding genome (microbiome). Surveys of healthy adults reveal that a signature composite of bacteria characterizes each unique body habitat (e.g., gut, skin, oral cavity, vagina). A myriad of clinical changes, including a basal proinflammatory state (inflamm-aging), that directly interface with the microbiota of older adults and enhance susceptibility to disease accompany aging. Studies in older adults demonstrate that the gut microbiota correlates with diet, location of residence (e.g., community dwelling, long-term care settings), and basal level of inflammation. Links exist between the microbiota and a variety of clinical problems plaguing older adults, including physical frailty, Clostridium difficile colitis, vulvovaginal atrophy, colorectal carcinoma, and atherosclerotic disease. Manipulation of the microbiota and microbiome of older adults holds promise as an innovative strategy to influence the development of comorbidities associated with aging.
Jonker, Marcel F; Attema, Arthur E; Donkers, Bas; Stolk, Elly A; Versteegh, Matthijs M
Health state valuations of patients and non-patients are not the same, whereas health state values obtained from general population samples are a weighted average of both. The latter constitutes an often-overlooked source of bias. This study investigates the resulting bias and tests for the impact of reference dependency on health state valuations using an efficient discrete choice experiment administered to a Dutch nationally representative sample of 788 respondents. A Bayesian discrete choice experiment design consisting of eight sets of 24 (matched pairwise) choice tasks was developed, with each set providing full identification of the included parameters. Mixed logit models were used to estimate health state preferences with respondents' own health included as an additional predictor. Our results indicate that respondents with impaired health worse than or equal to the health state levels under evaluation have approximately 30% smaller health state decrements. This confirms that reference dependency can be observed in general population samples and affirms the relevance of prospect theory in health state valuations. At the same time, the limited number of respondents with severe health impairments does not appear to bias social tariffs as obtained from general population samples. Copyright © 2016 John Wiley & Sons, Ltd.
McAvoy, Brian R; Coster, Gregor D
New Zealand's health sector has undergone three significant restructures within 10 years. The most recent has involved a Primary Health Care Strategy, launched in 2001. Primary Health Organisations (PHOs), administered by 21 District Health Boards, are the local structures for implementing the Primary Health Care Strategy. Ninety-three percent of the New Zealand population is now enrolled within 79 PHOs, which pose a challenge to the well-established Independent Practitioner Associations (IPAs). Although there was initial widespread support for the philosophy underlying the Primary Health Care Strategy, there are concerns amongst general practitioners (GPs) and their professional organisations relating to its implementation. These centre around 6 main issues: 1. Loss of autonomy 2. Inadequate management funding and support 3. Inconsistency and variations in contracting processes 4. Lack of publicity and advice around enrolment issues 5. Workforce and workload issues 6. Financial risks On the other hand, many GPs are feeling positive regarding the opportunities for PHOs, particularly for being involved in the provision of a wider range of community health services. Australia has much to learn from New Zealand's latest health sector and primary health care reforms. The key lessons concern: • the need for a national primary health care strategy • active engagement of general practitioners and their professional organisations • recognition of implementation costs • the need for infrastructural support, including information technology and quality systems • robust management and governance arrangements • issues related to critical mass and population/distance trade offs in service delivery models PMID:16262908
Ybarra, Michele; Suman, Michael
The Internet is transforming the way in which consumers approach their health care needs. Sex and age are influential aspects of one's health as well as disease risk and are thus integral components of the emerging picture of health information seekers. Using data from Surveying the Digital Future, Year 4, a nationally representative, longitudinal telephone survey of Americans 12 years of age and older (n = 2010), we examine the reasons for, assessments of and actions taken as a result of health information found online among men and women and older and younger people. Although we tend to think of the Internet as a young person's technology, the percent of adults 60 years of age and older is similar to that of adolescents using the Internet as a health care information resource, thus suggesting an untapped opportunity with online interventions for older adults. Nonetheless, as age increases so too does the report of frustration with the experience. Men are more likely to report a positive seeking experience than women. Differences in Internet use fail to explain these observed sex and age differences in the seeking experience. Across the spectrum of age, sex and Internet skill, Internet health information seeking appears to enhance the patient-provider relationship.
Montalto, M; Dunt, D; Young, D
General practitioners have been part of multidisciplinary services in Victoria Community Health Centres (CHCs) for 20 years. This model institutionalizes a high degree of integration between general practitioners and other primary care and community service personnel. Of 51 eligible full-time general practitioners in Victorian CHCs, 46 were interviewed, using a structured questionnaire. General practitioners in CHCs were younger, less experienced and more likely to be female than other general practitioners. Nearly three-quarters were salaried. The philosophy of practice and the conditions of employment were the commonest reasons for entering CHC practice. Teamwork and the conditions of employment were felt to be the biggest advantages of CHC practice, while difficulties with management and the perceived loss of professional ownership and control were the commonest disadvantages. None reported interference from the CHC management in their clinical practice. Nearly a quarter of full-time CHC general practitioners do not undertake any formal community health promotion activities. Forty-five per cent of respondents intended to leave their CHC within the next five years. Universal health insurance has diminished the impact of CHC general practice. The philosophy of CHCs and the salaried nature of the employment continues to attract general practitioners. High staff turnover is a feature of CHC general practice, in part related to young doctors making an initial, but not long-term commitment to CHC practice. However, the loss of professional control and management difficulties should be addressed, as these may contribute to the high turnover.
Vorhies, Vanessa; Davis, Kristin E; Frounfelker, Rochelle L; Kaiser, Susan M
Vulnerable transition age youth, such as those in foster care and with serious mental health conditions, are at increased risk for lower rates of employment. Social capital is empirically linked to employment in the general population, yet little is known about the role of social capital in employment for at-risk transition age youth. Focus groups were conducted with young people with serious mental health conditions and their vocational specialists. Discussions reveal that both social and cultural capital influence employment processes. Those with employment experience value the motivation to work provided through others compared to those with no employment experience. Consistently employed describe strong working relationships with vocational specialists and possession of self-awareness, professionalism, and work-place knowledge as critical for employment success, while inconsistently employed describe worries about controlling emotions or behaviors on the job. Building social and cultural capital are explored as potential service provider goals.
Lee, David M; Nazroo, James; O'Connor, Daryl B; Blake, Margaret; Pendleton, Neil
We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples' sexual health should be managed, not just in the context of their age, gender
Feng, Pu; Huang, Liquan; Wang, Hong
The mammalian taste bud is an onion-shaped epithelial structure with 50-100 tightly packed cells, including taste receptor cells, supporting cells, and basal cells. Taste receptor cells detect nutrients and toxins in the oral cavity and transmit the sensory information to gustatory nerve endings in the buds. Supporting cells may play a role in the clearance of excess neurotransmitters after their release from taste receptor cells. Basal cells are precursor cells that differentiate into mature taste cells. Similar to other epithelial cells, taste cells turn over continuously, with an average life span of about 8-12 days. To maintain structural homeostasis in taste buds, new cells are generated to replace dying cells. Several recent studies using genetic lineage tracing methods have identified populations of progenitor/stem cells for taste buds, although contributions of these progenitor/stem cell populations to taste bud homeostasis have yet to be fully determined. Some regulatory factors of taste cell differentiation and degeneration have been identified, but our understanding of these aspects of taste bud homoeostasis remains limited. Many patients with various diseases develop taste disorders, including taste loss and taste distortion. Decline in taste function also occurs during aging. Recent studies suggest that disruption or alteration of taste bud homeostasis may contribute to taste dysfunction associated with disease and aging.
The mammalian taste bud is an onion-shaped epithelial structure with 50–100 tightly packed cells, including taste receptor cells, supporting cells, and basal cells. Taste receptor cells detect nutrients and toxins in the oral cavity and transmit the sensory information to gustatory nerve endings in the buds. Supporting cells may play a role in the clearance of excess neurotransmitters after their release from taste receptor cells. Basal cells are precursor cells that differentiate into mature taste cells. Similar to other epithelial cells, taste cells turn over continuously, with an average life span of about 8–12 days. To maintain structural homeostasis in taste buds, new cells are generated to replace dying cells. Several recent studies using genetic lineage tracing methods have identified populations of progenitor/stem cells for taste buds, although contributions of these progenitor/stem cell populations to taste bud homeostasis have yet to be fully determined. Some regulatory factors of taste cell differentiation and degeneration have been identified, but our understanding of these aspects of taste bud homoeostasis remains limited. Many patients with various diseases develop taste disorders, including taste loss and taste distortion. Decline in taste function also occurs during aging. Recent studies suggest that disruption or alteration of taste bud homeostasis may contribute to taste dysfunction associated with disease and aging. PMID:24287552
Hategan, Ana; Bourgeois, James A; Goldberg, Jeremy
From 1943, when Leo Kanner originally described autism, and to the first objective criteria for "infantile autism" in DSM-III and the inclusion of Asperger's disorder in DSM-IV, the subsequent classification scheme for autistic disorders has led to a substantial change with the 2013 issuance of the DSM-5 by including subcategories into one umbrella diagnosis of autism spectrum disorder (ASD) (Baker, 2013). ASD is a lifelong neurodevelopmental disorder, characterized by social and communication impairments and restricted, stereotypical patterns of behavior (Baker, 2013). It is currently expected that most, or all of the actual cases of ASD, are identified in a timely way (i.e. in early childhood). However, there are many undiagnosed older adults who may have met the current diagnostic criteria for ASD as children, but never received such a diagnosis due to the fact it had yet to be established. In addition, some patients with relatively less impairing phenotypes may escape formal diagnosis in childhood, only to later be diagnosed in adulthood. Nevertheless, the first generation of diagnosed patients with ASD is now in old age. Many such ASD patients have needed family and institutional support for their lives subsequent to childhood diagnosis. Due to aging and death of their parents and other supportive figures leading to a loss of social structures, there is no better time than now for the medical community to act.
Raybould, Ted P; Wrightson, A Stevens; Massey, Christi Sporl; Smith, Tim A; Skelton, Judith
Childhood oral disease is a significant health problem, particularly for vulnerable populations. Since a major focus of General Dentistry Program directors is the management of vulnerable populations, we wanted to assess their attitudes regarding the inclusion of physicians in the prevention, assessment, and treatment of childhood oral disease. A survey was mailed to all General Practice Residency and Advanced Education in General Dentistry program directors (accessed through the ADA website) to gather data. Spearman's rho was used to determine correlation among variables due to nonnormal distributions. Overall, Advanced General Dentistry directors were supportive of physicians' involvement in basic aspects of oral health care for children, with the exception of applying fluoride varnish. The large majority of directors agreed with physicians' assessing children's oral health and counseling patients on the prevention of dental problems. Directors who treated larger numbers of children from vulnerable populations tended to strongly support physician assistance with early assessment and preventive counseling.
Randall, G. Kevin; Martin, Peter; Bishop, Alex J.; Johnson, Mary Ann; Poon, Leonard W.
This study examined the mediating and moderating role of social resources on the association between age and change in functional health for three age groups of older adults. Data were provided by those in their 60s, 80s, and 100s who participated in the first two phases of the Georgia Centenarian study. Analyses confirmed the study's hypothesis…
Vidzis, Aldis; Cema, Ingrida; Krasta, Ingrida; Brinkmane, Anda; Kalnins, Imants
INTRODUCTION. Latvian government Health care financing regulations do not envisage free dental care in nursing homes. Consequently, in this situation arises need to carry out comparative evaluation of oral health status and quantity indicators of dental prosthodontics among retirement-age population in Latvia. The aim of the study was to estimate oral health and dental prosthodontics indicators among retirement-age population in Latvia. PATIENTS AND METHODS. We examinated 465 retirement-age inhabitants in Latvia. We assessed dental status, quantity and quality of the existing complete dental prostheses. We also evaluated the DMF-T index. RESULTS. Oral health indicators among Latvian retirement-age population are better than those for nursing homes residents in the same age group. Complete dental prostheses used by nursing homes residents do not meet denture's quality criteria. Retirement-age patients have oral hygiene problems. CONCLUSIONS. DMF-T index among Latvian retirement-age population is lower than among residents of nursing homes. The major component of DMF-T index is the number of lost teeth. The assessment of dental prostheses among residents of nursing homes showed unsatisfactory results. Retirement-age population in Latvia needs treatment of oral mucosal diseases, improvement of oral hygienic measures and increase of amount of dental prosthodontics.
Goldman, Dana P; Cutler, David; Rowe, John W; Michaud, Pierre-Carl; Sullivan, Jeffrey; Peneva, Desi; Olshansky, S Jay
Recent scientific advances suggest that slowing the aging process (senescence) is now a realistic goal. Yet most medical research remains focused on combating individual diseases. Using the Future Elderly Model--a microsimulation of the future health and spending of older Americans--we compared optimistic "disease specific" scenarios with a hypothetical "delayed aging" scenario in terms of the scenarios' impact on longevity, disability, and major entitlement program costs. Delayed aging could increase life expectancy by an additional 2.2 years, most of which would be spent in good health. The economic value of delayed aging is estimated to be $7.1 trillion over fifty years. In contrast, addressing heart disease and cancer separately would yield diminishing improvements in health and longevity by 2060--mainly due to competing risks. Delayed aging would greatly increase entitlement outlays, especially for Social Security. However, these changes could be offset by increasing the Medicare eligibility age and the normal retirement age for Social Security. Overall, greater investment in research to delay aging appears to be a highly efficient way to forestall disease, extend healthy life, and improve public health.
Gu, Xiangli; Chang, Mei; Solmon, Melinda A.
Purpose: This study examined the association between physical activity (PA), physical fitness, and health-related quality of life (HRQOL) among school-aged children. Methods: Participants were 201 children (91 boys, 110 girls; M[subscript age] = 9.82) enrolled in one school in the southern US. Students' PA (self-reported PA, pedometer-based PA)…
Shiovitz-Ezra, Sharon; Leitsch, Sara A.
The authors explore associations between objective and subjective social network characteristics and loneliness in later life, using data from the National Social Life, Health, and Aging Project, a nationally representative sample of individuals ages 57 to 85 in the United States. Hierarchical linear regression was used to examine the associations…
Michael, Yvonne L; Yen, Irene H
The articles in this special issue make it clear that there are interesting and policy-relevant research to identify place-based strategies to improve health and reduce health disparities among older adults. The articles also reveal important areas of future research and policy innovation that are needed related to place and aging.
Lebowitz, Barry D.; And Others
Examined coordination between community mental health centers (CMHCs) and Area Agencies on Aging (AAAs) through survey of 281 CMHCs. Found affiliation with AAA associated with more indirect services of all types; more sites where mental health programs were offered to elderly; and more provision of direct services, such as Alzheimer's disease…
Kim, Giyeon; DeCoster, Jamie; Huang, Chao-Hui; Parmelee, Patricia
Purpose of the Study: The present study examined the characteristics of health disparities grants funded by National Institute on Aging (NIA) from 2000 to 2010. Objectives were (a) to examine longitudinal trends in health disparities-related grants funded by NIA and (b) to identify moderators of these trends. Design and Methods: Our primary data…
Garrett, Douglas D.; Tuokko, Holly; Stajduhar, Kelli I.; Lindsay, Joan; Buehler, Sharon
Steps involved in formalizing end-of-life care preferences and factors related to these steps are unclear in the literature. Using data from the third wave of the Canadian Study of Health and Aging (CSHA-3), we examined the relations between demographic and health predictors, on the one hand, and three outcomes, on the other (whether participants…
Pruski, Linda A.; Blalock, Cheryl L.; Plaetke, Rosemarie; Murphy, Douglas L.; Marshall, Carolyn E.; Lichtenstein, Michael J.
A middle school positive aging curriculum included an oral health unit integrated into reading classes and correlated with state and national standards. Pre/posttest results from 68 eighth graders indicated that health materials were easily incorporated into the standards-based curriculum and knowledge scores improved. (Contains 22 references.)…
Haveman, Meindert; Perry, Jonathan; Salvador-Carulla, Luis; Walsh, Patricia Noonan; Kerr, Mike; Lantman-De Valk, Henny Van Schrojenstein; Van Hove, Geert; Berger, Dasa Moravec; Azema, Bernard; Buono, Serafino; Cara, Alexandra Carmen; Germanavicius, Arunas; Linehan, Christine; Maatta, Tuomo; Tossebro, Jan; Weber, Germain
Background: POMONA II was a European Commission public health-funded project. The research questions in this article focus on age-specific differences relating to environmental and lifestyle factors, and the 17 medical conditions measured by the POMONA Checklist of Health Indicators (P15). Method: The P15 was completed in a cross-sectional design…
Pincus, Harold Alan; Jun, Miraya; Franx, Gerdien; van der Feltz-Cornelis, Christina; Ito, Hiroto; Mossialos, Elias
A range of integration models for providing effective care to individuals with comorbid general medical and behavioral health conditions have been described and tested in varied settings internationally for several subsets of this population. This column examines models in three countries selected to showcase implementation in a variety of health systems: the national health system in England, nationally regulated individual insurance market in the Netherlands, and a mixture of employer-sponsored and government-funded health insurance plans in Japan. The authors describe a set of key practices for and challenges to the successful implementation of these models.
Human lifespan is positively correlated with childhood intelligence, as measured by psychometric (IQ) tests. The strength of this correlation is similar to the negative effect that smoking has on the life course. This result suggests that people who perform well on psychometric tests in childhood may remain healthier and live longer. The correlation, however, is debated: is it caused exclusively by social-environmental factors or could it also have a biological component? Biological traits of systems integrity that might result in correlations between brain function and lifespan have been suggested but are not well-established, and it is questioned what useful knowledge can come from understanding such mechanisms. In a recent study, we found a positive correlation between brain function and longevity in honey bees. Honey bees are highly social, but relevant social-environmental factors that contribute to cognition-survival correlations in humans are largely absent from insect colonies. Our results, therefore, suggest a biological explanation for the correlation in the bee. Here, we argue that individual differences in stress handling (coping) mechanisms, which both affect the bees’ performance in tests of brain function and their survival could be a trait of systems integrity. Individual differences in coping are much studied in vertebrates, and several species provide attractive models. Here, we discuss how pigs are an interesting model for studying behavioural, physiological and molecular mechanisms that are recruited during stress and that can drive correlations between health, cognition and longevity traits. By revealing biological factors that make individuals susceptible to stress, it might be possible to alleviate health and longevity disparities in people. PMID:24472488
Zanjani, Faika; Kruger, Tina; Murray, Deborah
The objective of this study is to evaluate the Mental Healthiness Aging Initiative, designed to promote community awareness and knowledge about mental health and aging issues. This study occurred during 2007-2009 in 67 of 120 counties in Kentucky. A rural region (11 counties) received the intervention, consisting of focus groups, Extension Agent training, and television-based social marketing campaign. Partial-intervention counties (29 counties) received only the television-based social marketing campaign. The control counties (27 counties) received no intervention activities. Results indicated that the intervention counties agreed more with being able to assist elder adults with a potential mental illness. Also, the intervention counties understood the risk of consuming alcohol and medications better, but had a poorer recognition of drinking problems in elder adults. These findings need to be considered within study limitations, such as measurement error, degree of intervention exposure, and regional differences across intervention groups. The study demonstrates that community interventions on mental health awareness and knowledge are feasible within majority rural regions, with Extension Agents being gatekeepers, for promoting positive messages about mental health and aging issues.
The study examined the utilization of health care facilities, the barriers to utilization, the need for health services, the coping mechanisms (family, religion, folk medicine, or other vehicles used by older persons to help cope with health problems), and the way in which the different phases (prevention, initial utilization, and maintenance) of…
Health promotion-disease prevention programs share with health behavior research the common objective of identifying population subgroups toward whom services can be targeted. For this report, six age-sex groups were examined to determine similarities and differences in the predictors of eight health practice indices. Data were from the 1979 National Survey of Personal Health Practices and Consequences. Results showed very little similarity of predictors across the three age cohorts (20-34, 35-49, 50-64), between men and women, and among the six age-sex groups. No predictor achieved significance consistently for several health practices in any of the six groups, although years of education made the best showing. The lack of overlap among predictors helps to explain why health promotion messages and recruitment strategies may not appeal to as diverse an audience as initially intended. Possible explanations for the absence of similar predictors include differences in the nature of the various practices themselves, absence of data on intentions behind a person's behavior, and the "over-determined" character of an individual person's behavior. PMID:3136496
van Meel, D; de Vrij, J H; Kunst, A E; Mackenbach, J P
The aim of this study was to determine whether the austerely living Trappist and Benedictine monks have a lower prevalence of a number of risk factors and health problems than the general Dutch population. A written questionnaire was submitted to monks of 7 monasteries. The response was 67 per cent (134 monks). The data were compared with data from the national Health Interview Survey of 1989, which used an almost identical questionnaire. Adjustment was made for differences in age and education. Monks consume less alcohol and tobacco and have a more austere diet. Their average Quetelet index is lower. The prevalence of cardiovascular disease is lower. On the other hand, monks more often report a number of other chronic diseases, physical complaints, and problems with activities of daily life. They more often have contact with general practitioners and with consultants. The lower prevalence of a number of risk factors among monks reflects their austere way of life. It is not certain whether the lower prevalence of cardiovascular diseases can be attributed to this way of life. The fact that, in general, health problems are more prevalent among monks suggests that changes in lifestyle do not necessarily lead to compression of morbidity.
Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J Mark G
Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations.
Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.
Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations. PMID:25716137
Taneja, Swadhin; Mitnitski, Arnold B.; Rockwood, Kenneth; Rutenberg, Andrew D.
How long people live depends on their health, and how it changes with age. Individual health can be tracked by the accumulation of age-related health deficits. The fraction of age-related deficits is a simple quantitative measure of human aging. This quantitative frailty index (F ) is as good as chronological age in predicting mortality. In this paper, we use a dynamical network model of deficits to explore the effects of interactions between deficits, deficit damage and repair processes, and the connection between the F and mortality. With our model, we qualitatively reproduce Gompertz's law of increasing human mortality with age, the broadening of the F distribution with age, the characteristic nonlinear increase of the F with age, and the increased mortality of high-frailty individuals. No explicit time-dependence in damage or repair rates is needed in our model. Instead, implicit time-dependence arises through deficit interactions—so that the average deficit damage rates increase, and deficit repair rates decrease, with age. We use a simple mortality criterion, where mortality occurs when the most connected node is damaged.
de Azevedo-Marques, João Mazzoncini; Coxon, Domenica; Santos, Jair Lício Ferreira
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
McConnell, Scott; McEvoy, Mary; Carta, Judith J.; Greenwood, Charles R.; Kaminski, Ruth; Good, Roland H., III; Shinn, Mark
This monograph reports on a national mail survey to validate a set of general growth outcomes for children, including those with disabilities, between birth and age 8. The survey was part of a 5-year project to create a comprehensive measurement system to track the developmental progress of individual children with disabilities in this age range…
Wiacek, Magdalena; Jegal, Bo Seul; Hagner, Wojciech; Hagner-Derengowska, Magdalena; Zubrzycki, Igor Z
The purpose of this study was to elucidate using time series analysis age and menopause induced differences in selected health quality related physiological factors. The study was conducted, using the Third National Health and Nutrition Examination Survey (NHANES III), and the NHANES 1999-2002 data, on women aged 35-60. Subjects who had not had surgical menopause, did not use contraceptives, did not smoke, and did not breastfeed during the examination, and did not use contraception and for whom follicle stimulating hormone and luteinizing hormone (LH) activity was assessed, were included in the study. Menopausal status was defined by months since the last period (<2, 2-12, and >12 months for pre-, peri-, and postmenopause, respectively). The results indicate that postmenopausal women, aged less than 45, are characterized by a decrease in systolic blood pressure (SBP), an increase in high density lipoprotein (HDL) levels, and a decrease in triglyceride (TG) levels. It was also determined that aging is the main factor leading to physiological variability in systolic blood pressure and high density lipoprotein levels, in pre- and perimenopausal women, and in follicle-stimulating hormone (FSH) activity in peri- and postmenopausal women.
Zołnierczyk-Zreda, Dorota; Bedyńska, Sylwia; Warszewska-Makuch, Magdalena
The aim of this study was to examine the relationship between work time control and mental health in workers working long hours. The study also attempted to show how that relationship depended on age and gender. Three hundred and six white-collar workers doing clerical work for over 8 h daily were diagnosed on work time control and mental health with the 28-item General Health Questionnaire. The results of an analysis of variance (ANOVA) showed that participants working long hours but having high control over their work time had a significantly higher level of their mental health with regard to somatic complaints and anxiety and marginally higher with regard to social dysfunction than workers with low control over their work time. Male and female workers reported different problems with their mental health depending on what age (stage of life) they were at. It is hypothesized that the work-family conflict, inability to fulfil social commitments and poor working conditions can influence those effects.
Zandiyeh, Zahra; Zare, Elaheh; Mehrabi, Tayebeh; Shiri, Mansour
Introduction: Improving the health of the elderly must be based on their special needs that can be achieved through self-needs assessments through education, which is one of the most important tools in the field of health improvement. The aim of the present study was to evaluate the effect of need-oriented educational interventions on the general health of the elderly living in nursing homes. Materials and Methods: The present study is a clinical trial conducted among the elderly living at the Sadeghieh nursing home of Isfahan, Iran. Seventy elderly people who satisfied the inclusion criteria were selected and divided into two groups of case and control. The case group went through 8 sessions of group therapy for educating participants who were previously investigated through needs assessment. The control group received the usual health care. The general health level of the participants was evaluated before and 1 week and 1 month after the intervention using Goldberg's general health questionnaire. Data were analyzed using Chi-square test, independent t-test, paired t-test, Mann–Whitney test, and variance analysis. Results: The score of general health had no significant difference between both the groups before the intervention, however, the difference in the score between both the groups 1 week and 1 month after the intervention was significant (1 week after the intervention, the scores were 15.6 and 30.3, and 1 month after the intervention, the scores were 16 and 32.2, respectively) (P < 0.001). Conclusions: Need-oriented educational intervention is an effective, safe, and inexpensive method for improving the general health of the elderly living in nursing homes.
Håkansson, Carita; Lissner, Lauren; Björkelund, Cecilia; Sonn, Ulla
The aim of the present cross-sectional study was to examine how subjective experiences of engagement in patterns of daily occupations (gainful employment, domestic work, enjoyable and recreational occupations) were associated with perceived health among women of working age. The sample (n=488) was drawn from a longitudinal cohort study of women of working age in Gothenburg, Sweden. Participants were women 38 (n=202) and 50 (n=286) years of age. They completed a questionnaire including questions about occupational experiences in relation to their patterns of daily occupations, perceived health, and socioeconomic factors. The results of the present study showed that a combination of different experience dimensions of patterns of daily occupations was associated with perceived health among women of working age, even when adjusted for socioeconomic factors and age. The results provided occupational pattern-related health indicators, i.e. manageability, personally meaningful occupations, and occupational balance. To combine these health indicators can be a way for occupational therapists to enable women to develop strategies to promote health and to prevent stress and sick leave.
Radius, S M; Dielman, T E; Becker, M H; Rosenstock, I M; Horvath, W J
Health educators are frequently exhorted to encourage the development of functional lifestyles among school-aged children. Current efforts, however, often neglect consideration of the full spectrum of relevant age groups and the context imposed by the students' existing health beliefs. Interview data from a probability sample of children 6-17 years of age enable such assessment. Findings indicate that "health" is a meaningful concept and of concern to a majority of students, regardless of age or sex. However, a majority also report engaging in health-related risk-taking behaviours, and yet deny personal responsibility for poor health outcomes. Children of all ages were found to discriminate among illnesses, in terms of both their perceived personal vulnerability to the conditions and the extent to which they worry about them. Finally, by incorporating these attitudinal components as well as other social and demographic characteristics, regression analyses provide exploratory profiles of the current cigarette smoker and user of alcohol. Differences between each risk-taking behaviour are reviewed, as are areas for improving research into children's health beliefs and behaviours.
Pudrovska, Tetyana; Carr, Deborah
Using a sample of 540 siblings and twins from the National Survey of Midlife Development in the United States, this study examines the relationship between the age at which men become biological fathers and their subsequent health. The analysis includes both between-family models that treat brothers as independent observations and within-family models that account for unobserved genetic and early-life environmental endowments shared by brothers within families. Findings indicate that age at first birth has a positive, linear effect on men's health, and this relationship is not explained by the confounding influences of unobserved early-life characteristics. However, the effect of age at first birth on fathers' health is explained by men's socioeconomic and family statuses. Whereas most research linking birth timing to specific diseases focuses narrowly on biological mechanisms among mothers, this study demonstrates the importance of reproductive decisions for men's health and well-being.
Behrman, Jere R.
Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women. PMID:23494570
Jokela, Markus; Ferrie, Jane E.; Gimeno, David; Chandola, Tarani; Shipley, Martin J.; Head, Jenny; Vahtera, Jussi; Westerlund, Hugo; Marmot, Michael G.; Kivimäki, Mika
Background Previous studies report contradictory findings regarding health effects of retirement. This study examines longitudinally the associations of retirement with mental health and physical functioning. Methods The participants were 7584 civil servants from the Whitehall II cohort study aged 39-64 years at baseline and 54-76 years at the last follow-up. Self-reported mental health and physical functioning were assessed using the Short Form Medical Outcomes Survey questionnaire (SF-36), and the scales were scored as T-scores (Mean [SD] =50 ). Retirement status and health were assessed with six repeated measurements over a 15-year period. Results The associations between retirement and health were dependent on age at retirement, reason for retirement, and length of time spent in retirement. Compared with continued employment, statutory retirement at age 60 and early voluntary retirement, respectively, were associated with 2.2 (95% confidence interval = 1.7 to 2.8) and 2.2 (1.7 to 2.7) points higher mental health and with 1.0 (0.6 to 1.5) and 1.1 (0.8 to 1.4) points higher physical functioning. Retirement due to ill health was associated with poorer mental health (-0.7 points [-1.62 to 0.2]) and physical functioning (-4.5 points [-5.1 to -3.9]). Within-subject analyses suggested a causal interpretation for statutory and voluntary retirement, but health selection for retirement due to ill health. Conclusions Longitudinal analyses of repeat data suggest that health status improves after statutory and voluntarily retirement, although the improvement appears to attenuate over time. By contrast, the association between retirement due to ill health and subsequent poor health seems to reflect selection rather than causation. PMID:20220519
Krause-Parello, Cheryl A
The relationship between loneliness and general health was investigated in 159 older females living in the community. Pet attachment support, a variable tested as a mediator of this relationship, was examined also. Participants completed the Revised UCLA Loneliness Scale, a Pet Attachment scale, and the Psychological General Well-Being Schedule: general health subscale. A negative relationship between loneliness and general health decreased when controlling for pet attachment support as a coping mechanism. The findings from this study support that pet attachment support has a mediating effect on the relationship between loneliness and general health in this sample of older females. Implications for community health nurses and public policy are discussed.
Porters, N; Polis, I; Moons, C P H; Van de Maele, I; Ducatelle, R; Goethals, K; Duchateau, L; de Rooster, H
Prepubertal gonadectomy (PPG) is promoted as a way of managing overpopulation in cats, but concerns about PPG and potential health issues still exist. The objective of the present study was to evaluate short-term and long-term health problems in cats subjected to PPG in comparison to gonadectomy at traditional age (TAG). In a prospective clinical trial, 800 shelter kittens aged between approximately 8 weeks and 12 weeks were recruited before adoption and randomly assigned to either the PPG group (gonadectomy performed immediately) or the TAG group (gonadectomy delayed until six months to eight months of age). Short-term health issues included mortality between when kittens arrived at the clinic and up to seven days after they returned to the shelter, as well as the occurrence of various other health issues arising in the first month following adoption. Kittens were followed-up until 24 months of age specifically for feline lower urinary tract disease, urethral obstruction (male cats), lameness, fractures and hypersensitivity disorders with dermatological presentation. In the short term, there were no significant differences between health problems in PPG and TAG kittens. Similarly, no significant differences were observed between treatment groups in terms of the type or number of health issues in the long term. In conclusion, there are no health-related contraindications to advocating PPG strategies in shelter cats. Ideally, PPG should be performed at the shelter facility itself as long as excellent infectious disease control and postoperative clinical observation before adoption are guaranteed.
Currie, Candace; Molcho, Michal; Boyce, William; Holstein, Bjørn; Torsheim, Torbjørn; Richter, Matthias
Socioeconomic inequalities in adolescent health have been little studied until recently, partly due to the lack of appropriate and agreed upon measures for this age group. The difficulties of measuring adolescent socioeconomic status (SES) are both conceptual and methodological. Conceptually, it is unclear whether parental SES should be used as a proxy, and if so, which aspect of SES is most relevant. Methodologically, parental SES information is difficult to obtain from adolescents resulting in high levels of missing data. These issues led to the development of a new measure, the Family Affluence Scale (FAS), in the context of an international study on adolescent health, the Health Behaviour in School-Aged Children (HBSC) Study. The paper reviews the evolution of the measure over the past 10 years and its utility in examining and explaining health related inequalities at national and cross-national levels in over 30 countries in Europe and North America. We present an overview of HBSC papers published to date that examine FAS-related socioeconomic inequalities in health and health behaviour, using data from the HBSC study. Findings suggest consistent inequalities in self-reported health, psychosomatic symptoms, physical activity and aspects of eating habits at both the individual and country level. FAS has recently been adopted, and in some cases adapted, by other research and policy related studies and this work is also reviewed. Finally, ongoing FAS validation work is described together with ideas for future development of the measure.
Lorem, Geir Fagerjord; Schirmer, Henrik; Wang, Catharina E A; Emaus, Nina
Objectives It is known that self-reported health (SRH) declines with increasing age and that comorbidity increases with age. We wished to examine how age transfers its effect to SRH through comorbid disease and mental illness and whether these processes remained stable from 1994 until 2008. The hypothesis is that ageing and/or the increased age-related burden of pathology explains the declining SRH. Setting The Tromsø Study (TS) is a cohort study using a survey approach with repeated physical examinations. It was conducted in the municipality of Tromsø, Norway, from 1974 to 2008. Participants A total of 21 199 women and 19 229 men participated. Primary and secondary outcome measures SRH is the outcome of interest. We calculated and compared the effect sizes of age, comorbidity and mental health symptoms using multimediator analysis based on OLS regression. Results Ageing had a negative impact on SRH, but the total effect of age decreased from 1994 to 2007. We assessed the direct effect of age and then the proportion of indirect age-related effects through physical illness and mental health symptoms on the total effect. The direct effect of age represented 79.3% of the total effect in 1994 and decreased to 58.8% in 2007. Physical illness emerged as an increasingly important factor and increased its influence from 15.7% to 41.2% of the total effect. Age alone had a protective effect on mental health symptoms and this increased (2.5% to 17.3%), but we found a stronger association between mental health symptoms and physical disease in the later waves of the study (increasing from 3.7% to 14.8%). Conclusions The results suggest that the effect on SRH of mental health symptoms caused by physical illness is an increasing public health problem. Treatment and care for specific medical conditions must therefore focus more strongly on how these conditions affect the patient's mental health and address these concerns accordingly. PMID:28100564
Beck, John; And Others
The first section of this Technical Committee Report provides a brief summary of the major health problems of the elderly. Problems are categorized under the general headings of health maintenance, chronic illness, mental illness, multiple impairments, demographic characteristics, manpower (geriatric medicine, nursing, and other health…
Gibson, Erin M; Williams, Wilbur P; Kriegsfeld, Lance J
The circadian system orchestrates internal physiology on a daily schedule to promote optimal health and maximize disease prevention. Chronic disruptions in circadian function are associated with an increase in a variety of disease states including, heart disease, ulcers and diabetes. With advanced age, the genes regulating circadian function at the cellular level become disorganized and the ability of the brain clock to entrain to local time diminishes. As a result, aged individuals exhibit a loss of temporal coordination among bodily systems, leading to deficits in homeostasis and sub-optimal functioning. Such disruptions in the circadian system appear to accelerate the aging process and contribute to senescence, with some systems being more vulnerable than others. This review explores aging-associated changes in circadian function and examines evidence linking such alterations to adverse health consequences in late life and promotion of the aging process.
Background This study aimed at examining the relationship between parental subjective health status and adolescents' health-related quality of life (HRQoL) as well as the role of gender, socioeconomic status, presence of chronic health care needs and social support on the above interaction. Methods Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1 194) aged 11-18 years and their parents (N = 973) in 2003. Adolescents' and parents' status was assessed, together with reports of socio-economic status and level of social support. Various statistical tests were used to determine the extent to which these variables were related to each other. Results and Discussion Parental subjective mental health status was significantly correlated with adolescents' better physical and psychological wellbeing, moods and emotions, parent-child relationships, school environment and financial resources. Parental subjective physical health status was strongly associated with more positive adolescents' self-perception. Adolescents' male gender, younger age, absence of chronic health care needs, high social support, and higher family income were positively associated with better HRQoL. Conclusions This study reinforces the importance of parental subjective health status, along with other variables, as a significant factor for the adolescents' HRQoL. PMID:20003508
Jelsma, Jennifer; Shumba, Darlies; Kristian, Hansen; De Weerdt, Willy; De Cock, Paul
OBJECTIVE: To determine the age-weighting preferences of urban Zimbabweans in relation to health care priorities. METHOD: A total of 67 randomly selected residents of a high-density area of Harare participated in the study. Participants were asked "person trade-off" questions to determine their preferences in terms of the numbers of people of various ages who would be saved from death and from suffering a year of ill-health relative to the number of 30-year-olds who would be saved from these eventualities. FINDINGS: The responses indicate that the value of averting a year of ill-health was judged greatest for 15-year-olds and was equal for people aged 1, 30, and 45 years. The value of averting a death primarily reflected the expected years of life lost, but the influence of age-weighting was evident in that 15 years was the most highly valued age. CONCLUSION: Although the age-weighting curves did not correspond exactly with the Global Burden of Disease (GBD) age-weights, Zimbabweans showed a preference for saving the lives of young adults. The GBD age-weights should be used to determine the disability-adjusted life years lost in the Zimbabwean population. PMID:11984606
Okun, Morris A; Rios, Rebeca; Crawford, Aaron V; Levy, Roy
Previous studies have established a positive association between organizational volunteering and well-being. In the current study, we examined whether the relations between organizational volunteering and positive affect, negative affect, and resilience are modified by respondents' age and number of chronic health conditions. This study used cross-sectional data from the 2008 Arizona Health Survey of residents 18 years old and older (N = 4,161). Multiple regression analyses provided no support for the hypothesis that age moderates the association between volunteer status and positive affect, negative affect, and resilience. In contrast, there was a significant (p < .05) interaction between volunteer status and chronic health conditions on positive affect and resilience. Consistent with the compensatory hypothesis, as number of chronic health conditions increased, the relations between volunteering and positive affect and resilience scores increased. Implications of these findings for increasing volunteering among adults with multiple chronic health conditions are discussed.
Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan
Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes. PMID:25588157
Wan, Yue; Yang, Hong-Wei; Masui, Toshihiko
There are currently two commonly used approaches to assessing economic impacts of health damage resulting from environmental pollution: human capital approach (HCA) and willingness-to-pay (WTP). WTP can be further divided into averted expenditure approach (AEA), hedonic wage approach (HWA), contingent valuation approach (CVA) and hedonic price approach (HPA). A general review of the principles behind these approaches by the authors indicates that these methods are incapable of unveiling the mechanism of health impact from the point of view of national economy. On a basis of economic system, the shocks brought about by health effects of environmental pollution change the labor supply and medical expenditure, which in turn affects the level of production activity in each sector and the total final consumption pattern of the society. The general equilibrium approach within the framework of macroeconomic theory is able to estimate the health impact on national economy comprehensively and objectively. Its mechanism and applicability are discussed in detail by the authors.
Torres, Luis R.; Kaplan, Charles; Valdez, Avelardo
Objectives Research on the health consequences of long-term injection drug use (IDU) is limited. This article examines these consequences among aging, male Mexican American injecting heroin users. Concern for this group is crucial, given its health disparities and the association of IDU with disease transmission. Method Aging, male Mexican American IDUs (N = 227) were recruited through intensive outreach. Participants self-reported health status, medical and substance use history, and completed behavioral and psychometric health scales. Results are compared to Hispanic national samples. Results Participants had significantly poorer self-rated health and negative health conditions. Selected medical conditions not associated with the heroin-use lifestyle (i.e., hypertension, diabetes, arthritis) were lower relative to the comparison samples. Discussion This population has a complex profile of health consequences linked to a heroin-using lifestyle. The study concludes that routine screening of infectious diseases and medical and behavioral conditions among aging substance using populations may contribute to reducing Hispanic health disparities. PMID:21451118
Thompson, Richard; Flaherty, Emalee G.; English, Diana J.; Litrownik, Alan J.; Dubowitz, Howard; Kotch, Jonathan B.; Runyan, Desmond K.
Objective Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health. Methods The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported age 18 health were examined using linear mixed models after controlling for earlier health status and demographics. Results The chronic ACEs group had increased self-reported health concerns and use of medical care at 18, but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes. Conclusions In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits. PMID:25441654
Seomun, Gyeongae; Lee, Jung-Ah; Kim, Eun-Young; Im, Meeyoung; Kim, Miran; Park, Sun-A; Lee, Youngjin
This qualitative study used the grounded theory approach to analyze digital textbook-related health experiences of school-age children. In-depth interviews were held with 40 elementary school students who had used digital textbooks for at least a year. Data analysis revealed a total of 56 concepts, 20 subcategories, and 11 categories related to digital textbook health issues, the central phenomena being "health-related experiences." Students' health-related experiences were classified into "physical" and "psychological" symptoms. Adverse health effects related to digital textbook usage were addressed via both "student-led" and "instructor-led" coping strategies. Students' coping strategies were often inefficient, but instructor-led strategies seemed to prevent health problems. When health issues were well managed, students tended to accept digital textbooks as educational tools. Our findings suggest that students can form healthy computer habits if digital textbook usage is directed in a positive manner.
Wroblewski, Kristen E.; Kern, David W.; Schumm, L. Philip; McClintock, Martha K.
Background. Age-related olfactory loss (presbyosmia) is a prevalent sensory impairment with a large public health impact. In cross-sectional analyses, we found striking health disparities in olfactory function among older U.S. adults. Here, we report a 5-year follow-up to determine the magnitude of within-person olfactory decline. Methods. The National Social Life, Health, and Aging Project (NSHAP) interviewed a probability sample of home-dwelling older U.S. adults (57–85 years) in 2005–2006 (Wave 1) and reinterviewed them in 2010–2011 (Wave 2), assessing demographics, social life, and health, including olfaction. Odor identification was measured with a 5-item version of the Sniffin’ Sticks (0–5 correct). Fourteen hundred and thirty-six respondents provided olfaction data in both waves. Multivariate linear and logistic regression were used to model the association between change in olfactory performance and demographic, health, and psychosocial factors. Results. Odor identification declined most rapidly among older individuals (0.25 additional errors per 5 years for each decade of age, p < .001) and in men (0.17 additional errors per 5 years compared to women, p = .005). Among those with perfect scores in Wave 1, African Americans declined more rapidly than Whites (p = .04). Neither socioeconomic status, health conditions, cognition, mental health, alcohol use nor smoking was associated with change in olfaction (p > .05, all). Conclusions. The rate of olfactory decline increases with age and is greater among men than women despite adjusting for differences in psychosocial and health conditions, indicating physiologic factors as drivers. African Americans are more likely to experience initial olfactory decline, consistent with an earlier onset of aging among this subgroup. PMID:26253908
González-Chica, David Alejandro; Mnisi, Zandile; Avery, Jodie; Duszynski, Katherine; Doust, Jenny; Tideman, Philip; Murphy, Andrew; Burgess, Jacquii; Beilby, Justin; Stocks, Nigel
Background Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. Objectives To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Methods Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression. Results A total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8–17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1–42.1), 42.1 (95%CI 40.8–43.3) and 44.8 (95%CI 43.3–46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL. Conclusion Inadequate health literacy is a contributing factor to poor physical
Karlsson, A; Nordström, G
The aim of the study was to describe HIV-infected patients with respect to nutritional status, symptoms experienced, general state of health, and relevant medical and laboratory data. An additional aim was to study the relationships between some of these variables. On admission to an acute care hospital in Sweden, 25 HIV-positive men were consecutively included in the study. Medical data, anthropometric variables such as weight, height, body mass index (BMI) and percentage weight loss were studied. The following instruments were used: the subjective global assessment (SGA) was used to determine nutritional status; the oral assessment guide (OAG) was used for subjective assessment of the oral cavity; and the numeric rating scale (NRS) was used to assess the symptoms experienced. The Health Index (HI) was used to evaluate general state of health. The results showed that more than half of the patients had suspected/severe malnutrition; between 48% and 72% complained of moderate to severe symptoms of various kinds. Two thirds felt their general state of health was rather poor or very poor. Correlations showed that the lower the BMI, the worse the nutritional status (SGA); the greater the weight loss in percent, the worse the nutritional status (SGA); and the worse the general state of health (HI), the worse the nutritional status (SGA). In conclusion, it is important that nurses have good knowledge concerning nutritional problems in order to be able to detect these conditions at an early stage and/or to endeavour to prevent them.
Skovgaard, Anne Mette; Houmann, Tine; Christiansen, Eva; Landorph, Susanne; Jorgensen, Torben; Olsen, E. M.; Heering, K.; Kaas-Nielsen, S.; Samberg, V.; Lichtenberg, A.
Background: The Copenhagen Child Cohort, CCC 2000, was established to investigate developmental psychopathology prospectively from birth in a general population. Methods: A random sample of 211 children from the CCC 2000 was investigated when the children were 1 1/2 years of age. The prevalence and associates of mental health problems and…
Singh, Kushpal; Nagaraj, Anup; Yousuf, Asif; Ganta, Shravani; Pareek, Sonia; Vishnani, Preeti
Objective: Cell phones use electromagnetic, nonionizing radiations in the microwave range, which some believe may be harmful to human health. The present study aimed to determine the effect of electromagnetic radiations (EMRs) on unstimulated/stimulated salivary flow rate and other health-related problems between the general populations residing in proximity to and far away from mobile phone base stations. Materials and Methods: A total of four mobile base stations were randomly selected from four zones of Jaipur, Rajasthan, India. Twenty individuals who were residing in proximity to the selected mobile phone towers were taken as the case group and the other 20 individuals (control group) who were living nearly 1 km away in the periphery were selected for salivary analysis. Questions related to sleep disturbances were measured using Pittsburgh Sleep Quality Index (PSQI) and other health problems were included in the questionnaire. Chi-square test was used for statistical analysis. Results: It was unveiled that a majority of the subjects who were residing near the mobile base station complained of sleep disturbances, headache, dizziness, irritability, concentration difficulties, and hypertension. A majority of the study subjects had significantly lesser stimulated salivary secretion (P < 0.01) as compared to the control subjects. Conclusions: The effects of prolonged exposure to EMRs from mobile phone base stations on the health and well-being of the general population cannot be ruled out. Further studies are warranted to evaluate the effect of electromagnetic fields (EMFs) on general health and more specifically on oral health. PMID:27011934
Schueneman, A L; Pickleman, J; Freeark, R J
Ability patterns and surgical proficiency were examined in matched groups of general surgery residents selected on the basis of age, gender, or hand preference from a population of 141 residents who had completed neuropsychologic tests of visuospatial, psychomotor, and stress tolerance abilities and had been rated on 12 aspects of technical skill exhibited during 1480 operative procedures. Older residents (ages 28 to 42 years) exhibited less motor speed (p less than 0.05) and coordination (p less than 0.005) and more caution in avoiding psychomotor errors (p less than 0.05) than did their younger counterparts. No differences were found for visuospatial abilities, stress tolerance, or rated surgical skill. These findings indicate that although age does appear to adversely affect pure motor skills, these are not important components of operative proficiency. Female residents exhibited superior (p less than 0.05) academic achievement (MCAT, Verbal and National Boards Part II) as compared with their male counterparts. They also excelled on a signal detection task requiring identification of visual patterns. However, the women scored less well (p less than 0.05) than men on a visuomotor task demonstrated to be a significant predictor of operative skill. Greater cautiousness in avoiding errors may be a contributing factor to their reduced efficiency on this task. In comparison to male controls, female residents received consistently lower surgical skills ratings, particularly on items measuring confidence and task organization. Left-handed residents were more reactive to stress (p less than 0.03), more cautious (p less than 0.04), and more proficient on a neuropsychologic test of tactile-spatial abilities (p less than 0.03) than right-handed counterparts. Although these traits correlated positively (p less than 0.05) with rated operative skill within the left-handed group, the group received consistently lower ratings than did right-handed residents. The inconvenience of
Fink, B; Bunse, L; Matts, P J; D'Emiliano, D
Although there is evidence that perception of facial age, health and attractiveness is informed by shape characteristics as well as by visible skin condition, studies on the latter have focused almost exclusively on female skin. Recent research, however, suggests that a decrease in skin colour homogeneity leads to older, less healthy and less attractive ratings of facial skin in both women and men. Here, we elaborate on the significance of the homogeneity of visible skin colouration in men by testing the hypothesis that perception of age, health and attractiveness of (non-contextual) digitally isolated fields of cheek skin only can predict that of whole facial images. Facial digital images of 160 British men (all Caucasian) aged between 10 and 70 were blind-rated for age, health and attractiveness by a total of 147 men and 154 women (mean age = 22.95, SD = 4.26), and these ratings were related to those of corresponding images of cheek skin reported by Fink et al. (J. Eur. Acad. Dermatol. Venereol. in press). Linear regression analysis showed that age, health and attractiveness perception of men's faces could be predicted by the ratings of cheek skin only, such that older men were viewed as older, less healthy and less attractive. This result underlines once again the potent signalling role of skin in its own right, independent of shape or other factors and suggests strongly that visible skin condition, and skin colour homogeneity in particular, plays a significant role in the perception of men's faces.
Lee, Dohoon; Jackson, Margot
A large literature demonstrates the direct and indirect influence of health on socioeconomic attainment, and reveals the ways in which health and socioeconomic background simultaneously and dynamically affect opportunities for attainment and mobility. Despite an increasing understanding of the effects of health on social processes, research to date remains limited in its conceptualization and measurement of the temporal dimensions of health, especially in the presence of socioeconomic circumstances that covary with health over time. Guided by life course theory, we use data from the British National Child Development Study, an ongoing panel study of a cohort born in 1958, to examine the association between lifetime health trajectories and socioeconomic attainment in middle age. We apply finite mixture modeling to identify distinct trajectories of health that simultaneously account for timing, duration and stability. Moreover, we employ propensity score weighting models to account for the presence of time-varying socioeconomic factors in estimating the impact of health trajectories. We find that, when poor health is limited to the childhood years, the disadvantage in socioeconomic attainment relative to being continuously healthy is either insignificant or largely explained by time-varying socioeconomic confounders. The socioeconomic impact of continuously deteriorating health over the life course is more persistent, however. Our results suggest that accounting for the timing, duration and stability of poor health throughout both childhood and adulthood is important for understanding how health works to produce social stratification. In addition, the findings highlight the importance of distinguishing between confounding and mediating effects of time-varying socioeconomic circumstances.
Bourassa, Kyle J; Memel, Molly; Woolverton, Cindy; Sbarra, David A
Married couples evidence interdependence in their psychological and physical wellbeing across the life span. This is particularly true in aging populations that experience declines in physical health and cognitive ability. This study investigated the effects of partners' physical health and cognition on quality of life (QoL) in a series of bivariate latent curve growth models. The sample included aging married couples (N = 8,187) who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE) study and provided data across 6 years. Results indicated that husbands' and wives' baseline levels and rates of change in QoL covaried significantly over time. In addition, husbands' and wives' physical health and cognition predicted their partners' baseline level of QoL above and beyond their own health and cognition, and these effects were of equivalent size for both men and women. The findings suggest that as couples age, husbands' and wives' QoL, cognition, and health are predictive of their partners' QoL.
Lazzeri, G; Giacchi, M V; Dalmasso, P; Vieno, A; Nardone, P; Lamberti, A; Spinelli, A; Cavallo, F
Italy has participated in the Health Behaviour in School-aged Children (HBSC) study since 2000. These surveys collect data every four years on the well-being and health behaviour of boys and girls aged 11, 13 and 15. Until 2007, the coordination group of the University of Turin, Siena and Padua directly sent the questionnaires to each sampled school to collect the data. The sample of about 4500 students was nationally representative. In 2008 the HBSC became part of the project "Surveys on behavioral risks in children aged 6-17 years", coordinated by the National Institute of Health (ISS) and promoted by the Ministry of Health, in collaboration with the Ministry of Education, University and Research. For the first time, in 2010, the survey was conducted by health workers in collaboration with teachers in all regions with a representative sample, not just at the national level, but also at regional level. In the 2,504 sampled schools, 77,113 students (25,079 eleven-year-old, 26,048 thirteen-year-old and 25,986 fifteen-year-old) completed an anonymous questionnaire. Knowledge of the health-related behaviour of school-aged adolescents may help monitoring and enable policies for young people to be formulated and implemented.
The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...
Malone, M; Harris, A L; Luscombe, D K
A general health status measure (the UK Sickness Impact Profile) was used to assess health-related quality of life in 212 cancer patients [143 women, mean (SD-standard deviation) age 55.3 (11.7) years] compared to 105 age-sex matched control subjects [71 women, mean (SD) age 54.7 (12.2) years]. The four main areas of impairment in the cancer patient group were work, recreation and pastimes, home management and sleep and rest. The majority of patients were unable to work or working shorter hours due to their disease. A diagnosis of cancer was likewise found to have a major impact on active leisure pursuits and led to reduced participation in social and community activities. Patients had particular problems in carrying out household chores and maintenance or repair work in the house. Many patients had difficulty sleeping at night and tended to sleep during the day or rest for much of the day. The majority of studies of quality of life in oncology patients concentrate upon alterations in symptoms, such measures would fail to detect impairment in the aspects described above. Greater attention should be directed towards addressing issues such as changes in employment status and the need for help in the home to improve the overall care of cancer patients. PMID:8046723
Hassel, Alexander Jochen; Danner, Daniel; Schmitt, Marina; Nitschke, Ina; Rammelsberg, Peter; Wahl, Hans-Werner
Although a body of research has targeted predictors of well-being and depression in old age, the consideration of oral health-related quality of life (OHRQoL) as a predictor of these major psychosocial endpoints has been rare in the previous literature. The objective of this study was to test whether OHRQoL is associated with well-being and depression, after controlling for relevant confounders; also, the mediating role of subjective health, a major predictor of both well-being and depression, has been explored. OHRQoL was measured by two commonly used assessment instruments, the geriatric oral health assessment index (GOHAI) and oral health impact profile (OHIP); well-being was assessed by the Philadelphia Geriatric Center Morale Scale (PGCMS) and depression by the self-rating depression scale (SDS). We used a subsample of 197 participants from the older cohort (1930-1932) of the Interdisciplinary Longitudinal Study of Adult Development. Regression models and structural equations modeling (SEM) were used for the test for study variable relationships. Both GOHAI and OHIP revealed significant associations to both PGCMS and SDS at the bivariate level. In regression analyses considering gender, household situation, subjective health, and both OHRQoL indicators, only OHIP remained a significant predictor of well-being and depression. In addition, supportive evidence for a mediating role of subjective health regarding the linkage between OHRQoL and an overall latent construct of well-being was found in the SEM analysis. In conclusion, OHRQoL is significantly linked with well-being and depression in old age, while subjective health is able to mediate the relationship. The generally underrated role of OHRQoL with respect to well-being and depression in late adulthood deserves more attention.
Marabelli, R; Ferri, G; Bellini, S
The Eighth Round of the General Agreement on Tariffs and Trade led to the creation of the World Trade Organization and to the adoption of the Sanitary and Phytosanitary (SPS) Agreement, thus considerably changing the rules of international trade in animals and animal products. Animal health measures may result in trade restrictions, but governments accept that these restrictions may sometimes be necessary and appropriate to ensure food safety and animal health protection. The SPS Agreement acknowledges the rights of governments to adopt measure to protect human, animal and plant health. To ensure effective animal health protection, without unjustifiable discrimination, the operational procedures of Veterinary Services must be standardised, especially those concerning disease notification, epidemiological information, certification for international trade and management of animal health emergencies. Veterinary Services must be further supported by a proper legislative framework and adequate financial resources.
Palmer, Michael; Mitra, Sophie; Mont, Daniel; Groce, Nora
Accessing health services at an early age is important to future health and life outcomes. Yet, little is currently known on the role of health insurance in facilitating access to care for children. Exploiting a regression discontinuity design made possible through a policy to provide health insurance to pre-school aged children in Vietnam, this paper evaluates the impact of health insurance on the health care utilization outcomes of children at the eligibility threshold of six years. Using three rounds of the Vietnam Household Living Standards Survey, the study finds a positive impact on inpatient and outpatient visits and no significant impact on expenditures per visit at public facilities. We find moderately high use of private outpatient services and no evidence of a switch from private to covered public facilities under insurance. Results suggest that adopting public health insurance programs for children under age 6 may be an important vehicle to improving service utilization in a low- and middle-income country context. Challenges remain in providing adequate protections from the costs and other barriers to care.
Ahmed, Syed Masud; Tomson, Göran; Petzold, Max; Kabir, Zarina Nahar
OBJECTIVE: To study the health-seeking behaviour of elderly members (aged > 60 years) of households in rural Bangladesh, to ascertain how their behaviour differs from that of younger people (aged 20-59 years) living in the same household and to explore the determinants of health-seeking behaviour. METHODS: Structured interviews were conducted to elicit information on the health-seeking behaviour of household members aged > 20 years. Respondents were asked about major illnesses occurring within 15 days prior to the interview. The sample consisted of 966 households that had at least one resident who was aged > 60 (32% of 3031 households). FINDINGS: We found no major differences in health-seeking behaviour between elderly people and younger adults. On average about 35% (405/1169) of those who reported having been ill during the previous 15 days in both age groups chose self-care/self-treatment; for both age groups the most commonly consulted type of provider was a paraprofessional such as a village doctor, a medical assistant or a community health worker. A household's poverty status emerged as a major determinant of health-seeking behaviour. The odds ratio (OR) that individuals from poor households would seek treatment from unqualified allopathic practitioners was 0.6 (95% confidence interval (CI) = 0.40-0.78); the odds ratio that individuals from poor households would seek treatment from qualified allopathic practitioners was 0.7 (95% CI = 0.60-0.95). For self-care or self-treatment it was 1.8 (95% CI = 1.43-2.36). Patients' level of education affected whether they avoided self-care/self-treatment and drugstore salespeople (who are usually unlicensed and untrained but who diagnose illnesses and sell medicine) and instead chose a formal allopathic practitioner (OR = 1.5; 95% CI = 1.15-1.96). When a household's poverty status was controlled for, there were no differences in age or gender in terms of health-care expenditure. CONCLUSION: We found that socioeconomic
Tait, Elizabeth M; Laditka, Sarah B; Laditka, James N; Nies, Mary A; Racine, Elizabeth F
We examined use of complementary and alternative medicine (CAM) for health and well-being by older women and men. Data were from the 2007 National Health Interview Survey, representing 89.5 million Americans ages 50+. Multivariate logistic regression accounted for the survey design. For general health, 52 million people used CAM. The numbers for immune function, physical performance, and energy were 21.6, 15.9, and 10.1 million respectively. In adjusted results, women were much more likely than men to use CAM for all four reasons, especially energy. Older adults, particularly women, could benefit from research on CAM benefits and risks.
Cylus, Jonathan; Hartman, Micah; Washington, Benjamin; Andrews, Kimberly; Catlin, Aaron
This paper examines differences in national health care spending by gender and age. Our research found significant variations in per person spending by gender across age groups, health services, and types of payers. For example, in 2004 per capita health care spending for females was 32 percent more than for males. Per capita differences were most pronounced among the working-age population, largely because of spending for maternity care. Except for children, total spending for and by females was greater than that for and by males, for most services and payers. The gender difference in total spending was most pronounced in the elderly, as a result of the longer life expectancy of women.
Mosing, Miriam A; Zietsch, Brendan P; Shekar, Sri N; Wright, Margaret J; Martin, Nicholas G
Optimism has been shown to be important in maintaining wellbeing into old age, but little is known about the sources of variation in optimism and its links to mental and somatic health. Optimism, mental, and self-rated health were measured in 3,053 twin individuals (501 MZF, 153 MZM, 274 DZF, 77 DZM, and 242 DZ opposite-sex twin pairs and 561 single twins) over 50 years using the life orientation test, the General Health Questionnaire and a single-item question for self-rated health. Additive genetic factors explained 36, 34, and 46% of the variation in optimism, mental, and self-rated health, respectively, with the remainder being due to non-shared environmental influences. Genetic influences accounted for most of the covariance between the variables (14-20% of the genetic variance) indicating that in older adults genes predisposing to high optimism also predispose to good mental health and self-rated health.
Behaviors , Health Education Interests, and Injuries among Employees at the General Leonard Wood Army Community Hospital, October 2014 – December 2014...2016 2. REPORT TYPE FINAL 3. DATES COVERED (From – To) October 2014-December 2014 4. TITLE AND SUBTITLE Assessment of Health Behaviors , Health...military as well as civilian populations. Purpose: To assess health behaviors , health education interests, perceived barriers to participation in health
Lockwood, Penelope; Chasteen, Alison L; Wong, Carol
The authors hypothesized that the effectiveness of role models varies across the adult life span because of differences in health-related regulatory orientations. Because young adults have strong health-related promotion orientations, they should be motivated by positive models who illustrate the benefits of good health. Because older adults have more balanced health-related promotion and prevention orientations, they should be motivated not only by positive models but also by negative models who illustrate the costs of poor health. Results indicated that both young and older adults perceived positive models to be motivating, but older adults found negative models to be more motivating than did young adults. Age differences in responses to negative models were partially mediated by differences in health-related prevention orientation.
Jakovljevic, Mihajlo B; Getzen, Thomas E; Torbica, Aleksandra; Anegawa, Tomofumi
The 10th consecutive World Health Economics conference was organized jointly by International Health Economics Association and European Conference on Health Economics Association and took place at The Trinity College, Dublin, Ireland in July 2014. It has attracted broad participation from the global professional community devoted to health economics teaching,research and policy applications. It has provided a forum for lively discussion on hot contemporary issues such as health expenditure projections, reimbursement regulations,health technology assessment, universal insurance coverage, demand and supply of hospital services, prosperity diseases, population aging and many others. The high-profile debate fostered by this meeting is likely to inspire further methodological advances worldwide and spreading of evidence-based policy practice from OECD towards emerging markets.
Vleck, Veronica; Millet, Gregoire P; Alves, Francisco Bessone
Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries 'causing cessation or reduction of training or seeking of medical aid' are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9-2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed.
Gordon, Nancy P; Iribarren, Carlos
Background Latinos are a fast growing segment of the U.S. health care population. Acculturation factors, including English fluency, result in an ethnic group heterogeneous with regard to SES, health practices, and health education needs. This study examined how demographic and health-related characteristics of Spanish-dominant (SD), Bilingual (BIL), and English-dominant (ED) Latino men and women aged 25–64 differed among members of a large Northern California health plan. Methods This observational study was based on data from cohorts of 171 SD (requiring an interpreter), 181 BIL, and 734 ED Latinos aged 25–64 who responded to random sample health plan member surveys conducted 2005–2006. Language groups were compared separately by gender on education, income, behavioral health risks (smoking, obesity, exercise frequency, dietary practices, health beliefs), health status (overall health and emotional health, diabetes, hypertension, high cholesterol, heartburn/acid reflux, back pain, depression), computer and Internet access, and health education modality preferences. Results Compared with ED Latinos, higher percentages of the SD and BIL groups had very low educational attainment and low income. While groups were similar in prevalence of diabetes, hypertension, and high cholesterol, SD were less likely than ED Latinos to rate overall health and emotional well-being as good, very good, or excellent and more likely to report heartburn and back pain (women only). The groups were similar with regard to smoking and obesity, but among women, SD were more likely to be physically inactive than ED, and BIL were less likely than SD and ED groups to eat <3 servings of fruit/vegetables per day. SD and BIL of both genders were significantly less likely than ED Latinos to believe that health practices had a large impact on health. Compared to ED men and women, SD and BIL Latinos had significantly lower Internet and computer access. As a result, SD Latinos had a greater
Lai, Dejian; Huang, Jin; Risser, Jan M.; Kapadia, Asha S.
In this article, we report statistical properties of two classes of generalized Gini coefficients (G1 and G2). The theoretical results were assessed via Monte Carlo simulations. Further, we used G1 and G2 on life expectancy to measure health inequalities among the provinces of China and the states of the United States. For China, the results…
The purpose of this study was to describe the structure of general education curricula at baccalaureate colleges of health science in relationship to Bergquist's Career-Based Model of curriculum. Using an explanatory sequential mixed methods approach, the model was tested by examining whether the curricula were both prescriptive and specific.…
Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…
Delgado-Gomez, David; Lopez-Castroman, Jorge; de Leon-Martinez, Victoria; Baca-Garcia, Enrique; Cabanas-Arrate, Maria Luisa; Sanchez-Gonzalez, Antonio; Aguado, David
There is a need to assess the psychiatric morbidity that appears as a consequence of terrorist attacks. The General Health Questionnaire (GHQ) has been used to this end, but its psychometric properties have never been evaluated in a population affected by terrorism. A sample of 891 participants included 162 direct victims of terrorist attacks and…
... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true General safety and health standards. 50-204.2 Section 50-204.2 Public Contracts and Property Management Other Provisions Relating to... Mining of Potash; Oil Shale, Sodium, and Phosphate; Sulphur; and Gold, Silver, or Quicksilver; and...
This study was undertaken to determine the level of understanding of Gold Coast general practitioners (GPs) pertaining to such criteria as reliability, interactive and usability components associated with health websites. These are important considerations due to the increased levels of computer and World Wide Web (WWW)/Internet use and health…
Tatullo, Marco; Gentile, Stefano; Paduano, Francesco; Santacroce, Luigi; Marrelli, Massimo
Abstract Electronic cigarette (e-cigarette) simulates the act of tobacco smoking by vaporizing a mixture of propylene glycol, nicotine, and flavoring agents. e-cigarette has been proposed as a product able to aid to stop smoking. The aim of the study is to verify the clinical variations of periodontal health induced by e-cigarettes use and, moreover, to investigate about the awareness of the e-smokers about their health variations and about their hypothetical need to turn back to smoke combustible cigarettes. This clinical observational pilot study involved 110 out of 350 smokers, who switched to e-cigarette. Patients were subjected to oral examinations. A questionnaire to self-assess the variations of some parameters of general health, and to self-assess the need to smoke combustible cigarettes, was distributed to such subjects involved in the study. At the end of the study, we registered a progressive improvement in the periodontal indexes, as well as in the general health perception. Finally, many patients reported an interesting reduction in the need to smoke. In the light of this pilot study, the e-cigarette can be considered as a valuable alternative to tobacco cigarettes, but with a positive impact on periodontal and general health status. PMID:27930577
Farrow, S C; Kaul, S; Littlepage, B C
Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results from 69 general practices and 21 health authority clinice in one health district are reported.Some form of sterilizer was used in 63 general practices. These included water boilers (49%), dry heat sterilizers (41%), autoclaves (5%) and pressure cookers (5%). Sixty one practices were using metal vaginal specula and of these 29 were disinfecting by boiling, three were using pressure cookers, 18 dry heat, seven chemical methods, three autoclaves and one the central sterile department of the local hospital. Of those who were boiling after simple washing, three practices boiled for five to 10 minutes and reused instruments during the same clinic. Of the 29 using simple boiling 20 (69%) were boiling for less than 20 minutes.The study highlights the fact that no formal advice has been given on disinfection practice by the DHSS, the health authorities or the family practitioner committees. The need to set up local guidelines and develop practical steps for their introduction are discussed.
Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C.
Objective To explore general practitioners’ (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. Conclusions GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. Key points Little is known about doctors’ experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care. PMID:28277051
Nematollahi, Shahrzad; Keshteli, Ammar Hassanzadeh; Esmaillzadeh, Ahmad; Roohafza, Hamidreza; Afshar, Hamid; Adibi, Peyman; Maracy, Mohammad Reza
Background: The aim of this study is to find a pathway to explaining the relations between dietary behaviors with mental health and psychological functioning. Materials and Methods: This cross-sectional study contains 4763 participants from the employees of Isfahan University of Medical Sciences. In this study, four questionnaires were administered which were provided as follows: demographic characteristics, 21-item dietary behaviors questionnaire, Hospital Anxiety and Depression Scale questionnaire, and 12-item General Health Questionnaire (GHQ-12). We started the analysis with the structural equation modeling (SEM) model with 4 unobserved latent and 16 observed variables. Results: The results show that the regression coefficient (standard error) of diet behavior on mental health and mental health on GHQ were − 1 (0.37) and 0.02 (0.01) with their P values as 0.007 and 0.01, respectively. For this model, the estimated root mean square error of approximation is 0.062 with 90% confidence interval of (0.060–0.065). In addition, the comparative fit indices (CFIs) were as 0.866 for incremental fit index and 0.866 for CFI. All these indices represent fairly good fit of the model to the data. Conclusion: We can conclude that “lower scores on diet behavior – higher scores on mental health problems” and “higher mean scores in depression and/or anxiety – higher scores in GHQ domains.” The SEM results showed that dietary behaviors have significance related to depression and/or anxiety and general health status. PMID:28349024
Hughes, Mark; Kentlyn, Sujay
While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace.
Slaets, J P J
The Health Council of the Netherlands, at the request of the policy committee for the elderly of the Dutch parliament, has deliberated over the intermediate- and long-term developments in the field of 'care and ageing'. In a comprehensive report, the overall conclusion is that there is sufficient room for the ambition to stimulate the health, independence and welfare of the elderly. The effects of biological ageing and the connections that exist between ageing, life span, illness and wellbeing are addressed. The number of people with illnesses and functional disorders will inevitably increase with ageing of the population. Nevertheless, numerous opportunities will arise to achieve health benefits and increase the quality of life. A range of measures is proposed in the field of prevention and treatment. An innovative policy on the elderly, political courage and social solidarity will be necessary in order to achieve 'ageing with ambition'. However, as pointed out in the report, health care is not merely an expense but also an important service industry that provides employment to a large number of people.
Huffman, Derek M.; Justice, Jamie N.; Stout, Michael B.; Kirkland, James L.; Barzilai, Nir
Life extension is no longer considered sufficient evidence of delayed aging in research animals. It must also be demonstrated that a broad swathe of health indicators have been extended. During a retreat of the Geroscience Network, a consortium of basic and clinical aging researchers, potential measures of mouse health were considered for their potential as easily standardized, highly informative metrics. Major health domains considered were neuromuscular, cognitive, cardiovascular, metabolic, and inflammatory functions as well as body composition and energetics and a multitude of assays interrogating these domains. A particularly sensitive metric of health is the ability to respond to, and recover, from stress. Therefore, the Network also considered stresses of human relevance that could be implemented in mouse models to assess frailty and resilience. Mouse models already exist for responses to forced immobility, cancer chemotherapy, infectious diseases, dietary challenges, and surgical stress, and it was felt that these could be employed to determine whether putative senescence-retarding interventions increased and extended organismal robustness. The Network discussed challenges in modeling age-related human chronic diseases and concluded that more attention needs to be paid to developing disease models with later age of onset, models of co- and multimorbidity, diversifying the strains and sexes commonly used in aging research, and considering additional species. PMID:27535967
Kydd, Angela; Fleming, Anne
Ageism and age discrimination are terms used in best practice statements and in the literature to define negative attitudes towards older people and towards people because of their age (whether old or young). However, 'old age' is a nebulous concept with definitions ranging from the over 50s to the over 85s. In seeking to explore ageism and age discrimination within health care, this paper discusses the concept of 'old' and discusses the findings of a narrative review of the literature on these two concepts. Results show that negative attitudes have been perceived by users of health care services, but the reasons are not clear. Such attitudes are usually reported in acute health care settings, where targets and quick turnover are encouraged. Thus people, usually those with complex needs, who require longer periods of recuperation and rehabilitation following an episode of ill health, are troublesome to staff working in a system geared up for early discharges. This type of service user is usually over the age of 85. Recommendations from this paper include the need for acute frailty units, with well trained staff, where frail older people can be comprehensively assessed, receive timely and targeted care, followed by a supported discharge.
Yeun, Eun Ja; Baek, Sunsook; Kim, Heejeong
This cross-sectional study was conducted to verify self-efficacy, self-esteem, and social support as characteristics of health promotion behavior in middle-aged Koreans, and the influence of social support on self-efficacy and self-esteem with respect to health promotion behavior. Data were collected from 310 subjects in South Korea using a self-administered questionnaire. We found a significant finding that self-efficacy positively influences health promotion behavior, focusing on the moderating effect of social support. Self-efficacy affected health promotion behavior (P < 0.01) as did social support. Mean self-efficacy, self-esteem, health promotion behavior, and social support scores were 50.27, 29.35, 124.39, and 76.51, respectively. This finding provides strong evidence that social support can be used as a model to understand health promotion behavior. Individualized nursing interventions based on social support and self-efficacy theory should be utilized in high-risk middle-aged patients so as to assist and improve health promotion behavior. Also, in community practice settings, nurses should consider that increased social support and self-efficacy are required to improve health promotion behaviors.
Terner, Michael; Reason, Ben; McKeag, Ali Moses; Tipper, Brenda; Webster, Greg
Which has more impact on health status and the use of healthcare services among seniors: age or the number of chronic conditions? To answer this question, we used responses from the 2008 Canadian Survey of Experiences with Primary Health Care to assess the effect of these two factors on seniors' self-perceived health status, prescription medication use and healthcare service use. We discovered that seniors with at least three chronic conditions were more likely to report poor health, take more prescription medications and use more healthcare services than seniors with two or fewer chronic conditions. The number of chronic conditions is better than age as a predictor of self-reported health status, prescription medication use and healthcare service use by seniors. Seniors with at least three conditions represented 24% of all seniors, but they accounted for 40% of the use of healthcare services. Health policies and programs focused on the prevention and improved management of co-morbidities among seniors could have a significant and positive impact on seniors' health (including self-perceived health status) and their use of healthcare services.
al-Shammari, S A; Khoja, T; Jarallah, J S
1344 expectant mothers were selected by random sampling from the catchment population of 15 health centres in Riyadh. The health centres were taken to represent all areas of urban Riyadh. These mothers were asked to complete a pre-designed questionnaire in Arabic and undergo a structured interview by trained midwives to explore their knowledge, attitude and practice toward antenatal visits. It was found that the average gestational age at booking was 13 weeks. The number of antenatal visits achieved during the current pregnancy was 6. 97% of expectant mothers were aware of the importance of antenatal visits. Various demographic characteristics were studied in relation to the number of antenatal visits achieved and the gestational age at booking. It was found that the level of education of both husband and wife and poor obstetric history significantly affected gestational age at booking, (P-values) were less than 0.03 and 0.002 respectively). However the family income and gestational age at booking affected the number of antenatal visits (P-values were less than 0.0003 and 0.0001 respectively). The respondents' most striking reason for non-compliance was related to accessibility to health centre. 23.3% thought that the health centres were far away from their residence and they needed to involve the husbands in driving them to health centres. Recommendations were given to improve aspects of accessibility and inviting more antenatal visits in addition to improving quality of such service.
Wade, Tracey D.; Lee, Christina
This paper investigated the prospective predictors of mental health after breast cancer diagnosis among mid-aged Australian women (initially aged 45-50 years). Two waves of data collected 2 years apart from a longitudinal population-based survey of 12,177 women identified a group of 63 women who reported onset of BC between T1 (T1) and Time 2…
Zweifel, P; Felder, S; Meier, M
Salas and Raftery allege that in our paper, (1) remaining life expectancy is an endogenous explanatory variable of health care expenditure and (2) the parameter designed to correct for sample selection bias in fact represents a hidden relationship between health care expenditure and age. We argue that claim (1) is not supported by the available empirical evidence, while claim (2) seems to derive from a too cursory reading of our paper.
Murray, Catherine; Johnson, Wendy; Wolf, Michael S.; Deary, Ian J.
Three hundred and four participants in the Lothian Birth Cohort 1936 study took a validated IQ-type test at age 11 years and a battery of cognitive tests at age 70 years. Three tests of health literacy were completed at age 72 years; the Rapid Estimate of Adult Literacy in Medicine (REALM), the Test of Functional Health Literacy in Adults…
Benson, Lawrence P.
This training manual for personnel who work with older adults is designed to create awareness and knowledge of health maintenance for older Americans. Increasing awareness of the health needs of the aging, and fostering understanding of biological, psychological, and sociological aging processes, and of positive attitudes toward health care and…
Goryakin, Yevgeniy; Suhrcke, Marc; Rocco, Lorenzo; Roberts, Bayard; McKee, Martin
Social capital has been proposed as a potentially important contributor to health, yet most of the existing research tends to ignore the challenge of assessing causality in this relationship. We deal with this issue by employing various instrumental variable estimation techniques. We apply the analysis to a set of nine former Soviet countries, using a unique multi-country household survey specifically designed for this region. Our results confirm that there appears to be a causal association running from several dimensions of individual social capital to general and mental health. Individual trust appears to be more strongly related to general health, while social isolation- to mental health. In addition, social support and trust seem to be more important determinants of health than the social capital dimensions that facilitate solidarity and collective action. Our findings are remarkably robust to a range of different specifications, including the use of instrumental variables. Certain interaction effects are also found: for instance, untrusting people who live in communities with higher aggregate level of trust are even less likely to experience good health than untrusting people living in the reference communities.
Ringdal, Gerd Inger; Ringdal, Kristen
War experiences may have an extensive impact on the health status of the exposed populations. This population-based study aimed to examine the relationship between war experiences and self-reported general health in representative sample surveys from Bosnia-Herzegovina (n = 3,313) and Kosovo (n = 1,000). Data were collected with face-to-face interviews fielded in the winter of 2003-2004. Logistic regression analysis was used to compute unadjusted and adjusted odds ratios (ORs). The adjusted effects of the extensiveness of war experiences on poor health were positive in both countries, but they were statistically significant only for Bosnia-Herzegovina: OR = 1.04, 95% CI [1.00, 1.08] for Bosnia-Herzegovina and OR = 1.03, 95% CI [0.98, 1.09] for Kosovo. The strongest observed effect was found for Kosovo only: The extensiveness of war experiences was relatively strongly related to longstanding health problems, OR = 1.09, 95% CI [1.03, 1.15]. We found that war experiences may contribute to increased poorer health in the exposed populations; however, the effects 4-9 years after the war ended were modest. Hence, war experiences seemed to be more strongly related to war-related distress and posttraumatic stress disorder than to self-reported general health.
Spirrison, C L; McCarley, N G
The present study examined relationships between the age at earliest memory and the personality traits and behavioral health of 107 undergraduates. Participants answered questions on their earliest memory and completed the Myers-Briggs Type Indicator (MBTI) and a medical history form. Analyses indicated that continuous scores on two MBTI scales (Sensing-Intuition and Judging-Perceiving) were inversely related to age at earliest memory as were participant's self-reported drug and alcohol problems, emotional and psychological symptoms, accident rates, physical symptoms, and satisfaction with health. Respondents who reported first memories at or after 7 years of age (i.e., approximately 1 SD above the mean age at recalled memory) were classified as repressors. Repressors scored in the Sensing and Judging directions on the MBTI and reported significantly fewer emotional symptoms, accidents, psychological symptoms, and less health satisfaction than nonrepressors. Results are consistent with the age at earliest memory and repression literature and support the use of earliest memory age as an index of repression.
Schoeberl, Mark R.; Douglass, Anne R.; Zhu, Zhengxin; Pawson, Steven
We use kinematic and diabatic back trajectory calculations, driven by winds from a general circulation model (GCM) and two different data assimilation systems (DAS), to compute the age spectrum at three latitudes in the lower stratosphere. The age-spectra are compared to chemical transport model (CTM) calculations, and the mean ages from all of these studies are compared to observations. The age spectra computed using the GCM winds show a reasonably isolated tropics in good agreement with observations; however, the age spectra determined from the DAS differ from the GCM spectra. For the DAS diabatic trajectory calculations there is too much exchange between the tropics and mid-latitudes. The age spectrum is thus too broad and the tropical mean age is too old as a result of mixing older mid latitude air with tropical air. Likewise the mid latitude mean age is too young due to the in mixing of tropical air. The DAS kinematic trajectory calculations show excessive vertical dispersion of parcels in addition to excessive exchange between the tropics and mid latitudes. Because air is moved rapidly to the troposphere from the vertical dispersion, the age spectrum is shifted toward the young side. The excessive vertical and meridional dispersion compensate in the kinematic case giving a reasonable tropical mean age. The CTM calculation of the age spectrum using the DAS winds shows the same vertical and meridional dispersive characteristics of the kinematic trajectory calculation. These results suggest that the current DAS products will not give realistic trace gas distributions for long integrations; they also help explain why the extra tropical mean ages determined in a number of previous DAS driven CTM s are too young compared with observations. Finally, we note trajectory-generated age spectra . show significant age anomalies correlated with the seasonal cycles. These anomalies can be linked to year-to-year variations in the tropical heating rate. The anomalies are
Zhang, Shutao; Qian, Jinwu; Zhang, Zhen; Shen, Linyong; Wu, Xi; Hu, Xiaowu
The degeneration of postural control in the elderly and patients with Parkinson's disease (PD) can be debilitating and may lead to increased fall risk. This study evaluated the changes in postural control during gait affected by PD and aging using a new method based on the General Tau Theory. Fifteen patients with PD, 11 healthy old adults (HOs), and 15 healthy young adults (HYs) were recruited. Foot trajectories of each participant were monitored during walking by a three-camera Optotrak Certus(®) motion capture system. The anteroposterior direction of foot movement during stepping was analyzed by tau-G and tau-J guidance strategies. Two linear regression analyses suggested that the tau of the step-gap was strongly coupled onto the tau-J guidance during walking. The regression slope K could estimate the coupling ratio in the tau-coupling equation which reflects the performance of postural control during gait. The mean K value for the PD group, which was highest among the three groups, was approximately 0.5. Therefore, participants in the PD group walked with the poorest postural control and exhibited a relatively hard contact with the endpoint during stepping when compared with those in the HO and HY groups. The HY and HO groups obtained mean K values significantly lower than 0.5, which indicated that the gait was well controlled and ended at low speed with low deceleration. However, the HO group showed a decreased tendency for postural control, in which the mean K value was significantly higher than that of the HY group. The K value was moderately positively correlated with the double support time and negatively correlated with the stride length and walking speed. The tau-J coupling ratio can provide additional insight into gait disturbances and may serve as a reliable, objective, and quantitative tool to evaluate dynamic postural control during walking.
Pain, Tilley; Stainkey, Lesley; Chapman, Sue
This paper describes a medical model to provide in-house GP services to residents of aged-care facilities. Access to GP services for aged-care residents is decreasing, partially due to the changing demographic of the Australian GP workforce. The model we have developed is an in-house GP (AgedCare+GP) trialled in a publicly funded residential aged-care facility (RACF). The service model was based on the GP cooperative used in our after-hours general practice (AfterHours+GP). Briefly, the service model involves rostering a core group of GPs to provide weekly sessional clinics at the RACF. Financial contributions from appropriate Medicare Benefits Schedule (MBS) items for aged-care planning (including chronic conditions) provided adequate funds to operate the clinic for RACF residents. Evaluation of the service model used the number of resident transfers to the local emergency department as the primary outcome measure. There were 37 transfers of residents in the 3 months before the commencement of the AgedCare+GP and 11 transfers over a 3-month period at the end of the first year of operation; a reduction of almost 70%. This project demonstrates that AgedCare+GP is a successful model for GP service provision to RACF residents, and it also reduces the number of emergency department transfers.
Khayamim, Nafiseh; Bahadoran, Parvin; Mehrabi, Tayebeh
Background: Fatigue and changes in sleep patterns are one of the impressive features in the first year after birth, which have negative effects on work, family life, and social relationships. Therefore, the objective of this research was to investigate the relationship between fatigue and Stanford sleepiness with the general health of mothers in the postpartum period. Materials and Methods: The current research is a descriptive correlational study which was performed on 190 mothers between 2 and 24 postpartum weeks, referring to the health centers of Isfahan in 2014. All mothers meeting the inclusion criteria were selected through cluster purposive sampling. Data were collected by use of four questionnaires including profile and fertility, fatigue, Stanford sleepiness, and general health. Data were analyzed by statistical tests at a significance level of ≤0.05. Results: The results showed that 5.3%, 59.5%, and 35.3% of subjects had mild, moderate, and severe fatigue, respectively. In addition, 26.3% of women showed a public health disorder, and according to Stanford sleepiness, 20.5% of subjects had sleepiness. The statistical results indicated that there were significant relationships between fatigue (P ≤ 0.001, r = 0.52) and Stanford sleepiness (P = 0.04, r = 0.14), and mothers’ general health. Conclusions: According to prevalence of fatigue and sleepiness in the postpartum period and its relationship with maternal health, application of sleep health education and appropriate counseling during pregnancy and after delivery is recommended to prevent mothers’ mental complications in order to achieve a safe pregnancy. PMID:27563322
Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children’s health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554). We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children’s unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers <25 years, odds ratios of hospital admission at 18 months were 0.97 [95% CI: 0.86, 1.09], 0.92 [0.81, 1.05], 0.76 [0.65, 0.90], and 0.71 [0.51, 0.98] for mothers aged 25.0–29.9, 30.0–34.9, 35.0–39.9, and >40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health. PMID:28234951
Barg, Carolyn J; Latimer, Amy E; Pomery, Elizabeth A; Rivers, Susan E; Rench, Tara A; Prapavessis, Harry; Salovey, Peter
This study tested several relationships predicted by the Health Action Process Approach (HAPA) in a sample of 175 generally healthy, inactive, middle-aged women (40-65 yrs old) over a 12 week period. Participants' physical activity, risk perceptions, outcome expectancies, action self-efficacy and intention were measured at baseline. Planning and maintenance self-efficacy were measured 4 weeks later. Physical activity behaviour was measured 12 weeks after baseline. The HAPA relationships were examined using a structural equation model. The data fit the model well and revealed several significant relationships. Action self-efficacy was the best predictor of intention. Maintenance self-efficacy was the best predictor of planning and behaviour. Contrary to the tenets of HAPA and to past research, planning did not predict behaviour. Overall, HAPA provides a useful framework for identifying determinants of physical activity intentions and behaviour within a group of inactive, middle-aged women.
Harris, Francesca; Hek, Gill; Condon, Louise
This paper aims to provide evidence of the healthcare needs of prisoners in relation to gender, age and ethnicity, drawing from a larger systematic overview of the policy and research literature concerning primary care nursing in prisons in England and Wales. The literature overview shaped the initial stages of a research project funded by the Department of Health to examine the views and perspectives of prisoners and nurses working in prisons, and to identify good primary care nursing in the prison environment. At total of 17 databases were searched using search terms related to primary healthcare in prisons (health, nurs*, primary care, healthcare, family medicine, prison*, offender*, inmate*) with terms truncated where possible in the different databases. Following this, a sifting phase was employed using inclusion/exclusion criteria to narrow and focus the literature perceived as relevant to the research questions. All papers were critically appraised for quality using standardised tools. Findings from the literature overview show that prisoners are more likely to have suffered some form of social exclusion compared to the rest of society, and there are significantly greater degrees of mental health problems, substance abuse and worse physical health in prisoners than in the general population. Women, young offenders, older prisoners and those from minority ethnic groups have distinct health needs compared to the prison population taken as a whole, with implications for the delivery of prison healthcare, and how these needs are met effectively and appropriately.