Sample records for adult health evidence

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

    McWilliams, J. Michael


    Context: Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform. However, evidence of the adverse health effects of uninsurance has been largely based on observational studies with designs that do not support causal conclusions. Although recent research using more rigorous methods m...

  2. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

    Helen Cheng

    Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

  3. Maternal Age and Offspring Adult Health: Evidence From the Health and Retirement Study

    Mikko Myrskylä; Andrew T. Fenelon


    Advanced maternal age is associated with negative offspring health outcomes. This interpretation often relies on physiological processes related to aging, such as decreasing oocyte quality. We use a large, population-based sample of American adults to analyze how selection and lifespan overlap between generations influence the maternal age–offspring adult health association. We find that offspring born to mothers younger than age 25 or older than 35 have worse outcomes with respect to mortali...

  4. Factors Influencing Adult Physical Health after Controlling for Current Health Conditions: Evidence from a British Cohort

    Cheng, Helen; Furnham, Adrian


    This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth), cognitive ability (at age 11 yrs), personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs), after taking account of current health conditions (number of illness). Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality t...

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

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


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

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

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


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

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

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


    In this study, we use the Health and Retirement Study to test whether older adult smokers, defined as those 50 years and older, respond to cigarette tax increases. Our preferred specifications show that older adult smokers respond modestly to tax increases: a $1.00 (131.6%) tax increase leads to a 3.8-5.2% reduction in cigarettes smoked per day (implied tax elasticity = -0.03 to -0.04). We identify heterogeneity in tax elasticity across demographic groups as defined by sex, race/ethnicity, education, and marital status and by smoking intensity and level of addictive stock. These findings have implications for public health policy implementation in an aging population. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25721732

  8. Adult health checkup

    Ridley, Jane; Ischayek, Amanda; Dubey, Vinita; Iglar, Karl


    Abstract Objective To describe updates to the Preventive Care Checklist Form© to help family physicians stay up to date with current preventive health care recommendations. Quality of evidence The Ovid MEDLINE database was searched using specified key words and other terms relevant to the periodic health examination. Secondary sources, such as the Canadian Task Force on Preventive Health Care, the Public Health Agency of Canada, the Trip database, and the Canadian Medical Association Infobase, were also searched. Recommendations for preventive health care for average-risk adults were reviewed. Strong and weak recommendations are presented on the form in bold and italic text, respectively. Main message Updates were made to the form based on the Canadian Task Force on Preventive Health Care recommendations on screening for obesity (2015), cervical cancer (2013), depression (2013), osteoporosis (2013), hypertension (2012), diabetes (2012, 2013), and breast cancer (2011). Updates were made based on recommendations from other Canadian organizations on screening for HIV (2013), screening for sexually transmitted infections (2013), immunizations (2012 to 2014), screening for dyslipidemia (2012), fertility counseling for women (2011, 2012), and screening for colorectal cancer (2010). Some previous recommendations were removed and others lacking evidence were not included. Conclusion The Preventive Care Checklist Form has been updated with current recommendations to enable family physicians to provide comprehensive, evidence-based care to patients during periodic health examinations. PMID:27076540

  9. Evidence of the efficacy of music therapy for adults diagnosed with mental health problems

    Wigram, Anthony Lewis; Odell-Miller, Helen


    improvisational music therapy and Guided Imagery is present in a small number of experimental studies, case studies, case reports, qualitative studies and from the recorded opinion of experts if the field. An overview of studies and clinical reports will be documented, by reviewing principle music therapy and......Music Therapy has been employed as an intervention in psychiatry since the initial development of the profession in the USA and Europe in the late 1940’s. Compared with the fields of special education, adult developmental disability, neurology and paediatrics, significantly less research has been...... undertaken in psychiatry, with a corresponding lack of experimental studies. Ethical issues relating to the collection and analysis of data have restricted more than in other fields, but there is nevertherless a substantial body of knowledge in this area. Evidence of the value of receptive music, active...

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

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


    Telomere length has been hypothesized to be a marker of cumulative exposure to stress, and stress is an established cause of depression and anxiety disorders. The aim of this study was to examine the relationship between depression, anxiety and telomere length, and to assess whether this relationship is moderated by race/ethnicity, gender and/or antidepressant use. Data were from the 1999-2002 National Health and Nutrition Examination Survey. Telomere length was assessed using the quantitative PCR method of telomere length relative to standard reference DNA. Past-year major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD), as well as depressed affect and anxious affect, were assessed using the Composite International Diagnostic Inventory (N=1290). Multiple linear regression was used to assess the relationship between depression and anxiety disorders and telomere length. Among women, those with GAD or PD had shorter telomeres than those with no anxious affect (β: -0.07, P0.05). Among respondents currently taking an antidepressant, those with MD had shorter telomeres than those without (β: -0.26, P0.05). Neither depressive nor anxiety disorders were directly associated with telomere length in young adults. There was suggestive evidence that pharmacologically treated MD is associated with shorter telomere length, likely reflecting the more severe nature of MD that has come to clinical attention. PMID:25178165

  11. Self-rated health and associated factors among older South Africans: evidence from the study on global ageing and adult health

    Nancy Phaswana-Mafuya


    Full Text Available Background: Population ageing has become significant in South African society, increasing the need to improve understandings of health and well-being among the aged. Objective: To describe the self-reported ratings of overall health and functioning, and to identify factors associated with self-rated health among older South Africans. Design: A national population-based cross-sectional survey, with a sample of 3,840 individuals aged 50 years and older, was completed in South Africa in 2008. Self-reported ratings of overall health and functioning were measured using a single self-reported health state covering nine health domains (used to generate the Study on Global Ageing and Adult Health (SAGE composite health state score. Disability was measured using the World Health Organization Disability Assessment Schedule II (WHODAS-II activities of daily living (ADLs, instrumental activities of daily living (IADLs, perceptions of well-being, and the World Health Organization Quality of Life index/metric (WHOQoL. Results: Overall, more than three quarters (76.8% of adults rated their health as moderate or good. On balance, men reported very good or good health more often than women (p<0.001. Older people (aged 70 years and above reported significantly poorer health status than those aged 50–59 (adjusted odds ratio (AOR 1.52; 95% confidence interval (CI 1.00–2.30. Indians and Blacks were significantly more likely to report poorer health status at (AOR = 4.01; 95% CI 1.27–12.70 and (AOR = 0.42; 95% CI 0.18_0.98; 30 p < 0.045, respectively, compared to Whites. Respondents with primary education (AOR = 1.83; 95% CI 1.19–2.80 and less than primary education (AOR = 1.94; 95% CI 1.37–2.76 were more likely to report poorer health compared to those with secondary education. In terms of wealth status, those in low wealth quintile (AOR = 2.02; 95% CI 1.14–3.57 and medium wealth quintile (AOR = 1.47; 95% CI 1.01–2.13 were more likely to report poorer

  12. Community-based services for homeless adults experiencing concurrent mental health and substance use disorders: a realist approach to synthesizing evidence.

    O'Campo, Patricia; Kirst, Maritt; Schaefer-McDaniel, Nicole; Firestone, Michelle; Scott, Allison; McShane, Kelly


    Consultations with community-based service providers in Toronto identified a lack of strong research evidence about successful community-based interventions that address the needs of homeless clients experiencing concurrent mental health and substance use disorders. We undertook a collaborative research effort between academic-based and community-based partners to conduct a systematic evidence synthesis drawing heavily from Pawson's realist review methodology to focus on both whether programs are successful and why and how they lead to improved outcomes. We examined scholarly and nonscholarly literature to explore program approaches and program elements that lead to improvements in mental health and substance use disorders among homeless individuals with concurrent disorders (CD). Information related to program contexts, elements, and successes and failures were extracted and further supplemented by key informant interviews and author communication regarding reviewed published studies. From the ten programs that we reviewed, we identified six important and promising program strategies that reduce mental health and, to a far lesser degree, substance use problems: client choice in treatment decision-making, positive interpersonal relationships between client and provider, assertive community treatment approaches, providing supportive housing, providing supports for instrumental needs, and nonrestrictive program approaches. These promising program strategies function, in part, by promoting and supporting autonomy among homeless adults experiencing CD. Our realist informed review is a useful methodology for synthesizing complex programming information on community-based interventions. PMID:19760155

  13. Oral Health and Older Adults


    This podcast discusses the importance of older adults maintaing good oral health habits. It is primarily targeted to public health and aging services professionals.  Created: 10/27/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/27/2008.

  14. Health Literacy in Older Adults


    In this podcast, Dr. Lynda Anderson, former Director of CDC’s Healthy Aging Program, discusses the importance of improving health literacy among older adults.  Created: 9/20/2011 by Office of the Associate Director for Communication (OADC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/20/2011.

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

    Needham, Belinda; Mezuk, Briana; Bareis, Natalie; Lin, Jue; Blackburn, Elizabeth; Epel, Elissa


    Telomere length has been hypothesized to be a marker of cumulative exposure to stress, and stress is an established cause of depression and anxiety disorders. The goal of this study was to examine the relationship between depression, anxiety and telomere length, and to assess whether this relationship is moderated by race/ethnicity, gender, and/or antidepressant use. Data were from the National Health and Nutrition Examination Survey, 1999–2002. Telomere length was assessed using the quantita...

  16. Adult Learning, Health and Well-Being--Changing Lives

    Field, John


    It is increasingly important for adult educators to articulate more clearly their understanding of the benefits and outcomes of adult learning. This paper reviews existing evidence of the impact of participation in education, and particularly explores the relevance of recent studies of how learning has influenced adults' health and well-being.…

  17. Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey.

    Krishna M Palipudi

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

  18. Association Between Socioeconomic Status and Obesity in Adults: Evidence From the 2001 to 2009 Korea National Health and Nutrition Examination Survey

    KIM, JIHYE; Sharma, Shreela V.; Park, Sung Kyun


    Objectives The present study examined relationships between socioeconomic status (SES) and obesity and body mass index (BMI) as well as the effects of health-related behavioral and psychological factors on the relationships. Methods A cross-sectional population-based study was conducted on Korean adults aged 20 to 79 years using data from the 2001, 2005, and 2007 to 2009 Korea National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to est...

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

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


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

  20. Health Literacy Education within Adult Literacy Instruction

    Diehl, Sandra J.


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

  1. Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey

    Ouattara Seydou


    Full Text Available Abstract Background In sub-Saharan Africa, the availability and accessibility of oral health services are seriously constrained and the provision of essential oral care is limited. Reports from the region show a very low utilization of oral health care services, and visits to dental-care facilities are mostly undertaken for symptomatic reasons. The objectives of the present study were to describe the prevalence of oral symptoms among adults in Ouagadougou, capital city of Burkina Faso and the use of oral health services and self-medication in response to these symptoms and to measure the associations between predisposing, enabling and needs factors and decisions to seek oral health care. Methods The conceptual design of the study was derived from both the Andersen-Newman model of health care utilization and the conceptual framework of the WHO International Collaborative Study of Oral Health Outcomes. Data were obtained by two-stage stratified sampling through four areas representative of different stages of urbanization of Ouagadougou. The final study population comprised 3030 adults aged 15 years or over and the response rate was 65%. Results Overall, 28% of the respondents had experienced an oral health problem during the past 12 months; a high proportion (62% reported pain or acute discomfort affecting daily life. In response to symptoms, only 28% used oral health facilities, 48% used self-medication and 24% sought no treatment at all. Multivariate analyses revealed that several socio-economic and socio-cultural factors such as religious affiliation, material living conditions and participation in a social network were significantly associated with the use of oral health care services by adults who had experienced oral health problems during the previous year. Conclusion The proportion of people who have obtained oral health care is alarmingly low in Ouagadougou and self-medication appears to be an important alternative source of care for

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

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


    Objectives This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period. Methods This study focused on 16,642 middle-aged adults, age 50–59 at baseline, from a population-based, six-year panel survey conducted by the J...

  3. Interactive Influences on Health and Adult Education

    Hill, Lilian H.


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

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

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


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

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

    South, Susan C; Jarnecke, Amber M


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

  6. Racial discrimination & health: pathways & evidence.

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


    This review provides an overview of the existing empirical research of the multiple ways by which discrimination can affect health. Institutional mechanisms of discrimination such as restricting marginalized groups to live in undesirable residential areas can have deleterious health consequences by limiting socio-economic status (SES) and creating health-damaging conditions in residential environments. Discrimination can also adversely affect health through restricting access to desirable services such as medical care and creating elevated exposure to traditional stressors such as unemployment and financial strain. Central to racism is an ideology of inferiority that can adversely affect non-dominant groups because some members of marginalized populations will accept as true the dominant society's ideology of their group's inferiority. Limited empirical research indicates that internalized racism is inversely related to health. In addition, the existence of these negative stereotypes can lead dominant group members to consciously and unconsciously discriminate against the stigmatized. An overview of the growing body of research examining the ways in which psychosocial stress generated by subjective experiences of discrimination can affect health is also provided. We review the evidence from the United States and other societies that suggest that the subjective experience of discrimination can adversely affect health and health enhancing behaviours. Advancing our understanding of the relationship between discrimination and health requires improved assessment of the phenomenon of discrimination and increased attention to identifying the psychosocial and biological pathways that may link exposure to discrimination to health status. PMID:18032807

  7. Senior Health: Older Adults and Newer Technology

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

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

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


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

  9. Medicaid Adult Health Care Quality Measures

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

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

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


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

  11. Exploring Older Adults' Health Information Seeking Behaviors

    Manafo, Elizabeth; Wong, Sharon


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

  12. Health Issues for Adults with Developmental Disability.

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


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

  13. Type 1 diabetes: addressing the transition from pediatric to adult-oriented health care

    Monaghan M


    Full Text Available Maureen Monaghan,1,2 Katherine Baumann2 1Center for Translational Science, Children's National Health System, 2George Washington University School of Medicine, Washington, DC, USA Abstract: Adolescents and young adults with type 1 diabetes are at risk for poor health outcomes, including poor glycemic control, acute and chronic complications, and emergency department admissions. During this developmental period, adolescent and young adult patients also experience significant changes in living situation, education, and/or health care delivery, including transferring from pediatric to adult health care. In recent years, professional and advocacy organizations have proposed expert guidelines to improve the process of preparation for and transition to adult-oriented health care. However, challenges remain and evidence-based practices for preparing youth for adult health care are still emerging. Qualitative research suggests that adolescent and young adult patients rely on health care providers to guide them through the transition process and appreciate a gradual approach to preparing for adult-oriented health care, keeping parents in supportive roles into young adulthood. Patients also benefit from specific referrals and contact information for adult care providers. Promising models of transition care include provision of transition navigators, attendance at a young adult bridge clinic, or joint visits with pediatric and adult care providers. However, much of this research is in its early stages, and more rigorous trials need to be conducted to evaluate health outcomes during transition into adult health care. The purpose of this review is to provide an overview of the transition process, patient and health care provider perceptions of transition care, and emerging evidence of successful models of care for engagement in adult-oriented health care. Recommendations and resources for health care providers are also presented. Keywords: type 1 diabetes

  14. Ethics, equality and evidence in health promotion

    Vallgårda, Signild


    interventions are recommended, where there is no evidence to support them, notwithstanding the ambition of interventions being evidence-informed. Ethical considerations are scanty, scattered and unsystematically integrated. Further, although some packages mention the importance of avoiding stigmatization, there......Abstract Aim: The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages.The aim of this article is...... to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. Methods: An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards...

  15. Health Tips for Older Adults

    ... income, eating too little, living alone, and certain diseases. Review the checklist Determine Your Nutritional Health to see if any of the warning ... income, eating too little, living alone, and certain diseases. Review the checklist Determine Your Nutritional Health to see if any of the warning ...

  16. Health Sciences Librarian as an Adult Trainer

    Τσαλαπατάνη, Ειρήνη; Καλογεράκη, Ελένη


    The role of the health sciences librarian as it is shaped by the socio-economic conditions, technological developments and specific information needs of health professionals requires knowledge, skills and attitudes combined with communication skills, management and leadership abilities. The modern health sciences librarian seems to be “borrowing" features from the adult qualified instructor who constantly has to adopt roles in a dynamic learning process, and depending on the circumstances...

  17. Investigating Adult Health Literacy in Tuyserkan City

    Maryam Afshari


    Full Text Available Introduction: Health literacy is the capacity of individuals to obtain, process and understand basic health information and services needed to make healthy decisions. Therefore, this study was designed to determine health literacy of adults Tuyserkan district. Materials and Methods: This cross-sectional descriptive-analytical study was performed on 285 subjects aged 20-60 years attending Tuyserkan health centers through convenience sampling method in 2014. Iranian health literacy questionnaire was used to collect data. Data was analyzed using Stata-11 by Independent T-test and one way ANOVA. Results: Most participants aged 20 to 30 years (52.3% and 53.7 % were males. Most participants had postgraduate diploma level (55.8 % and were students (31.9 %. Participants had a weak level to access information (42.1%, weak level to perceive data (54.4%, moderate in judgment and assessment (64.9% and moderate in use of information (88.8%. Conclusion: Overall, there was a poor health literacy in adults. This indicates the need for more attention to health education and health promotion programs. It seems necessary to design and implement comprehensive plans using media and simple training methods for adults with a low level of health literacy.

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

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


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

  19. Reproductive health of adolescents and young adults

    Ahmet Reşit Ersay


    Full Text Available In Turkey, one out of five person belonging to 10-24 age group, is at risk concerning reproductive health. Topics related to the reproductive health, are neither discussed within the family or society, nor within the educational system. Adolescents, who have to experience sexual intercourse with insufficient and incorrect knowledge, have to face with sexually transmitted diseases (STD, teenage pregnancy, abortion and other problems as a consequence of this experience. Research on this area has showed that both adolescents and young adults, especially health personnel, requested training on reproductive health. In terms of planning health services effectively, these topics should be evaluated carefully in Turkey. In this research, reproductive health regarding adolescents and young adults is examined under the four headings of sexual experience, STD, use of protection and productivity. As a result, depending on all the cultural restrictions and health service limitations, it is observed that adolescents and young adults experience sexual relationship with an inadequate knowledge and consequently, they have to face with problems. Within this context, it is suggested to expand the reproductive health educational programmes involving family, school and society within long term.

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

    Darden, Michael; Gilleskie, Donna


    An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25981179

  1. Oral Health of Irish Adults 2000 - 2002

    Department of Health


    Oral Health of Irish Adults 2000 Р2002 Publication of the strategy document - Shaping a Healthier Future̢?T1 marked a major milestone in the development of the health care delivery system in Ireland. The strategy was underpinned by three key principles: equity, quality of service and accountability. It was emphasised that the benefit to be derived from the health services should be measured in terms of health gain and social gain. Click here to download PDF 5.6mb

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

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


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

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

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


    As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original...

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

    Sorrell, Jeanne M


    New research is providing health care professionals with evidence for the effectiveness of mindfulness meditation as an intervention for older adults. Recent studies have provided evidence that meditation results in observable changes in brain structure related to memory, sense of self, empathy, and stress. Health care professionals should consider mindfulness training as a helpful intervention for older adults with problems such as depression, anxiety, chronic pain, loneliness, and caregiver burden. PMID:25876613

  5. Evidence-based health care in pediatrics.

    Robertson-Malt, Suzanne


    This article examines current trends in the type and quality of systematic reviews underpinning the evidence base for pediatric health care. A case study is used to highlight the quality standards for the conduct and publication of systematic reviews and the processes being used to transition the evidence produced from systematic reviews into the everyday systems and processes of care. PMID:25458134

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

    Aisenberg, Eugene


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

  7. Association of micronutrient status with subclinical health complaints in lactovegetarian adults

    Chiplonkar, Shashi Ajit; Agte, Vaishali Vilas


    Background Micronutrient malnutrition has many adverse effects on human health, not all of which may be clinically evident. Objective To explore linkages between subclinical health complaints and micronutrient status in lactovegetarian Indian adults. Design Health was assessed in 502 lactovegetarian adults (275 men, 227 women, aged 30.6±9 years) using a structured questionnaire for existing complaints with severity of symptoms on a four-point scale and morbidity over the preceding month. Subj...

  8. Association of micronutrient status with subclinical health complaints in lactovegetarian adults

    Ajit Chiplonkar, Shashi; Vilas Agte, Vaishali


    Background: Micronutrient malnutrition has many adverse effects on human health, not all of which may be clinically evident. Objective: To explore linkages between subclinical health complaints and micronutrient status in lactovegetarian Indian adults. Design: Health was assessed in 502 lactovegetarian adults (275 men, 227 women, aged 30.6±9 years) using a structured questionnaire for existing complaints with severity of symptoms on a four-point scale and morbidity over the preceding m...

  9. The Mental Health of Older LGBT Adults.

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


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


    Williams, Mark Edward; Fredriksen-Goldsen, Karen I.


    While extensive research has examined associations between marriage, cohabitation, and the health of heterosexual adults, it remains unclear whether similar patterns of health are associated with same-sex partnerships for lesbian, gay, and bisexual (LGB) older adults. This article examines whether having a same-sex partner is associated with general self-reported health and depressive symptoms for LGB older adults. Based on survey data collected from LGB adults 50 years of age and older, havi...

  11. Adapting a Brief Evidence-Based Intervention for Text Message Delivery to Young Adult Black Women

    Montgomery, Tiffany Monique


    Young adult Black women have the highest sexually transmitted disease rates among all U.S. women. There are several evidence-based interventions (EBIs) targeted toward this population, yet they each require travel to a healthcare facility or other location. With the increased use of mobile devices, mobile health technology is being utilized more frequently to deliver health interventions. Instead of creating entirely new technologically savvy interventions, the CDC recommends adaptation of EB...

  12. Do Sedentary Behaviors Modify the Health Status of Older Adults?

    Elizabeth K. Lenz


    Full Text Available Evidence suggests sedentary behavior (SB negatively impacts the health of adults but less is known about SB impact on older adult (OA health.  Seventy OA (73.4±6years living in the southeast region of Wisconsin, United States of America (USA completed three SB diaries and had risk factors associated with cardiovascular disease (CVD assessed. Sedentary behaviors were quantified as time spent in sitting/lying activities. Pearson correlation coefficients, independent samples t-tests, and one-way ANOVA were performed to explore the relationship between SB and health. Older adults engaged in 620.3±91.2mins/d of SB with television watching (144.3±99.8mins/d being the most prominent. Total SB and television watching were correlated to multiple risk factors for CVD (r=-.241-.415, p=.009-.027 and these variables worsened as OA spent more time in those activities. Television watching was the only SB that increased across risk categories of CVD [F (2,67 =4.158, p=.020, eta squared=.11]. These results suggest SB, especially television watching to be related to risk factors of CVD in OA.

  13. Tracheobronchial calcification in adult health study subjects

    Tracheobronchial calcification is reportedly more frequent in women than in men. Ten cases of extensive tracehobronchial calcification were identified on chest radiographs of 1,152 consecutively examined Adult Health Study subjects, for a prevalence of 0.87 %. An additional 51 subjects having this coded diagnosis were identified among 11,758 members of this fixed population sample. Sixty of the 61 subjects were women. The manifestations and extent of this type of calcification and its correlations with clinical and histopathologic features, which have not been previously reported, are described here. (author)

  14. Comprehensibility of Health-Related Documents for Older Adults with Different Levels of Health Literacy: A Systematic Review.

    Koops van 't Jagt, Ruth; Hoeks, John C J; Jansen, Carel J M; de Winter, Andrea F; Reijneveld, Sijmen A


    A systematic review was conducted to assess the available evidence for the effectiveness of interventions aiming to improve the comprehensibility of health-related documents in older adults (≥50) with different levels of health literacy. Seven databases were searched (2005 forward), and references in relevant reviews were checked. The selection procedure was conducted by 2 independent reviewers. Data extraction and assessment of the quality of the resulting studies were conducted by 1 reviewer and checked for accuracy by a 2nd reviewer. A total of 38 intervention studies had a study population of older adults (n = 35) or made an explicit comparison between age groups, including older adults (n = 3). Inconsistent evidence was found for the importance of design features to enhance the comprehensibility of health-related documents. Only for narratives and multiple-feature revisions (e.g., combining revisions in textual and visual characteristics) did the included studies provide evidence that they may be effective for older adults. Using narrative formats and/or multiple-feature revisions of health-related documents seem to be promising strategies for enhancing the comprehensibility of health-related documents for older adults. The lack of consistent evidence for effective interventions stresses the importance of (a) replication and (b) the use of standardized research methodologies. PMID:26594852

  15. Health literacy, health status, and healthcare utilization of taiwanese adults: results from a national survey

    Kuo Ken N; Tsai Yi-Wen; Tsai Tzu-I; Lee Shoou-Yih D


    Abstract Background Low health literacy is considered a worldwide health threat. The purpose of this study is to assess the prevalence and socio-demographic covariates of low health literacy in Taiwanese adults and to investigate the relationships between health literacy and health status and health care utilization. Methods A national survey of 1493 adults was conducted in 2008. Health literacy was measured using the Mandarin Health Literacy Scale. Health status was measured based on self-ra...

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

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


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

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

    Manafo, Elizabeth; Wong, Sharon


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

  18. Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy

    ... Finance Peer Search Education Finance Statistics Center Compare Academic Libraries IPEDS Data Center State Education Data Profiles ... box Title: The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy ...

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

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


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

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

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

  1. Dimensions of self-rated health in older adults

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


    OBJECTIVE To analyze the association between negative self-rated health and indicators of health, wellbeing and sociodemographic variables in older adults. METHODS Cross-sectional study that used data from a population-based health survey with a probability cluster sample that was carried out in Campinas, SP, Southeastern Brazil,, in 2008 and 2009. The participants were older adults (≥ 60 years) and the dependent variable was self-rated health, categorized as: excellent, very good, good, ...

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

    Caroline Fall


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

  3. The relationship between functional health literacy and health promoting behaviors among older adults

    Reisi, Mahnoush; Javadzade, Seyed Homamodin; Heydarabadi, Akbar Babaei; Mostafavi, Firouzeh; Tavassoli, Elahe; Sharifirad, Gholamreza


    Background: Health literacy is a measure of individual's ability to read, comprehend, and act on medical instructions. Older adults are one of the most important at risk groups affected by the impact of inadequate health literacy. Health promoting behaviors in older adults have potential impact on their health and quality of life and reduce the costs incurred to health care. Given the paucity of information health literacy and health promoting behavior, the purpose of this study was to examin...

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

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health care provider - adult ... Questions you should ask: Can I eat dairy foods? What foods can make my problem worse? Can I have greasy or spicy foods? ...

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

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


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

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

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


    As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original observational and intervention studies on the relationship between cycle ergometer training and health among older patients over 70. Twenty-five studies examined interventions aimed specifically at promoting cycling for older adults over 70. These studies reported a positive effect on the prevention of cardiovascular disease, and a significant improvement in metabolic responses. Improving functional status, muscle strength and cognitive performance are also well established. Overall, this review demonstrates a positive effect of cycle ergometer training with functional benefits and positive health outcomes for older adults over 70. Based on this evidence, clinicians can now encourage older adults to profit from the health benefits of cycle ergometer training to be able to pursue their daily activities independently. PMID:26865872

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

    Thomas, Jason R.; Högnäs, Robin S.


    Decades of research have produced evidence that parental divorce is negatively associated with offspring outcomes from early childhood, through adolescence, and into the adult years. This study adds to the literature on the effects of parental divorce by examining how the timing of a parental divorce influences the total effect on adult health. Furthermore, we look at how this long-term effect of parental divorce depends on mediators such as the family’s socioeconomic status, parental involve...

  8. The Affordable Care Act and implications for young adult health

    Monaghan, Maureen


    In the USA, young adults are most likely to be uninsured and least likely to report a usual source of medical care than any age group. The Patient Protection and Affordable Care Act (ACA) recognizes the critical need for expanded insurance coverage for this age group, and multiple provisions of the ACA address insurance coverage and health care utilization in young adults. This paper presents a brief overview of the challenges of maintaining health insurance coverage and accessing health care...

  9. A population perspective to evidence based medicine: "evidence for population health"

    Heller, R.; Page, J.


    We explore the notion that the public health community could learn lessons from the success of evidence based medicine (EBM) and develop a public health counterpart called "Evidence for Population Health". While EBM focuses on individual patients, its public health counterpart would aim to improve the health of communities effectively and efficiently.

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

    Åstrøm Anne


    Full Text Available Abstract Background This study identified optimistic biases in health and oral health hazards, and explored whether comparative risk judgements for oral health hazards vary systematically with socio-economic characteristics and self-reported risk experience. Methods A simple random sample of 1,190 residents born in 1972 was drawn from the population resident in three counties of Norway. A total of 735 adults (51% women completed postal questionnaires at home. Results Mean ratings of comparative risk judgements differed significantly (p Conclusion Optimism in comparative judgements for health and oral health hazards was evident in young Norwegian adults. When judging their comparative susceptibility for oral health hazards, they consider personal health situation and risk behaviour experience.


    Tarkhanova, Irina; Pavlova, Oksana; Arnis, Voldemārs


    The article actualizes the problem of decreasing of the physical activity of a modern man, describes the results of the research of the adult population with application of the International questionnaire for assessing physical activity (IPAQ). Based on the analysis of the obtained results a model of the education of adults to healthcare issues. Possible ways of socialization and recreation of the adult population through the implementation of educational programs are discussed.

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

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


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

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

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


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

  14. Health Literacy among Adults: A Study from Turkey

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


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

  15. Mental Health Problems in Adults with Williams Syndrome

    Stinton, Chris; Elison, Sarah; Howlin, Patricia


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

  16. Health in adults with congenital heart disease.

    Cuypers, Judith A A E; Utens, Elisabeth M W J; Roos-Hesselink, Jolien W


    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many adults with congenital heart disease encounter late complications. Late morbidity can be related to the congenital heart defect itself, but may also be the consequence of the surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. This narrative review describes the cardiac and non-cardiac long-term morbidity in the adult population with congenital heart disease. PMID:27451323

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

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


    Socioeconomic status is generally associated with better health, but recent evidence suggests that this ‘social gradient’ in health is far from universal. This study examines whether social gradients in smoking and obesity in Mexico—a country in the midst of rapid socioeconomic change—conform to or diverge from results for richer countries. Using a nationally-representative sample of 39 129 Mexican adults, we calculate the odds of smoking and of being obese by educational attainment and by ho...

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

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


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

  19. Does childhood socioeconomic status influence adult health through behavioural factors?

    van de Mheen, Dike; Stronks, Karien; Looman, Caspar; Mackenbach, Johan


    textabstractBACKGROUND: The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. METHODS: Data were obtained from the baseline of a prospective cohort study in the Netherlands (13 854 respondents, aged between 25 and 74). Childhood socioeconomic group was indicated by occupation of the father, and adult health was ind...

  20. Attendance patterns of older adults in a health promotion program.

    Watkins, A. J.; Kligman, E W


    A group of 224 participants in a health promotion program for older adults had complete baseline data, including demographic information, self-perceived mental and physical health ratings, and measures of socialization and health limitations. Participants were offered exercise sessions 3 times a week, weekly health education classes, and a weekly stress management group. Their attendance at these classes varied from no classes to approximately 750 classes. Initially, participants were divided...

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

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


    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pie...

  2. Oral health-related quality of life in Norwegian adults


    Objectives The general aim of this thesis was to describe oral health-related quality of life (OHRQoL) in adults in the county of Nord-Trøndelag and in a national representative sample of Norwegian adults. A further goal was to study whether oral-health related quality of life is associated with clinical dental health, use of dental services, oral hygiene behaviours and demographic variables. The use of clinical measures only to assess the oral status of individuals has been criticized...

  3. Dimensions of self-rated health in older adults

    Flávia Silva Arbex Borim


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

  4. [Transition in health care, from pediatrics to adult care].

    De Cunto, Carmen L


    The number of adolescent patients with chronic diseases and special heath needs are increasing, and they are reaching adulthood. Sometimes the passage to the adult health care is abrupt, depending upon the chronological age reached or because of an acute health problem that requires hospitalization. In order to facilitate the transition process, preparation of the child, the family and the health professionals involved is needed, as well as the coordination between the pediatric group and the adult team that will be incharge of the patient. This review shows the obstacles to this process and the recommended implementation steps required to a successful transition. It also describes the main aspects of a program that we implemented at the Hospital Italiano de Buenos Aires in conjunction with some departments of adult health care high lighting the main steps to follow before and during program´s implementation. PMID:22859330

  5. Health insurance status of young adults in the United States.

    McManus, M A; Greaney, A M; Newacheck, P W


    Sociodemographic and health characteristics of young adults who are uninsured, publicly insured, and privately insured were examined using the 1984 National Health Interview Survey. The results indicated that 26% of 19 to 24-year-old persons had no health insurance protection, 65% were privately insured, 7% were publicly insured, and 1% had both private and public coverage. Young adults at greatest risk for being uninsured were male, Hispanic and black, poor and near-poor, unemployed, high school dropouts, living with others, and residing in the South and West. All young adults predictably lose or change health insurance as they move from dependence to independence. It was concluded that greater use of new and existing transitional insurance options should be offered as well as targeted educational and communication strategies to assure that all young persons enter adulthood with some basic insurance protection. PMID:2780134

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

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


    In contrast to a previous study we conducted and other evidence, a recent study found no significant effects of Medicare coverage after age 65 on overall health for previously uninsured adults and significant adverse effects on survival for some of these adults. We discuss explanations for these inconsistent findings, particularly the different ways in which deaths were handled, a key methodological challenge in longitudinal analyses of health. We demonstrate that analytic approaches suitable...

  7. Effects of physical activity on health status in older adults. II. Intervention studies.

    Buchner, D M; Beresford, S A; Larson, E B; LaCroix, A Z; Wagner, E H


    This review has focused on a specific part of the relationship of exercise to health. The overall evidence supporting the health benefits of exercise is substantial and has been critically reviewed recently (18, 94). Thus, the United States Preventive Services Task Force recommends that all adults exercise regularly (94). The conclusions summarized below regarding older adults do not affect this basic recommendation. There is solid evidence that exercise can improve measures of fitness in older adults, particularly strength and aerobic capacity. These exercise effects occur in chronically ill adults, as well as in healthy adults. Because physical fitness is a determinant of functional status, it is logical to ask whether exercise can prevent or improve impairments in functional status in older adults. The evidence that exercise improves functional status is promising, but inconclusive. Problems with existing studies include a lack of randomized controlled trials, a lack of evidence that effects of exercise can be sustained over long periods of time, inadequate statistical power, and failure to target physically unfit individuals. Existing studies suggest that exercise may produce improvements in gait and balance. Arthritis patients may experience long-term functional status benefits from exercise, including improved mobility and decreased pain symptoms. Nonrandomized trials suggest exercise promotes bone mineral density and thereby decreases fracture risk. Recent studies have generally concluded that short-term exercise does not improve cognitive function. Yet the limited statistical power of these studies does not preclude what may be a modest, but functionally meaningful, effect of exercise on cognition. Future research, beyond correcting methodologic deficiencies in existing studies, should systematically study how functional status effects of exercise vary with the type, intensity, and duration of exercise. It should address issues in recruiting functionally

  8. Reproductive health of adolescents and young adults

    Ahmet Reşit Ersay; Gülbu Tortumluoğlu


                   In Turkey, one out of five person belonging to 10-24 age group, is at risk concerning reproductive health. Topics related to the reproductive health, are neither discussed within the family or society, nor within the educational system. Adolescents, who have to experience sexual intercourse with insufficient and incorrect knowledge, have to face with sexually transmitted diseases (STD), teenage pregnancy, abo...

  9. Child Physical Abuse and Adult Mental Health: A National Study

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


    This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000–2001 and 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric dis...

  10. Abdominal ultrasonographic screening of adult health study participants

    To assess ultrasonography's capabilities in the detection of cancer and other diseases, abdominal ultrasonographic screening was performed for 3,707 Hiroshima and 2,294 Nagasaki atomic bomb survivors and comparison subjects who participated in the Adult Health Study from 1 November 1981 to 31 October 1985 in Hiroshima and from 1 August 1984 to 31 July 1986 in Nagasaki. A total of 20 cancers was detected, consisting of 7 hepatomas, 3 gastric cancers, 3 renal cancers, 2 cancers of the urinary bladder, and 1 cancer each of the ovary, pancreas, colon, ureter and liver (metastatic). The cancer detection rate was 0.33 %. The diagnoses of seven cancer subjects in each city were subsequently confirmed at autopsy or surgery; diagnoses of four cancer subjects in Hiroshima and two in Nagasaki were obtained from death certificates. Among the 20 cancer patients, 13 were asymptomatic. After the ultrasonographic detection and diagnosis of these 20 cancers, the medical records of each of the 20 cancer patients were reviewed for any evidence of cancer detection by other examining techniques, and the records of only 3 patients revealed such recent detection. The tumor and tissue registries were similarly checked, but no evidence of earlier diagnosis of their disease was found. Ten of the cancer patients had received ionizing radiation doses from the A-bombs ranging up to 3,421 mGy (DS86), but no correlation was established between cancer prevalence and the A-bomb doses. A variety of tumors, 259 in number and most probably benign, were also detected with ultrasonography. In addition, numerous other abnormalities were diagnosed, with prevalences of 7.7 % for cholelithiasis, 5.7 % for renal cysts, and 3.8 % for liver cysts. No statistical analysis was performed concerning the prevalence of the diseases detected. (author)

  11. Pathways to Health Risk Exposure in Adult Film Performers

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


    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male pe...

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

    O'Brien, K. K.; Solomon, P; Trentham, B.; MacLachlan, D.; MacDermid, J; Tynan, A. -M; Baxter, L.; Casey, A.; Chegwidden, W.; Robinson, G; Tran, T.; Wu, J.; Zack, E


    Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effec...

  13. The Health of Aging Lesbian, Gay and Bisexual Adults in California

    Wallace, Steven P; Cochran, Susan D.; Durazo, Eva M.; Ford, Chandra L.


    Research on the health of lesbian, gay and bisexual (LGB) adults generally overlooks the chronic conditions that are the most common health concerns of older adults. This brief presents unique population-level data on aging LGB adults (ages 50–70) documenting that they have higher rates of several serious chronic physical and mental health conditions compared to similar heterosexual adults. Although access to care appears similar for aging LGB and heterosexual adults, aging LGB adults general...

  14. The Health of Aging Lesbian, Gay and Bisexual Adults in California

    Wallace, Steven P; Cochran, Susan D.; Durazo, Eva M.; Ford, Chandra L.


    Research on the health of lesbian, gay and bisexual (LGB) adults generally overlooks the chronic conditions that are the most common health concerns of older adults. This brief presents unique population-level data on aging LGB adults (ages 50-70) documenting that they have higher rates of several serious chronic physical and mental health conditions compared to similar heterosexual adults. Although access to care appears similar for aging LGB and heterosexual adults, aging LGB adults general...

  15. Empirical evidence about recovery and mental health

    Slade, Mike; Longden, Eleanor


    Background Two discourses exist in mental health research and practice. The first focuses on the limitations associated with disability arising from mental disorder. The second focuses on the possibilities for living well with mental health problems. Discussion This article was prompted by a review to inform disability policy. We identify seven findings from this review: recovery is best judged by experts or using standardised assessment; few people with mental health problems recover; if a p...

  16. Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

    Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.


    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justic...

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

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


    Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. We report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adu...

  18. Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets

    Cherepanov, Dasha; Palta, Mari; Fryback, Dennis G.; Robert, Stephanie A.


    The purpose of this study was to describe gender differences in self-reported health-related quality-of-life (HRQoL) and to examine whether differences are explained by sociodemographic and socioeconomic status (SES) differentials between men and women. Data were from four US nationally representative surveys: US Valuation of the EuroQol EQ-5D Health States Survey (USVEQ), Medical Expenditure Panel Survey (MEPS), National Health Measurement Study (NHMS) and Joint Canada/US Survey of Health...

  19. Alcohol Consumption, Medical Conditions, and Health Behavior in Older Adults

    Satre, Derek; Nancy P. Gordon; Weisner, Constance


    Objectives: To examine associations between drinking patterns, medical conditions and behavioral health risks among older adults. Methods: Analyses compared survey participants (health plan members ages 65 to 90, N = 6,662) who drank moderately to those who drank over recommended limits or did not drink. Results: Over-limit drinking was associated with smoking; not trying to eat low fat foods (in men), and lower BMI (in women). Predictors of not drinking during the prior 12 months included...

  20. Mental ill-health in contemporary young adults

    Kosidou, Kyriaki


    Young adulthood is the peak age for the onset of most mental disorders and is a period of crucial importance for the establishment of emotional well-being in adult life. Mental health problems, including psychological distress and depressive symptoms, as well as suicide attempts, are reported to be increasing among young people, especially females, in many Western countries. Thus, the overall purpose of this thesis is to examine trends and causes of mental ill-health in contemp...

  1. Accessibility of mental health care for adults with cerebral palsy

    Pihlaja, Kimmo; Päivärinta, Paula


    The purpose of this thesis is to describe the accessibility in mental health care from the point of view of an adult with cerebral palsy. The theoretical framework of this thesis is constructed from the related literature and previous studies closely linked to the topic. Research was done to clarify the concepts of disability, cerebral palsy, and mental health. The research showed cerebral palsy as a multidimensional physical disability which may include different types of accompanying im...

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

    Ronis, D L


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

  3. Trauma, stress, health, and mental health issues among ethnically diverse older adult prisoners.

    Haugebrook, Sabrina; Zgoba, Kristen M; Maschi, Tina; Morgen, Keith; Brown, Derek


    The United States' older adult prison population is growing rapidly. This study identifies and describes important psychosocial characteristics, particularly trauma, life-event stressors, health, mental health, and substance abuse, among older adults in prison. Data were collected using case record reviews of 114 prisoners aged 55 or older in the New Jersey Department of Corrections. Findings revealed that the study participants are a diverse group with varied psychosocial issues and needs, including trauma and stress histories, substance use, and health and mental health issues. Most had childhood or adult trauma, such as physical or sexual abuse. Family problems were common in childhood and adulthood. Understanding the problems and needs of older adult prisoners may help improve practice, promote advocacy, and prompt research that can enhance the quality of life of this population. PMID:20472867

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

    Griffith, Richard


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

  5. The Health Status of Adults on the Autism Spectrum

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


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

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

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


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

  7. Does childhood socioeconomic status influence adult health through behavioural factors?

    H. van de Mheen (Dike); K. Stronks (Karien); C.W.N. Looman (Caspar); J.P. Mackenbach (Johan)


    textabstractBACKGROUND: The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. METHODS: Da

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

    Black, Stephen


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

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

    Stinton, Chris; Tomlinson, Katie; Estes, Zachary


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

  10. In Sickness and in Health: Health Care Experiences of Korean Immigrant Older Adults

    Juhn, Erica


    The purpose of this study was to document the health care experiences of Korean immigrant older adults, 65 years of age or older, living in Los Angeles County, who have health care access through Medicare and/or Medi-Cal, access to a large Korean ethnic enclave, and a diverse social support network. Twelve Korean immigrant older adults were recruited through word-of-mouth via community contacts. Semi-structured qualitative interviews were conducted with individual seniors, with the help of ...

  11. Mechanisms linking early life stress to adult health outcomes

    Taylor, Shelley E.


    Research relating stress to health has progressed from anecdotal evidence in the 1930s and 1940s to complex multivariate models that identify underlying longitudinal mechanisms. Enduring questions that have guided our research are: How does the early life environment affect health outcomes into adulthood? How is the latent damage stored and what processes are set into motion that link early life stress to health disorders in the later years? An emerging perspective focuses on the accumulation...

  12. Healthy minds in healthy bodies: An international comparison of education-related inequality in physical health among older adults

    Jürges, Hendrik


    Education is arguably the most important correlate of health We study education-related inequality in the physical of older adults across 11 European countries and the US. Combining data from HRS 2002, ELSA 2002 and SHARE 2004, our results suggest that education is strongly correlated with health both across and within countries. Education-related inequality in health is larger in Mediterranean and Anglo-Saxon countries than in western European countries. We find no evidence of a trade-off be...

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

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


    Health promotion practice has evolved over the past four decades in response to the rising rates of chronic disease. The focus of health promotion is attaining wellness by managing modifiable risk factors, such as smoking, diet, or physical activity. Occupational health nurses are often asked to conduct worksite health promotion programs for individuals or groups, yet may be unfamiliar with evidence-based strategies. Occupational health nurses should lead interprofessional groups in designing and implementing worksite health promotion programs. This article introduces occupational health nurses to health promotion concepts and discusses evidence-based theories and planning models that can be easily introduced into practice. PMID:25101931

  14. Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets

    Cherepanov, Dasha; Palta, Mari; Fryback, Dennis G.; Robert, Stephanie A.


    Purpose The purpose of this study was to describe gender differences in self-reported health-related quality-of-life (HRQoL) and to examine whether differences are explained by sociodemographic and socioeconomic status (SES) differentials between men and women. Methods Data were from four US nationally representative surveys: US Valuation of the EuroQol EQ-5D Health States Survey (USVEQ), Medical Expenditure Panel Survey (MEPS), National Health Measurement Study (NHMS) and Joint Canada/US Sur...

  15. Children and Parental Health: Evidence from China

    Asadul Islam; Russell Smyth


    In most developing countries children provide some form of insurance against risks when parents are old, which, in turn, justifies parental preference to have more children. In this paper, we examine the causal effect of number of children on several measures of health status of elderly parents using newly available China Health and Retirement Survey data. Because number of children in a family is not exogenously determined, we use a natural experiment (variations in China’s one child polic...

  16. Healthy(?), Wealthy, and Wise Birth Order and Adult Health.

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


    While recent research finds strong evidence that birth order affects children’s outcomes such as education, IQ scores, and earnings, the evidence for effects on health is more limited. This paper uses a large dataset on the population of Norway and focuses on the effect of birth order on a range of health and health-related behaviors, outcomes not previously available in datasets of this magnitude. Interestingly, we find complicated effects of birth order. First-borns are more likely to be ov...


    Macias, Eduardo P.; Morales, Leo S.


    A bilingual survey was developed to collect information regarding socio-demographics, access to medical and dental care, health insurance coverage, perceived health status, and use of folk medicine providers from 70 adults presenting to a health fair in South Los Angeles County. Ninety-seven percent of respondents were foreign-born. Seventy-nine percent reported having no health insurance during the year prior to survey. Of the uninsured, 61 percent lacked a doctor visit and 76 percent lacked...

  18. The Effect of Gambling on Health: Evidence from Canada

    Humphreys, Brad; Nyman, John; Ruseski, Jane


    The relationship between gambling and health has important economic and public policy implications. We develop causal evidence about the relationship between recreational gambling and health using data from the Canadian Community Health Survey (CCHS) cycles 2.1, 3.1 and 4.1. Recreational gamblers are gamblers who are classifi ed as "non-problem" gamblers according to the Canadian Problem Gambling Index (CPGI). Gambling is treated as an endogenous regressor in the health equations. The results...

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

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


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

  20. Parental Health and Child Behavior: Evidence from Parental Health Shocks

    Westermaier, Franz; Mühlenweg, Andrea M.; Morefield, Brant


    This study examines the importance of parental health in the development of child behavior during early childhood. Our analysis is based on child psychometric measures from a longitudinal German dataset, which tracks mothers and their newborns up to age six. We identify major changes in parental health (shocks) and control for a variety of initial characteristics of the child including prenatal conditions. The results are robust to placebo regressions of health shocks that occur after the out...

  1. Adopting a Clinical Assessment Framework in Older Adult Mental Health.

    Hung, Lillian; Lee, Patience Anne; Au-Yeung, Andy T; Kucherova, Irina; Harrigan, MaryLou


    Obtaining new knowledge accepted and used by practitioners remains a slow process. A dearth of knowledge translation research exists that explores how to effectively move knowledge to practice in the field of older adult mental health. The current article reports findings of a knowledge translation study that examined what factors enabled the adoption of a new clinical assessment framework, P.I.E.C.E.S.™, into practice in an older adult tertiary mental health unit. Theoretical insights of appreciative inquiry were used to guide the study. Qualitative methods were used, including focus groups with 20 staff and individual interviews with three leaders. The appreciative inquiry approach helped researchers successfully facilitate knowledge translation. Enabling factors included: (a) fostering positive energy to make continuous improvement, (b) working with team members across disciplines at all levels, and (c) using knowledge translation tools to enable and sustain the new practice. [Journal of Psychosocial Nursing and Mental Health Services, 54 (7), 26-31.]. PMID:27362382

  2. [Baseline- and health enhancing physical activity in adults with obesity].

    Haider, Sandra; Lamprecht, Thomas; Dick, Daniel; Lackinger, Christian


    Physical inactivity is one of the major risk factors for people to become overweight or obese. To achieve a substantial health benefit, adults should do at least 150 min of moderate or 75 min of high intensity aerobic activity per week and additionally they should do muscle strengthening exercises. This recommendation represents the lower limit and not the optimum. To loose body weight a significantly higher level of physical activity is required. Exercise programs can play an important part to reach the required level of health-enhancing physical activity. The Austrian pilot projects "Aktiv Bewegt" and "GEHE-Adipositas" showed that obese adults were interested in structured exercise programs and that they were also willing to use them. Clear defined quality criteria, the differentiation from conventional programs for already active and fit people and a recommendation from a doctor or other health professionals were important motivation reasons. PMID:26847443

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

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


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

  4. Fuel poverty and human health: A review of recent evidence

    The health impacts of tackling fuel poverty are reviewed, drawing primarily on large-scale studies completed in the last 10 years. Although physical health effects on adults appear to be modest, caregivers and children perceive significant impacts on children's respiratory health. There also appear to be significant effects on the physical health of infants, particularly on weight gain and susceptibility to illness. Mental health effects on adults emerge as significant in most studies, as do mental health impacts on adolescents. Mental health effects on children have, as yet, never been systematically assessed. Whilst several studies are methodologically rigorous, with some also based on very large samples, methodological problems remain. In future evaluations of health impacts, clinical outcomes could be more comprehensively augmented with measures that extend beyond physical health. These include measures reflecting quality of life, changes in patterns of social engagement and daily routine, and their concomitant impacts on mental wellbeing, Such measures may provide more rounded insights into the potential health impacts of tackling fuel poverty and-equally as important for policy and practice-the processes by which these impacts become manifest.

  5. The ethics of evidence implementation in health care.

    Kumar, Saravana; Grimmer-Somers, Karen; Hughes, Bernard


    Evidence based practice is increasingly mandated by all stakeholders as an integral process of ensuring safe and quality health care. It is recognised that evidence based practice can contribute to minimising misuse, overuse and underuse of health care. Operationalising evidence based practice requires physiotherapists to access relevant evidence, appraise the evidence for its methodological quality, extract information relevant to their practice, and implement it as part of health care service delivery. The final step in this process is to evaluate evidence implementation and reflect what, if any, changes to health care processes and outcomes was achieved. From a theoretical perspective, these steps seem logical and readily achievable. However, practical application in clinical practice settings has encountered numerous barriers. One such barrier, which is commonly encountered and is a contentious area, is the issue of ethics in evidence implementation. Using two hypothetical case studies, we aim to highlight common frustrations encountered by physiotherapists when implementing evidence into practice, ethical ambiguity underpinning evidence implementation and discuss implications in terms of clinical practice and research. PMID:20564759

  6. Reduction of inequalities in health: assessing evidence-based tools

    Shea Beverley


    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  7. Competency, confidence and conflicting evidence: key issues affecting health visitors' use of research evidence in practice

    Calnan Michael


    Full Text Available Abstract Background Health visitors play a pivotal position in providing parents with up-to-date evidence-based care on child health. The recent controversy over the safety of the MMR vaccine has drawn attention to the difficulties they face when new research which raises doubts about current guidelines and practices is published. In the aftermath of the MMR controversy, this paper investigates the sources health visitors use to find out about new research evidence on immunisation and examines barriers and facilitators to using evidence in practice. It also assesses health visitors' confidence in using research evidence. Methods Health visitors were recruited from the 2007 UK Community Practitioners' and Health Visitors' Association conference. All delegates were eligible to complete the questionnaire if in their current professional role they advise parents about childhood immunisation or administer vaccines to children. Of 228 who were eligible, 185 completed the survey (81.1%. Results These health visitors used a wide range of resources to find out about new research evidence on childhood immunisation. Popular sources included information leaflets and publications, training days, nursing journals and networking with colleagues. A lack of time was cited as the main barrier to searching for new evidence. The most common reason given for not using research in practice was a perception of conflicting research evidence. Understanding the evidence was a key facilitator. Health visitors expressed less confidence about searching and explaining research on childhood immunisation than evidence on weaning and a baby's sleep position. Conclusion Even motivated health visitors feel they lack the time and, in some cases, the skills to locate and appraise research evidence. This research suggests that of the provision of already-appraised research would help to keep busy health professionals informed, up-to-date and confident in responding to public

  8. Programmatic influences on outcomes of an evidence-based fall prevention program for older adults: a translational assessment

    Smith, Matthew Lee; Hochhalter, Angela K; Cheng, Yichen; Wang, Suojin; Marcia G. Ory


    Investigating the implementation and dissemination of evidence-based health-promotion programs to reach large numbers of diverse older adults is needed. The purpose of this study is to examine relationships between class size and session attendance and assess differences in intervention outcomes based on these community-based fall prevention program characteristics. Pre-post data were analyzed from 2,056 falls prevention program participants. PROC MIXED for repeated measures and ordinary leas...

  9. Health-promoting schools: evidence for a holistic approach to promoting health and improving health literacy.

    Lee, Albert


    Chronic diseases are now the major causes of death and disability worldwide, and non-communicable diseases (NCD) account for the majority of the global health burden. About half of premature deaths are related to health-risking behaviours that are often established during youth and extend to adulthood. While these diseases might not be curable, they are preventable. Prevention is possible when sustained actions are directed at individuals and families, as well as at the broader social, economic and cultural determinants of NCD. A 'life-course' approach to promoting healthy behaviour should begin early in life. The aim of this article is to discuss the impact of the 'health-promoting school' (HPS) on improvements in youth health. HPS can be described as a holistic, whole-school approach in which a broad health education curriculum is supported by the environment and ethos of the school. HPS moves beyond individual behavioural change to consider organizational and policy change such as improving the physical and social environment of the school, as well as its curricula and teaching and learning methods. A positive culture for health would facilitate higher levels of health literacy by helping individuals tackle the determinants of health better as they build the personal, cognitive and social skills for maintaining good health. There is reasonable evidence to demonstrate that the whole-school approach using the HPS framework is effective in improving health, ranging from physical activities and healthy eating to emotional health. Schools adopting the HPS framework have demonstrated changes in culture and organizational practice to become more conducive to health improvement. These schools were reported to have better school health policies, higher degrees of community participation, and a more hygienic environment than non-HPS schools, and students in these schools had a more positive health behaviour profile. Health promotion and disease prevention is essential to

  10. Abortion and Mental Health: Evaluating the Evidence

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


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

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

    Emerson, Eric


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

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

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


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

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

    Hand, Carri


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

  14. A review of evidence-based strategies to treat obesity in adults.

    Laddu, Deepika; Dow, Caitlin; Hingle, Melanie; Thomson, Cynthia; Going, Scott


    Obesity, with its comorbidities, is a major public health problem. Population-based surveys estimate 2 of every 3 U.S. adults are overweight or obese. Despite billions of dollars spent annually on weight loss attempts, recidivism is high and long-term results are disappointing. In simplest terms, weight loss and maintenance depend on energy balance, and a combination of increased energy expenditure by exercise and decreased energy intake through caloric restriction is the mainstay of behavioral interventions. Many individuals successfully lose 5%-10% of body weight through behavioral approaches and thereby significantly improve health. Similar success occurs with some weight loss prescriptions, although evidence for successful weight loss with over-the-counter medications and supplements is weak. Commercial weight loss programs have helped many individuals achieve their goals, although few programs have been carefully evaluated and compared, limiting recommendations of one program over another. For the very obese, bariatric surgery is an option that leads to significant weight loss and improved health, although risks must be carefully weighed. Lifestyle changes, including regular physical activity, healthy food choices, and portion control, must be adopted, regardless of the weight loss approach, which requires ongoing support. Patients can best decide the appropriate approach working with a multidisciplinary team, including their health care provider and experts in nutrition, exercise, and behavioral intervention. PMID:21947634

  15. Information systems: the key to evidence-based health practice.


    Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyo...

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

    Beckfield, Jason


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

  17. Evidence-based health promotion programs for schools and communities.

    Inman, Dianna D; van Bakergem, Karen M; Larosa, Angela C; Garr, David R


    Healthy People 2020 includes an objective to increase the proportion of elementary, middle, and senior high schools that provide comprehensive school health education to prevent health problems in the following areas: unintentional injury; violence; suicide; tobacco use and addiction; alcohol or other drug use; unintended pregnancy, HIV/AIDS, and sexually transmitted infections (STI); unhealthy dietary patterns; and inadequate physical activity. These specific goals are part of the efforts of Healthy People 2020 to increase the proportion of elementary, middle, and senior high schools that have health education goals or objectives that address the knowledge and skills articulated in the National Health Education Standards. A focus on Pre-K through 12 health education is a prerequisite for the implementation of a coordinated, seamless approach to health education as advocated by the Healthy People Curriculum Task Force and incorporated into the Education for Health framework. To help accomplish these goals, this article views the role of education as part of the broader socioecologic model of health. A comprehensive literature review was undertaken to identify evidence-based, peer-reviewed programs, strategies, and resources. The results of this review are presented organized as sexual health, mental and emotional health, injury prevention, tobacco and substance abuse, and exercise and healthy eating. Evidence-based implementation strategies, often considered the missing link, are recommended to help achieve the Healthy People 2020 objective of increasing the prevalence of comprehensive school health education programs designed to reduce health risks for children. PMID:21238871

  18. Self-rated health: Importance of use in elderly adults

    José Mauricio Ocampo


    Full Text Available Introduction: The concept of self-rated health (SRH was conceived during the first half of the twentieth century. Since then, numerous studies have documented the validity of its measurement and it has been widely accepted as a reliable measurement of overall health. SRH is considered a subjective measurement integrating the biological, mental, social, and functional aspects of an individual.Objective: To review the literature to determine theoretical determinants, related outcomes, and utility of SRH in elderly adults (EAs.Methods: The databases reviewed were Medline, SciELO, EMBASE, Science Direct, Proquest, and Ovid, along with information available in websites from international health agencies.Results: SRH is considered a sensitive measurement of overall health in EAs. It is influenced by physical function, the presence of disease, the existence of disabilities, functional limitations, and by the rate of aging. Many studies suggest it may be modified by demographics, as well as by social and mental factors. Thus, the perception of health is the result of multiple and complex interactions of variables determining it at any given time. SRH is based on systems theory and the bio-psychosocial health model. It has proven to be a significant independent predictor for development of morbidity, mortality, and disability in basic physical and instrumental daily life activities among elderly adults.Conclusion: In addition to reflecting the overall health status of EAs, SRH can provide information to aid health personnel and decision makers in the development and implementation of health promotion and disease prevention programs, as well as the adequacy and planning of different levels of care for this population.

  19. The Effect of Job Loss on Health: Evidence from Biomarkers

    Michaud, Pierre-Carl; Crimmins, Eileen; Hurd, Michael D.


    The effect of job loss on health may play an important role in the development of the SES-health gradient. In this paper, we estimate the effect of job loss on objective measures of physiological dysregulation using longitudinal data from the Health and Re- tirement Study and biomarker measures collected in 2006 and 2008. We use a variety of econometric methods to account for selection and reverse causality. Distinguishing between layoffs and business closures, we find no evidence that busine...

  20. Development of an Evidence-Based Multidisciplinary Guideline for Policy and Practice to Increase Health Literacy among Older Adults in Europe: engaging stakeholders is crucial for optimal adoption and use of the guideline.

    Landsman-Dijkstra, Johanna; Koot, Jaap; Reijneveld, Sijmen; de Winter, Andrea


    Introduction. Guidelines are often not fully implemented into practice or policy. It has been recommended to engage end-users in the development of guidelines to promote adoption and use of the guidelines. Therefore, the Intervention Research On Health Literacy (IROHLA) project aimed to produce a he

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

    Wang, Yang; Yang, Muzhe


    Using data from the National Longitudinal Study of Adolescent Health, we provide evidence that young adults respond to crisis-induced depression by exercising less and having breakfast less often. Exogenous variation in the crisis-induced depression is obtained through a unique event in our sample period - the 9/11 terrorist attacks. We compare those who were interviewed just before and just after 9/11 and find a significant and sharp increase in the symptoms of depression. We also provide evidence that this increase is not a September effect, but an effect of the external traumatic event. PMID:22959863

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

    Parker Eleanor J


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

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

    Tonmyr, L


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

  4. Experimental evidence for sex-specific plasticity in adult brain

    Herczeg, Gábor; Gonda, Abigél; Balázs, Gergely; Noreikiene, Kristina; Merilä, Juha


    Background Plasticity in brain size and the size of different brain regions during early ontogeny is known from many vertebrate taxa, but less is known about plasticity in the brains of adults. In contrast to mammals and birds, most parts of a fish’s brain continue to undergo neurogenesis throughout adulthood, making lifelong plasticity in brain size possible. We tested whether maturing adult three-spined sticklebacks (Gasterosteus aculeatus) reared in a stimulus-poor environment exhibited br...

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

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


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

  6. Intimate Partner Violence Among Hong Kong Young Adults: Prevalence, Risk Factors, and Associated Health Problems.

    Zhang, Huiping; Wong, William C W; Ip, Patrick; Fan, Susan; Yip, Paul S F


    Intimate partner violence is a serious social problem and public health issue affecting the well-being of the young adults. However, there is very little epidemiological evidence on the incidence and associated health problems in contemporary Chinese society. Using a representative community sample of 1,223 young adults aged 18 to 27 years conducted by Hong Kong Family Planning Association in 2011, this study aimed to estimate the prevalence, risk factors, and possible health consequences of intimate partner violence among young adults in Hong Kong. It is found that the prevalence of lifetime and preceding 1-year intimate partner violence by former or current partners was 8.6% and 4.9% respectively. Male youths who were older were less likely to experience past-year intimate partner violence (odds ratio [OR] = 0.21, p violence (OR = 8.48, p violence (OR = 0.15, p violence (OR = 5.00, p violence (OR = 5.63, p male victims were more likely to be subjected to mental health problems and only female victims felt fear for the violent partner. PMID:25304670

  7. The Health Status and Unique Health Challenges or Rural Older Adults in California

    Durazo, Eva; Jones, Melissa; Wallace, Steven; Van Arsdale, Jessica; Aydin, May; Stewart, Connie


    Despite living in the countryside where open space is plentiful and there is often significant agricultural production, rural older adults have higher rates of overweight/obesity, physical inactivity and food insecurity than older adults living in suburban areas. All three conditions are risk factors for heart disease, diabetes and repeated falls. This policy brief examines the health of rural elders and, by contrast, their urban counterparts, and finds that both groups lmost one in five Cali...

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

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


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

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

    Shibata, Ai; Ishii, Kaori; Oka, Koichiro


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

  10. Population health metrics: crucial inputs to the development of evidence for health policy

    Salomon Joshua A; Gakidou Emmanuela; Ezzati Majid; Murray Christopher JL; Mathers Colin D; Stein Claudia


    Abstract Valid, reliable and comparable measures of the health states of individuals and of the health status of populations are critical components of the evidence base for health policy. We need to develop population health measurement strategies that coherently address the relationships between epidemiological measures (such as risk exposures, incidence, and mortality rates) and multi-domain measures of population health status, while ensuring validity and cross-population comparability. S...

  11. Pinnacle Health / Zynx Health / Siemens Medical Solutions A Study of Integration of Evidence Based Nursing Content

    Matter, Sheri; Brown, Cindy; Button, Patricia S.; Kennedy, Rosemary


    In 2005, Pinnacle Health System, Zynx Health, and Siemens Medical Solutions developed a partnership to conduct a study to explore the opportunities and challenges associated with the integration of evidence-based knowledge within the EHR with the goal of creating repeatable methodologies for integrating nursing knowledge within the EHR. The two-phase study involved access to referential evidence-based content, as well as integration of customized evidence-based plans of care within the docume...

  12. Preventive interventions addressing underage drinking: state of the evidence and steps toward public health impact.

    Spoth, Richard; Greenberg, Mark; Turrisi, Robert


    The epidemiological features of underage drinking and evidence of its social, health, and economic consequences suggest compelling reasons for the development and dissemination of effective preventive interventions. To clarify the nature and extent of the current evidence base on preventive interventions addressing underage drinking, a review of the literature was conducted through extensive searches of the research literature on outcome evaluations, existing reviews of this body of outcome research (N = 25), and summary reports of evidence on specific interventions. More than 400 interventions were identified and screened, and the evidence for 127 was reviewed. Criteria for the evaluation of evidence were established for intervention studies with alcohol-specific outcome measures for 3 developmental periods ( or = 20 years of age). Ultimately, 12 interventions met criteria for "most promising" evidence and 29 met criteria for "mixed or emerging" evidence. Conducting this review revealed clear advances in the number of evidence-based interventions available and the quality of outcome research; however, much work remains to achieve greater public health impact through evidence-based interventions. This work should consider (1) the great need for intervention research related to understudied developmental phases, intervention domains (eg, family, school, community, and media), and populations (eg, early tweens, late teens, young adults not attending college, and nonmajority populations); (2) the critical importance of addressing key issues in research design and methods (eg, limited longitudinal studies, replication studies, and dissemination research); and (3) the need for improved consistency in application of evidence and reporting standards. Finally, we recommend the application of emerging consumer-oriented and community-participatory models for intervention development and research, designed to increase the likelihood of "real-world" public health impact

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

    Boardman, Jason D.; Alexander, Kari B.


    This paper uses data from the National Longitudinal Study of Adolescent Health to examine the mental health of non-Hispanic black and white young adults in the US. We use latent growth curve modeling to characterize the typical stress trajectories experienced by black and white young adults spanning the bulk of their lives. We identify the following four stress trajectories: 1) relatively stress free; 2) stress peak at age 15 and a subsequent decline; 3) stress peak at age 17 and a subsequent...

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

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


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

  15. Causal Effect of Health on Labor Market Outcomes: Experimental Evidence

    Thomas, Duncan; Frankenberg, Elizabeth; Friedman, Jed; Habicht, Jean-Pierre; Hakimi, Mohammed; Ingwersen, Nicholas; Jaswadi; Jones, Nathan; McKelvey, Christopher; Pelto, Gretel; Sikoki, Bondan; Seeman, Teresa E.; Smith, James P.; Sumantri, Cecep; Suriastini, Wayan


    Iron deficiency is widespread throughout the developing world. We provide new evidence on the effect of iron deficiency on economic and social prosperity of older adults drawing on data from a random assignment treatment-control design intervention. The Work and Iron Status Evaluation is an on-going study following over 17,000 individuals in Central Java, Indonesia. Half the respondents receive a treatment of 120 mg of iron every week for a year; the controls receive a placebo. Compliance is ...

  16. A computerized program to educate adults about environmental health risks

    A computerized program called Environmental Risk Appraisal (ERA) has been developed to educate adults about environmental health risks and to motivate positive behavior change. A questionnaire addresses issues such as radon, environmental tobacco smoke, pesticides, lead, air and water pollution, and work-site risks. Responses are computer processed in seconds to produce an individualized computer printout containing a score, educational messages, and phone numbers to call for more information. A variety of audiences including environmental groups, worksites, women's organizations and health professionals were represented in this study of 269 participants. Many respondents indicated they were exposed to important environmental hazards and nearly 40 percent reported they had, or might have had, an environmental related illness at some time. Preliminary evaluation indicates the program is effective as an educational tool in raising awareness of environmental health risks

  17. Evidence-Based Assessment of Anxiety Disorders in Adults

    Antony, Martin M.; Rowa, Karen


    This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability,…

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

    Dionigi, Alberto; Canestrari, Carla


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

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

    Dionigi, Alberto; Canestrari, Carla


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

  20. Slow early growers have more muscle in relation to adult activity: Evidence from Cebu, Philippines

    Workman, Megan; McDade, Thomas W.; Adair, Linda S.; Kuzawa, Christopher W.


    Background/objectives Adult skeletal muscle mass (SMM) protects against type 2 diabetes but little is known about its developmental antecedents. We examined whether pace of early weight gain predicted adult SMM in a birth cohort from Cebu City, Philippines. Additionally, we examined whether increases in SMM associated with adult muscle-building exercise varied according to early growth. Subjects/methods Data came from 1472 participants of the Cebu Longitudinal Health and Nutrition Survey. Wei...

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

    Law, Catherine


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

  2. Elder Mistreatment and Health Status of Rural Older Adults.

    Chokkanathan, Srinivasan


    There is limited information on the nature of and health factors associated with elder mistreatment in rural areas. To address this gap in the literature, the current study described the nature of such mistreatment and investigated the association between different types of mistreatment and health factors among 897 randomly selected elderly persons in rural India. The results show that elder mistreatment was widely prevalent (21%). Furthermore, the higher frequency of and simultaneous occurrence of multiple types of mistreatment (83.4%) suggest that mistreatment was a continuous stressor. The presence of overall mistreatment was positively associated with depression symptoms and subjective health status. The higher levels of chronicity and multiple mistreatments further increased depression symptoms and lowered the health status of those who were mistreated. Although women, more than men, were more likely to experience mistreatment, chronic mistreatment, and multiple mistreatments, there were no significant gender differences in the mistreatment-health relationship. These findings suggest that older adults with depression symptoms and poor health should be screened for mistreatment. PMID:25381286

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

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


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

  4. Finding Qualitative Research Evidence for Health Technology Assessment.

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


    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. PMID:27117960

  5. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians

    Olusile, Adeyemi Oluniyi; Adeniyi, Abiola Adetokunbo; Orebanjo, Olufemi


    Background There is scarce information available on oral health service utilization patterns and common oral hygiene practices among adult Nigerians. We conducted the 2010–2011 national oral health survey before the introduction of the national oral health policy to determine the prevalence of oral health service utilization, patterns of oral hygiene practices, and self reported oral health status, among adults in various social classes, educational strata, ethnic groups and geopolitical zone...

  6. Memory for allergies and health foods: how younger and older adults strategically remember critical health information

    Middlebrooks, C. D.; McGillivray, S.; Murayama, Kou; Castel, A. D.


    Objectives. While older adults often display memory deficits, with practice they can sometimes selectively remember valuable information at the expense of less value information. We examined age-related differences and similarities in memory for health-related information under conditions where some information was critical to remember. Method. In Experiment 1, participants studied three lists of allergens, ranging in severity from 0 (not a health risk) to 10 (potentially fatal), with the...

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

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


    Osteoporosis is a major health problem in the elderly. Epidemiological evidence has shown an association between tea consumption and the prevention of bone loss in the elderly population. Ingestion of green tea and green tea bioactive compounds may be beneficial in mitigating bone loss of this population and decreasing their risk of osteoporotic fractures. This review describes the effect of green tea with its bioactive components on bone health with an emphasis on the following: (i) the etio...

  8. Psychiatric stigma in treatment seeking adults with personality problems: evidence from a sample of 214 patients.

    Kirsten eCatthoor


    Full Text Available Stigmatization is a major hindrance in adult psychiatric patients with Axis-I diagnoses, as shown consistently in most studies. Significantly fewer studies on the emergence of psychiatric stigma in adult patients with personality disorders exist, although the resulting evidence is conclusive. Some authors consider patients with personality disorders at risk for severe stigmatization because of intense difficulties during interpersonal contact, even in a psychotherapeutic relationship. The aim of this study was primarily the assessment of pre-existing stigma in patients referred for intensive treatment for personality disorders. The study enrolled 214 patients admitted to the adult department of a highly specialized mental health care institute offering psychotherapy for patients with severe and complex personality pathology. All patients underwent a standard assessment with self-report questionnaires and a semi-structured interview to measure Axis II personality disorders. The Stigma Consciousness Questionnaire (SCQ and the Perceived Devaluation-Discrimination Questionnaire (DDQ, both validated instruments, were used to measure perceived and actual experiences of stigma. Independent sample t-tests were used to investigate differences in the mean total stigma scores for patients both with and without a personality disorder. One-way ANOVA’s were performed to assess the differences between having a borderline personality disorder, another personality disorder, or no personality disorder diagnosis.Multiple regression main effect analyses were conducted in order to explore the impact of the different personality disorder diagnosis on the level of stigma. The mean scores across all patient groups were consistent with rather low stigma. No differences were found for patients with or without a personality disorder diagnosis. Level of stigma in general was not associated with an accumulating number of personality disorders.

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

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


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at To obtain contact hours you must: 1. Read the article, "Familism and Health Care Provision to Hispanic Older Adults" found on pages 21-29, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until December 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Explain familism and its potential effect on health care provision to Hispanic older adults. 2. Describe cultural

  10. Health effects of protein intake in healthy adults: a systematic literature review

    Agnes N. Pedersen; Kondrup, Jens; Børsheim, Elisabet


    The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy adults. The literature search covered the years 2000–2011. Prospective cohort, case-control, and intervention studies were included. Out of a total of 5,718 abstracts, 412 full papers were identified as potentially relevant, and after careful scrutiny, 64 papers were quality graded as A (highest), B, or C. The grade of ...

  11. Reduction of referral to assessment time for an older adults community mental health team

    Sin Fai Lam, Chun Chiang


    Anecdotal evidence suggested that waiting times within the older adults community mental health team (OA CMHT) had been increasing over time. An assessment and evaluation was indicated to ensure best quality care was provided for patients. A comparison was made between waiting times in January to December 2011 compared with August 2013 to July 2014. In 2011 the mean number of days until initial assessment from the point of referral was 12 days for routine cases, and 3.6 days for urgent cases....

  12. Evidence of Uncultivated Bacteria in the Adult Female Bladder

    Wolfe, Alan J.; Toh, Evelyn; Shibata, Noriko; Rong, Ruichen; Kenton, Kimberly; FitzGerald, MaryPat; Mueller, Elizabeth R.; Schreckenberger, Paul; Dong, Qunfeng; Nelson, David E; Brubaker, Linda


    Clinical urine specimens are usually considered to be sterile when they do not yield uropathogens using standard clinical cultivation procedures. Our aim was to test if the adult female bladder might contain bacteria that are not identified by these routine procedures. An additional aim was to identify and recommend the appropriate urine collection method for the study of bacterial communities in the female bladder. Consenting participants who were free of known urinary tract infection provid...

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

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


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

  14. [Glocalization: the outlook for Taiwan evidence based health care].

    Chen, Chiehfeng


    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality. PMID:25464951

  15. Social determinants of health information seeking among Chinese adults in Hong Kong.

    Man Ping Wang

    Full Text Available BACKGROUND: Health communication inequalities were observed in Western population but less is known about them among the Chinese. We investigated health information seeking behaviours and its social determinants among Chinese adults in Hong Kong. METHODS: Probability-based sample surveys over telephone were conducted in 2009, 2010/11 and 2012 to monitor family health and information use. Frequency of health information seeking from television, radio, newspapers/magazines and Internet were recorded and dichotomised as ≥1 time/month and <1 time/month (reference. Logistic regression was used to yield adjusted odds ratios (aOR of health information seeking for different demographic characteristics, socioeconomic status (education, employment and income, chronic disease and behaviours (smoking, drinking and physical activity. RESULTS: Among 4553 subjects in all surveys, most (85.1% had sought health information monthly from newspapers/magazines (66.2%, television (61.4%, radio (35.6% or Internet (33.2%. Overall, being male, lower education attainment, lower household income, ever-smoking and physical inactivity were associated with less frequent health information seeking (all P <0.05. Compared with younger people, older people were less likely to search health information from Internet but more like to obtain it from radio (both P for trend <0.001. Having chronic diseases was associated with frequent health information seeking from television (aOR  =  1.25, 95% CI: 1.07-1.47 and Internet (aOR  =  1.46, 95% CI: 1.24-1.73. CONCLUSIONS: This study has provided the first evidence on health information inequalities from a non-Western population with advanced mass media and Internet penetration. Socioeconomic inequalities and behavioural clustering of health information seeking suggested more resources are needed for improving health communication in disadvantage groups.

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

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


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

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

    Chih-Hsiang Yang


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

  18. Translating evidence into practice: the role of health research funders

    Holmes Bev


    Full Text Available Abstract Background A growing body of work on knowledge translation (KT reveals significant gaps between what is known to improve health, and what is done to improve health. The literature and practice also suggest that KT has the potential to narrow those gaps, leading to more evidence-informed healthcare. In response, Canadian health research funders and agencies have made KT a priority. This article describes how one funding agency determined its KT role and in the process developed a model that other agencies could use when considering KT programs. Discussion While ‘excellence’ is an important criterion by which to evaluate and fund health research, it alone does not ensure relevance to societal health priorities. There is increased demand for return on investments in health research in the form of societal and health system benefits. Canadian health research funding agencies are responding to these demands by emphasizing relevance as a funding criterion and supporting researchers and research users to use the evidence generated. Based on recommendations from the literature, an environmental scan, broad circulation of an iterative discussion paper, and an expert working group process, our agency developed a plan to maximize our role in KT. Key to the process was development of a model comprising five key functional areas that together create the conditions for effective KT: advancing KT science; building KT capacity; managing KT projects; funding KT activities; and advocating for KT. Observations made during the planning process of relevance to the KT enterprise are: the importance of delineating KT and communications, and information and knowledge; determining responsibility for KT; supporting implementation and evaluation; and promoting the message that both research and KT take time to realize results. Summary Challenges exist in fulfilling expectations that research evidence results in beneficial impacts for society. However, health

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


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

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

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


    Making evidence-informed decisions with the aim of improving the health of individuals or populations can be facilitated by using a systematic approach. While a number of algorithms already exist, and while there is no single 'right' way of summarizing or ordering the various elements that should be involved in making such health-related decisions, an algorithm is presented here that lays out many of the key issues that should be considered, and which adds a special emphasis on balancing the values of individual patients and entire populations, as well as the importance of incorporating contextual considerations. Indeed many different types of evidence and value judgements are needed during the decision-making process to answer a wide range of questions, including (1) What is the priority health problem? (2) What causes this health problem? (3) What are the different strategies or interventions that can be used to address this health problem? (4) Which of these options, as compared to the status quo, has an added benefit that outweighs the harms? (5) Which options would be acceptable to the individuals or populations involved? (6) What are the costs and opportunity costs? (7) Would these options be feasible and sustainable in this specific context? (8) What are the ethical, legal and social implications of choosing one option over another? (9) What do different stakeholders stand to gain or lose from each option? and (10) Taking into account the multiple perspectives and considerations involved, which option is most likely to improve health while minimizing harms? This third and final article in the 'Evidence for Health' series will go through each of the steps in the algorithm in greater detail to promote more evidence-informed decisions that aim to improve health and reduce inequities. PMID:26976393

  1. Childhood circumstances and adult outcomes: Evidence from World War II

    Enkelejda Havari; Franco Peracchi


    This paper studies the effects of episodes of stress, poor health, financial hardship and hunger earlier in life on education and health in later life. As a source of identification, we exploit the huge temporal and regional variation of war-related events in Europe during the period from the beginning of the Spanish Civil War in 1936 to the end of World War II in 1945. We focus on the cohorts born between 1930 and 1954 in 13 European countries, and combine the available historical informatio...

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

    Font, Sarah A; Maguire-Jack, Kathryn


    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact. PMID:26059537

  3. Elder Mistreatment and Physical Health among Older Adults: The South Carolina Elder Mistreatment Study

    Cisler, Josh M.; Amstadter, Ananda B.; Begle, Angela M.; Hernandez, Melba; Acierno, Ron


    Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among older adults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among older adults residing in South Carolina. 902 older adults aged 60 and above participated in a structured interview assessin...

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

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

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

    Hester, Eva Jackson


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

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

    Bozzoli, Carlos G


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

  7. Incorporating health literacy in education for socially disadvantaged adults: an Australian feasibility study

    Muscat, Danielle M.; Smith, Sian; Dhillon, Haryana M; Morony, Suzanne; Davis, Esther L.; Luxford, Karen; Shepherd, Heather L; Hayen, Andrew; Comings, John; Nutbeam, Don; McCaffery, Kirsten


    Background Adult education institutions have been identified as potential settings to improve health literacy and address the health inequalities that stem from limited health literacy. However, few health literacy interventions have been tested in this setting. Methods Feasibility study for an RCT of the UK Skilled for Health Program adapted for implementation in Australian adult education settings. Implementation at two sites with mixed methods evaluation to examine feasibility, test for ch...

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

    Wei, Mi-Hsiu


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

  9. Angry facial expressions bias gender categorization in children and adults: behavioral and computational evidence

    Bayet, Laurie; Pascalis, Olivier; Quinn, Paul C.; Lee, Kang; Gentaz, Édouard; Tanaka, James W.


    International audience Angry facial expressions bias gender categorization in children and adults: behavioral and computational evidence Angry faces are perceived as more masculine by adults. However, the developmental course and underlying mechanism (bottom-up stimulus driven or top-down belief driven) associated with the angry-male bias remain unclear. Here we report that anger biases face gender categorization toward " male " responding in children as young as 5–6 years. The bias is obs...

  10. Comparing Information Needs of Health Care Providers and Older Adults: Findings from a Wellness Study

    Reeder, Blaine; Le, Thai; Thompson, Hilaire J.; Demiris, George


    Consumer health informatics technologies have the potential to enhance shared decision-making and communication between older adults, health care providers, and other stakeholders. The objective of this study was to characterize the information needs of these stakeholders to inform the design of informatics tools that support wellness in older adults. We conducted four focus groups with 31 older adults and three focus groups with 10 health care providers to explore information needs, goals, a...

  11. Improving the Neighborhood Environment for Urban Older Adults: Social Context and Self-Rated Health

    Arlesia Mathis; Ronica Rooks; Daniel Kruger


    Objective: By 2030, older adults will account for 20% of the U.S. population. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. Methods: We selected 217 individuals aged 65+ living in a deindustrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and self-rated health (SRH) was analyzed using r...

  12. The physical health of British adults with intellectual disability: cross sectional study

    Emerson, Eric; Hatton, Chris; Baines, Susannah; Robertson, Janet


    Background Adults with intellectual disability have poorer health than their non-disabled peers. However, little is known about the health of the ‘hidden majority’ of adults with primarily mild intellectual disability who do not use intellectual disability services. The aims of the present study were: to estimate the physical health status of a population-based sample of British adults with and without mild intellectual disability while controlling for any potentially confounding effects resu...

  13. Internet Usage by Low-Literacy Adults Seeking Health Information: An Observational Analysis

    Birru, Mehret S; Monaco, Valerie M; Charles, Lonelyss; Drew, Hadiya; Njie, Valerie; Bierria, Timothy; Detlefsen, Ellen; Steinman, Richard A


    Background Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. Objective The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. Meth...

  14. Employment precariousness and poor mental health: evidence from Spain on a new social determinant of health

    Alejandra Vives; Marcelo Amable; Montserrat Ferrer; Salvador Moncada; Clara Llorens; Carles Muntaner; Benavides, Fernando G.; Joan Benach


    Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health w...

  15. The Effects of Childhood, Adult, and Community Socioeconomic Conditions on Health and Mortality among Older Adults in China

    Wen, Ming; Gu, Danan


    Using a large, nationally representative longitudinal sample of Chinese aged 65 and older, this study examines the effects of childhood, adult, and community socioeconomic conditions on mortality and several major health outcomes. The role of social mobility is also tested. We find that childhood socioeconomic conditions exert long-term effects on functional limitations, cognitive impairment, self-rated health, and mortality independent of adult and community socioeconomic conditions. Achieve...

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

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


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

  17. A New Evaluation Tool to Obtain Practice-Based Evidence of Worksite Health Promotion Programs

    Diane O. Dunet, PhD


    Full Text Available IntroductionThe Centers for Disease Control and Prevention developed the Swift Worksite Assessment and Translation (SWAT evaluation method to identify promising practices in worksite health promotion programs. The new method complements research studies and evaluation studies of evidence-based practices that promote healthy weight in working adults.MethodsWe used nationally recognized program evaluation standards of utility, feasibility, accuracy, and propriety as the foundation for our 5-step method: 1 site identification and selection, 2 site visit, 3 post-visit evaluation of promising practices, 4 evaluation capacity building, and 5 translation and dissemination. An independent, outside evaluation team conducted process and summative evaluations of SWAT to determine its efficacy in providing accurate, useful information and its compliance with evaluation standards.ResultsThe SWAT evaluation approach is feasible in small and medium-sized workplace settings. The independent evaluation team judged SWAT favorably as an evaluation method, noting among its strengths its systematic and detailed procedures and service orientation. Experts in worksite health promotion evaluation concluded that the data obtained by using this evaluation method were sufficient to allow them to make judgments about promising practices.ConclusionSWAT is a useful, business-friendly approach to systematic, yet rapid, evaluation that comports with program evaluation standards. The method provides a new tool to obtain practice-based evidence of worksite health promotion programs that help prevent obesity and, more broadly, may advance public health goals for chronic disease prevention and health promotion.

  18. Evidence of Adverse Selection in Iranian Supplementary Health Insurance Market

    Gh Mahdavi


    Full Text Available Background: Existence or non-existence of adverse selection in insurance market is one of the important cases that have always been considered by insurers. Adverse selection is one of the consequences of asymmetric information. Theory of adverse selection states that high-risk individuals demand the insurance service more than low risk individuals do.Methods: The presence of adverse selection in Irans supplementary health insurance market is tested in this paper. The study group consists of 420 practitioner individuals aged 20 to 59. We estimate two logistic regression models in order to determine the effect of individual's characteristics on decision to purchase health insurance coverage and loss occurrence. Using the correlation between claim occurrence and decision to purchase health insurance, the adverse selection problem in Iranian supplementary health insurance market is examined.Results: Individuals with higher level of education and income level purchase less supplementary health insurance and make fewer claims than others make and there is positive correlation between claim occurrence and decision to purchase supplementary health insurance.Conclusion: Our findings prove the evidence of the presence of adverse selection in Iranian supplementary health insurance market.

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

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


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

  20. The relationship between health, education, and health literacy: results from the Dutch adult literacy and life skills survey.

    Heide, I. van der; J. Wang(Institute of High Energy Physics, Chinese Academy of Sciences, Beijing); Droomers, M.; Spreeuwenberg, P.; Rademakers, J.; Uiters, E.


    Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by which level of education affects health status. Health literacy was measured by the Health Activities and Literacy Scale, using data from a subsample of 5,136 adults between the ages of 25 and 65 year...

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

    Heide, I. van der; Wang, J.; Droomers, M.; Spreeuwenberg, P; Rademakers, J.; Uiters, E.


    Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by which level of education affects health status. Health literacy was measured by the Health Activities and Literacy Scale, using data from a subsample of 5,136 adults between the ages of 25 and 65 year...

  2. Exercise and Sleep in Community-Dwelling Older Adults: Evidence for a Reciprocal Relationship

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


    Exercise behavior and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into the later life. The current investigation examined both the chronic and acute relationships between exercise behavior and self-reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy-nine community-dwelling, initially sedentary, older adults (Mean age = 63.58, SD = 8.66 years) completed da...

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

    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

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

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


    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 ( and WHO’s archive using the National Data Archive application ( PMID:23283715

  5. Dental health education: training of homecarers of mentally handicapped adults.

    Davies, K W; Whittle, J G


    A seven week induction course for homecarers of mentally handicapped adults, organised by the Social Services Department in Salford, UK, includes a dental health education session of one and a half hours. The session is divided into three parts; an illustrated discussion, a demonstration of tooth-brushing and a practical component session where carers are divided into pairs and carry out oral hygiene measures for each other. The effectiveness of the session has been assessed using a questionnaire. This was completed by 33 carers who attended the session and 31 carers who had not. Many members of both groups knew about the shape and colour of healthy gums and what plaque was. However significantly fewer of the control group knew that gum disease resulted from a lack of toothbrushing, what to do with bleeding gums and the amount of toothpaste to use on the toothbrush. PMID:2379095

  6. Women's childhood and adult adverse experiences, mental health, and binge drinking: The California Women's Health Survey

    Pavao Joanne


    Full Text Available Abstract Background This study examined sociodemographic, physical and mental health, and adult and childhood adverse experiences associated with binge drinking in a representative sample of women in the State of California. Materials and methods Data were from the 2003 to 2004 (response rates of 72% and 74%, respectively California Women's Health Survey (CWHS, a population-based, random-digit-dial annual probability survey sponsored by the California Department of Health Services. The sample was 6,942 women aged 18 years or older. Results The prevalence of binge drinking was 9.3%. Poor physical health, and poorer mental health (i.e., symptoms of PTSD, anxiety, and depression, feeling overwhelmed by stress, were associated with binge drinking when demographics were controlled, as were adverse experiences in adulthood (intimate partner violence, having been physically or sexually assaulted, or having experienced the death of someone close and in childhood (living with someone abusing substances or mentally ill, or with a mother vicimized by violence, or having been physically or sexually assaulted. When adult mental health and adverse experiences were also controlled, having lived as a child with someone who abused substances or was mentally ill was associated with binge drinking. Associations between childhood adverse experiences and binge drinking could not be explained by women's poorer mental health status in adulthood. Conclusion Identifying characteristics of women who engage in binge drinking is a key step in prevention and intervention efforts. Binge drinking programs should consider comprehensive approaches that address women's mental health symptoms as well as circumstances in the childhood home.

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

    Krenzelok, Edward P; Royal, Mike A


    Acetaminophen (paracetamol) plays a vital role in American health care, with in excess of 25 billion doses being used annually as a nonprescription medication. Over 200 million acetaminophen-containing prescriptions, usually in combination with an opioid, are dispensed annually. While acetaminophen is recognized as a safe and effective analgesic and antipyretic, it is also associated with significant morbidity and mortality (hepatotoxicity) if doses in excess of the therapeutic amount are ingested inappropriately. The maximum daily therapeutic dose of 3900-4000 mg was established in separate actions in 1977 and 1988, respectively, via the Food and Drug Administration (FDA) monograph process for nonprescription medications. The FDA has conducted multiple advisory committee meetings to evaluate acetaminophen and its safety profile, and has suggested (but not mandated) a reduction in the maximum daily dosage from 3900-4000 mg to 3000-3250 mg. In 2011, McNeil, the producer of the Tylenol® brand of acetaminophen, voluntarily reduced the maximum daily dose of its 500 mg tablet product to 3000 mg/day, and it has pledged to change the labeling of its 325 mg/tablet product to reflect a maximum of 3250 mg/day. Generic manufacturers have not changed their dosing regimens and they have remained consistent with the established monograph dose. Therefore, confusion will be inevitable as both consumers and health care professionals try to determine the proper therapeutic dose of acetaminophen. Which is the correct dose of acetaminophen: 3000 mg if 500 mg tablets are used, 3250 mg with 325 mg tablets, or 3900 mg when 650 mg arthritis-strength products are used? PMID:22530736

  8. Population health metrics: crucial inputs to the development of evidence for health policy

    Salomon Joshua A


    Full Text Available Abstract Valid, reliable and comparable measures of the health states of individuals and of the health status of populations are critical components of the evidence base for health policy. We need to develop population health measurement strategies that coherently address the relationships between epidemiological measures (such as risk exposures, incidence, and mortality rates and multi-domain measures of population health status, while ensuring validity and cross-population comparability. Studies reporting on descriptive epidemiology of major diseases, injuries and risk factors, and on the measurement of health at the population level – either for monitoring trends in health levels or inequalities or for measuring broad outcomes of health systems and social interventions – are not well-represented in traditional epidemiology journals, which tend to concentrate on causal studies and on quasi-experimental design. In particular, key methodological issues relating to the clear conceptualisation of, and the validity and comparability of measures of population health are currently not addressed coherently by any discipline, and cross-disciplinary debate is fragmented and often conducted in mutually incomprehensible language or paradigms. Population health measurement potentially bridges a range of currently disjoint fields of inquiry relating to health: biology, demography, epidemiology, health economics, and broader social science disciplines relevant to assessment of health determinants, health state valuations and health inequalities. This new journal will focus on the importance of a population based approach to measurement as a way to characterize the complexity of people's health, the diseases and risks that affect it, its distribution, and its valuation, and will attempt to provide a forum for innovative work and debate that bridge the many fields of inquiry relevant to population health in order to contribute to the development of valid

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

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

  10. Evidence-based uncertainty in mental health nursing.

    Franks, V


    The drive towards evidence-based practice is part of a modern reflective and caring service. However there is a paradox at the heart of the notion of evidence-based care. In order to perform any systemized examination of treatment there has to be a conscious acknowledgement of uncertainty about that treatment. This is uncomfortable and when research does find evidence in favour of a treatment, there is a relief and a return to conviction about what is the best. The paradox is that it seems the most valued research practices are predicated on generalizations about patient treatments and categories. However, nursing care is based on the notion of the uniqueness of the patient and the nurse-patient relationship. Sometimes it is necessary to address the particular and not to rush to generalizations and certainty. The psychoanalytic framework promotes a capacity to tolerate uncertainty and provides a model for understanding conflicting feelings, which can occur within the nurse-patient relationship. The author proposes the psychoanalytic observational method as an adjunct to other research methods. This method places certain kinds of evidence within the rubric of evidence-based nursing practice. The evidence collected in this method is the evidence of the conscious and unconscious experience within the nurse-patient relationship. The author will describe and argue for the place of this research method within the canon of other more widely practised methods within mental health practice. She will propose that for safe practice it is necessary to value and examine the veracity of the feelings and tacit understanding of the nurse. She contends that the current climate of excessive bureaucracy and persecutory risk management is having a damaging effect on both the research process and effective nursing care. PMID:14723645

  11. Adult Reye-like syndrome associated with serologic evidence of acute parvovirus B19 infection

    Paulo Sérgio Gonçalves da Costa


    Full Text Available Reye's syndrome is an infrequently diagnosed medical condition affecting mainly children. The etiology, epidemiology and natural history of Reye's syndrome have been cloudily written in footnotes of medical books and exotic papers since the initial description in early 1950s. We report here a case of adult Reye's syndrome associated with serologic evidence of parvovirus B19 infection.

  12. Assessment of mercury health risks to adults from coal combustion

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.


    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  13. Health-related quality of life in adult survivors of childhood sarcoidosis

    Milman, Nils; Svendsen, Claus Bo; Hoffmann, Anne Lisbeth


    AIM: To describe health-related quality of life (hrQOL) in adult subjects who had sarcoidosis in childhood. METHODS: Forty-six children (24 boys), all ethnic Danes......AIM: To describe health-related quality of life (hrQOL) in adult subjects who had sarcoidosis in childhood. METHODS: Forty-six children (24 boys), all ethnic Danes...

  14. High Blood Pressure in Adults with Disabilities: Influence of Gender, Body Weight and Health Behaviors

    Lin, Lan-Ping; Liu, Chien-Ting; Liou, Shih-Wen; Hsu, Shang-Wei; Lin, Jin-Ding


    The aims of this study were to explore the mean and distribution of systolic and diastolic blood pressure, and to examine the influence of gender, body weight and health behaviors on hypertension in adults with disabilities. We analyzed the 2010 annual community health examination chart of adults with disabilities in east Taiwan. The study samples…

  15. Multigenerational Perceptions of Mental Health Services of Deaf Adults in Florida

    Feldman, David M.; Gum, Amber


    The objective of the study was to better understand the perceptions and needs of multigenerational Deaf adults related to mental health services. A survey sampled participants who were between 20 and 85 years old and Deaf. Questions were developed to identify the perspectives of Deaf adults related to the availability of mental health services,…

  16. Adult Basic Education and Health Literacy: Program Efforts and Perceived Student Needs

    Mackert, Michael; Poag, Meg


    Objective: This project examined health literacy efforts among adult basic education providers in Central Texas. Methods: A survey was conducted with all adult literacy providers in Central Texas (N = 58). Results: Most programs provide health-related information. Literacy programs see needs for helping students communicate with doctors, filling…

  17. Undergraduate Public Health Capstone Course: Teaching Evidence-Based Public Health

    Veronica Eileen Fitzpatrick


    Full Text Available The University at Albany School of Public Health has offered a bachelor of science in public health (BSPH degree for the past seven years. The final requirement of the BSPH degree is a capstone evidence-based public health class designed to cumulate the degree program. This capstone course is framed by identifying a public health problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course students achieved the necessary competencies and skills to identify a public health problem, analyze information from peer-reviewed literature and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys.

  18. Undergraduate Public Health Capstone Course: Teaching Evidence-Based Public Health.

    Fitzpatrick, Veronica Eileen; Mayer, Christen; Sherman, Barry R


    The University at Albany School of Public Health has offered a Bachelor of Science in Public Health (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based public health class designed to culminate the degree program. This capstone course is framed by identifying a public health problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a public health problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys. PMID:27148516

  19. Undergraduate Public Health Capstone Course: Teaching Evidence-Based Public Health

    Fitzpatrick, Veronica Eileen; Mayer, Christen; Sherman, Barry R.


    The University at Albany School of Public Health has offered a Bachelor of Science in Public Health (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based public health class designed to culminate the degree program. This capstone course is framed by identifying a public health problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a public health problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys. PMID:27148516

  20. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin


    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. PMID:24072881

  1. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    Ljunge, Martin


    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. PMID:27015612

  2. Reducing recidivism and symptoms in emerging adults with serious mental health conditions and justice system involvement.

    Davis, Maryann; Sheidow, Ashli J; McCart, Michael R


    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers. PMID:25023764

  3. ERP evidence for scarce rule representation in older adults following short, but not long preparatory intervals



    Full Text Available The focus of the present study was to examine the cognitive processes comprising advance preparation – rule representation, task-set updating and task-set reconfiguration - in young (20-25 years and older adults (61-83 years. Specifically, this study aimed at further characterizing age-related differences in advance preparation, and evaluating how additional time to prepare might reduce behavioral costs in older adults. In line with previous findings, RT mixing costs were slightly larger for older compared to young adults, whereas behavioral switch costs were age-invariant. Following short preparation (600 ms, smaller antero-frontal ERP correlates for rule representation were associated with pronounced congruency costs in older adults. Centro-parietal ERP correlates of task-set updating and task-set reconfiguration were not delayed, but smaller in magnitude for older compared to young adults. Longer preparation (1200 ms enabled older adults to re-activate relevant task rules, as evident in reduced congruency costs, and temporally sustained ERP correlates of task-set updating and rule representation well beyond 600 ms. Age-invariant switch costs appear related to additional, potentially compensatory frontal activity recruited by older adults to overcome difficulties in task-set reconfiguration.

  4. Age-related face processing bias in infancy: evidence of perceptual narrowing for adult faces.

    Macchi Cassia, Viola; Bulf, Hermann; Quadrelli, Ermanno; Proietti, Valentina


    Recent data demonstrate a perceptual processing advantage for adult faces in both adults and young children, suggesting that face representation is shaped by visual experience accumulated with different face-age groups. As for species and race, this age bias may emerge during the first year of life as part of the general process of perceptual narrowing, given the extensive amount of social and perceptual experience accumulated with caregivers and/or other adult individuals. Using infant-controlled habituation and visual-paired comparison at test, two experiments were carried out to examine 3- and 9-month-olds' ability to discriminate within adult and infant faces. Results showed that, when they are provided with adequate time to visually compare the stimuli during test trials (Experiment 2), 3-month-olds exhibit above-chance discrimination of adult and infant faces. Instead, 9-month-olds discriminate adult faces but not infant faces (Experiments 1 and 2). Results provide the first evidence of age-related face processing biases in infancy, and show that by 9 months face representations tune to adult human faces. PMID:24374735

  5. Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique.

    Anselmi, L; M Lagarde; Hanson, K.


    Low-income countries are plagued by a high burden of preventable and curable disease as well as unmet need for healthcare, but detailed microeconomic evidence on the relationship between supply-side factors and service use is limited. Causality has rarely been assessed due to the challenges posed by the endogeneity of health service supply.In this study, using data from Mozambique, we investigate the effect of healthcare service availability, measured as the type of health facilities and thei...

  6. A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks

    Jerome J. Schleier III


    Full Text Available Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin used for adult mosquito management to generate an overall estimate of risk quotient (RQ. The utility of the Bayesian inference for risk management is that the estimated risk represents a probability distribution from which the probability of exceeding a threshold can be estimated. The mean RQs after all studies were incorporated were 0.4386, with a variance of 0.0163 for malathion and 0.3281 with a variance of 0.0083 for permethrin. After taking into account all of the evidence available on the risks of ULV insecticides, the probability that malathion or permethrin would exceed a level of concern was less than 0.0001. Bayesian estimates can substantially improve decisions by allowing decision makers to estimate the probability that a risk will exceed a level of concern by considering seemingly disparate lines of evidence.

  7. Evidence-based Health Care via Multi-Criteria Decision Analytic decision

    Kjer Kaltoft, Mette; Dowie, Jack

    Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study......’Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study...

  8. Guiding Hypertensive Adult Patients : A Literature Review of Evidence- Based Nursing

    Afolabi, Joshua; Guo, Haochuan


    Abstract of Thesis LAPLAND UNIVERSITY OF APPLIED SCIENCES Health Care And Social Services Degree Programme in Nursing Bachelor’s Thesis________________________________________ Authors Guo Haochuan And Joshua Afolabi Year 2014 Advisors Mirja Anttila And Seppo Kilpiäinen Title Guiding Hypertensive Adult Patients Pages 47pages________________________________________ This thesis dealt with the guida...

  9. Correlates of health and financial literacy in older adults without dementia

    Bennett Jarred S; Boyle Patricia A; James Bryan D; Bennett David A


    Abstract Background Recent research has begun to recognize the important influence of literacy levels and how they affect health and wellbeing, especially in older adults. Our study focuses on health and financial literacy, two domains of literacy which previous research has suggested may be significantly related to health and wellbeing. Our study examines the relation of health and financial literacy with health promoting behaviors and health status among community-based older persons. Metho...

  10. The global stock of research evidence relevant to health systems policymaking

    Wilson, Michael G; Moat, Kaelan A; Lavis, John N


    Background: Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. Methods: We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) ( The research evidence types include evidence briefs fo...

  11. Poverty indicators and mental health functioning among adults living with HIV in Delhi, India.

    Kang, Ezer; Delzell, Darcie A P; McNamara, Paul E; Cuffey, Joel; Cherian, Anil; Matthew, Saira


    Poor mental health functioning among persons living with HIV (PLHIV) has gained considerable attention particularly in low-income countries that disproportionately carry the global HIV/AIDS burden. Fewer studies, however, have examined the relationship between poverty indicators and mental health among PHLIV in India. Based on this cross-sectional study of 196 HIV-seropositive adults who received medical services at Shalom AIDS Project in Delhi, India, structural equation modeling and mediation analysis were employed to estimate the associations between poverty indices (household asset index, food security, unemployment, water treatment, sanitation), HIV-health factors (illness in the past 3 months, co-morbid medical conditions), and psychological distress. In the final model, ownership of fewer household assets was associated with higher levels of food insecurity, which in turn was associated with higher psychological distress. Also, the household asset index, food insecurity, and unemployment had a larger effect on psychological distress than new opportunistic infections. These findings build on increasing evidence that support concerted efforts to design, evaluate, and refine HIV mental health interventions that are mainstreamed with livelihood programming in high poverty regions in India. PMID:26513366

  12. Uncomplicated Resistance Training and Health-Related Outcomes: Evidence for a Public Health Mandate

    Phillips, Stuart M.; Winett, Richard A.


    PHILLIPS, S.M. and R.A. WINETT. Uncomplicated Resistance Training and Health-Related Outcomes: Evidence for a Public Health Mandate. Curr. Sports Med. Rep., Vol. 9, No. 4, pp. 208–213, 2010. Compared to aerobic training (AT), resistance training (RT) has received far less attention as a prescription for general health. However, RT is as effective as AT in lowering risk for cardiovascular disease, diabetes, and other diseases. There is a clear ability of RT, in contrast to AT, to promote gains...

  13. Xanthophylls and eye health of infants and adults.

    Moukarzel, Adib A; Bejjani, Riad A; Fares, Florence N


    Lutein and zeaxanthin are the only carotenoids present in the eye. They cannot be synthesized de novo and are specifically concentrated in the macula. They appear to have at least two major functions: to filter out blue light and thus prevent ensuing damages to the eye and to act as antioxidants. Infants are particularly at risk from both blue light and oxidative damage to eye tissues. Lutein is present in human milk but is not currently added to infant formulas. Fortifying formulae with lutein in order to match more closely human milk might help protect the infant's sensitive eyes. In adults, the exact pathogenesis of age-related maculopathy remains unknown. Light damage, inflammation, and the disruption of cellular processes by oxidative stress may play an important role in the degenerative process. Manipulation of intake of xanthophylls has been shown to augment macular pigment, therefore it is thought that carotenoid dietary supplements could prevent, delay, or modify the course of age-related maculopathy. However, definite evidence of the effect of carotenoids, the optimal doses to use, and the supplementation duration are still under investigation. PMID:20027805

  14. Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health.

    Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Chatterji, Somnath


    This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum. PMID:26895999

  15. Participatory health system priority setting: Evidence from a budget experiment.

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa


    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. PMID:26517295

  16. Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

    Alejandra Vives


    Full Text Available Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent’s sex and age. Prevalence proportion ratios (PPRs of poor mental health across quintiles of employment precariousness (reference: 1st quintile were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31 for women and 2.23 (95% CI: 1.86–2.68 for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making.

  17. Adapting evidence-based, cognitive-behavioral interventions for anxiety for use with adults in integrated primary care settings.

    Shepardson, Robyn L; Funderburk, Jennifer S; Weisberg, Risa B


    Evidence-based treatments for adult patients with anxiety are greatly needed within primary care settings. Psychotherapy protocols, including those for cognitive-behavioral therapy (CBT), are often disorder-specific and were developed for specialty mental health settings, rendering them infeasible in primary care. Behavioral health consultants (BHCs) integrated into primary care settings are uniquely positioned to provide anxiety treatment. However, due to the dearth of empirically supported brief treatments for anxiety, BHCs are tasked with adapting existing treatments for use in primary care, which is quite challenging due to the abbreviated format and population-based approach to care. CBT protocols are highly effective in the treatment of anxiety and fit well with the self-management emphasis of integrated primary care. We review the rationale and procedure for 6 evidence-based CBT intervention techniques (psycho-education, mindfulness and acceptance-based behavioral techniques, relaxation training, exposure, cognitive restructuring, and behavioral activation) that can be adapted for use in the brief format typical of integrated primary care. We offer tips based on our clinical experience, highlight resources (e.g., handouts, websites, apps), and discuss 2 case examples to aid BHCs in their everyday practice. Our goal is to provide BHCs with practical knowledge that will facilitate the use of evidence-based interventions to improve the treatment of anxiety in primary care settings. (PsycINFO Database Record PMID:27064434

  18. Health risks and benefits from UVR exposure: perceptions and evidence

    . While there is a perception of widespread vitamin D deficiency in Australia, it is not clear that this is accurate, due to high variability between assays, and failure to examine the findings in a representative population sample. This presentation will review and evaluate the evidence for the health risks and benefits of UVR exposure, discuss the evidence relating to the perception of the relative risks of too much or too little sun exposure and consider the future implications for health of changing sun exposure behaviour.

  19. Self-harm in trafficked adults accessing secondary mental health services in England

    Borschmann, Rohan; Oram, Sian; Howard, Louise Michele; Kinner, Stuart; Dutta, Rina; Zimmerman, Cathy


    Objective: This study estimated the prevalence, correlates and mental health service responses to self-harm among trafficked adults accessing secondary mental health services in England. Methods: A clinical records database was searched to identify trafficked adults who accessed secondary mental health services in South London from 2006-2012. A matched cohort of non-trafficked patients was selected. Data were extracted on self-harm, socio-demographic, clinical and service use characteristics....

  20. Understanding the Health Literacy of America Results of the National Assessment of Adult Literacy

    Cutilli, Carolyn Crane; Bennett, Ian M.


    Health literacy refers to an individual’s ability to understand healthcare information to make appropriate decisions (S. C Ratzen & R. M. Parker, 2000). Healthcare professionals are obligated to make sure that patients understand information to maximize the benefits of healthcare. The National Assessment of Adult Literacy (NAAL) provides information on the literacy/health literacy levels of the U.S. adult population. The NAAL is the only large-scale survey of health literacy. The results of t...

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

    Ljunge, Martin


    This paper presents evidence that generalized trust promotes health. Children of immigrants in a broad set of European countries with ancestry from across the world are studied. Individuals are examined within country of residence using variation in trust across countries of ancestry. The approach addresses reverse causality and concerns that the trust measure picks up institutional factors in the individual's contextual setting. There is a significant positive estimate of ancestral trust in explaining self-assessed health. The finding is robust to accounting for individual, parental, and extensive ancestral country characteristics. Individuals with higher ancestral trust are also less likely to be hampered by health problems in their daily life, providing evidence of trust influencing real life outcomes. Individuals with high trust feel and act healthier, enabling a more productive life. PMID:25464341

  2. Identifying Family History and Substance Use Associations for Adult Epilepsy from the Electronic Health Record.

    Wang, Yan; Chen, Elizabeth S; Leppik, Ilo; Pakhomov, Serguei; Sarkar, Indra Neil; Melton, Genevieve B


    Epilepsy is a prevalent chronic neurological disorder afflicting about 50 million people worldwide. There is evidence of a strong relationship between familial risk factors and epilepsy, as well as associations with substance use. The goal of this study was to explore the interactions between familial risk factors and substance use based on structured data from the family and social history modules of an electronic health record system for adult epilepsy patients. A total of 8,957patients with 38,802 family history entries and 8,822 substance use entries were gathered and mined for associations at different levels of granularity for three age groupings (>18, 18-64, and ≥65 years old). Our results demonstrate the value of an association rule mining approach to validate knowledge of familial risk factors. The preliminary findings also suggest that substance use does not demonstrate significant association between social and familial risk factors for epilepsy. PMID:27570679

  3. e-Health technologies for adult hearing screening

    S. Stenfelt


    Full Text Available The development of hearing diagnosis methods and hearing screening methods are not isolated phenomena: they are intimately related to changes in the cultural background and to advances in fields of medicine and engineering. In the recent years, there has been a rapid evolution in the development of fast, easy and reliable techniques for lowcost hearing screening initiatives. Since adults and elderly people typically experience a reduced hearing ability in challenging listening situations [e.g., in background noise, in reverberation, or with competing speech (Pichora‑Fuller & Souza, 2003], these newly developed screening tests mainly rely on the recognition of speech stimuli in noise, so that the real experienced listening difficulties can be effectively targeted (Killion & Niquette, 2000. New tests based on the recognition of speech in noise are being developed on portable, battery- operated devices (see, for example, Paglialonga et al., 2011, or distributed diffusely using information and communication technologies. The evolutions of e-Health and telemedicine have shifted focus from patients coming to the hearing clinic for hearing health evaluation towards the possibility of evaluating the hearing status remotely at home. So far, two ways of distributing the hearing test have primarily been used: ordinary telephone networks (excluding mobile networks and the internet. When using the telephone network for hearing screening, the predominantly test is a speech-in-noise test often referred to as the digit triplet test where the subjects hearing status is evaluated as the speech-to-noise threshold for spoken digits. This test is today available in some ten countries in Europe, North America and Australia. The use of internet as testing platform allows several different types of hearing assessment tests such as questionnaires, different types of speech in noise tests, temporal gap detection, sound localization (minimum audible angle, and spectral

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

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


    Child maltreatment impacts approximately two million children each year, with physical abuse and neglect the most common form of maltreatment. These children are at risk for mental and physical health concerns and the ability to form positive social relationships is also adversely affected. Child Adult Relationship Enhancement (CARE) is a set of skills designed to improve interactions of any adult and child or adolescent. Based on parent training programs, including the strong evidence-based treatment, Parent-Child Interaction Therapy (PCIT), CARE was initially developed to fill an important gap in mental health services for children of any age who are considered at-risk for maltreatment or other problems. CARE subsequently has been extended for use by adults who interact with children and youth outside of existing mental health therapeutic services as well as to compliment other services the child or adolescent may be receiving. Developed through discussions with Parent-Child Interaction Therapy (PCIT) therapists and requests for a training similar to PCIT for the non-mental health professional, CARE is not therapy, but is comprised of a set of skills that can support other services provided to families. Since 2006, over 2000 caregivers, mental health, child welfare, educators, and other professionals have received CARE training with a focus on children who are exposed to trauma and maltreatment. This article presents implementation successes and challenges of a trauma-informed training designed to help adults connect and enhance their relationships with children considered at-risk. PMID:26613674

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

    Gunvi Johansson


    Full Text Available The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL. The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21–29 years, were interviewed. The findings from the interviews were summarized under the theme “Young adults reflected on their OHRQoL in a time perspective” consisting of three categories: “Past experiences, Present situation, and Future prospects.” The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up.

  6. Prevalence of anemia and associated factors in older adults: evidence from the SABE Study

    Ligiana Pires Corona; Yeda Aparecida de Oliveira Duarte; Maria Lucia Lebrão


    OBJECTIVE To assess the prevalence of anemia and associated factors in older adults. METHODS The prevalence and factors associated with anemia in older adults were studied on the basis of the results of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Welfare and Aging) study. A group of 1,256 individuals were interviewed during the third wave of the SABE study performed in Sao Paulo, SP, in 2010. The study included 60.4% females; the mean age of the participants was 70.4 years, and ...

  7. Ultrastructural Evidence of Exosome Secretion by Progenitor Cells in Adult Mouse Myocardium and Adult Human Cardiospheres

    Lucio Barile


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

  8. Stomach cancer screening in the adult health study population

    Examinations for parietal cell antibody (PCA) were performed on 1334 subjects of the Adult Health Study (AHS), Hiroshima, during a 1-year period. Findings revealed PCA in 112 subjects (8.4%), but no difference in frequency was noted by sex. The relationship of PCA to age showed the positive rate to be significantly higher in those age 50 or over than in those under 50. No correlation was noted between estimated A-bomb exposure dose and PCA frequency. PCA was found in 58 (11.6%) of the 502 cases presenting achlorhydria on tubeless gastric analysis, and particularly in the age 50 and over group, PCA was demonstrated in 43 (14.2%) of the 302 subjects presenting achlorhydria, which is a significant difference compared with the under 50 age group in which PCA was demonstrated in 15 (7.5%) of 200 such subjects. PCA was detected in 11 (7.2%) of 152 subjects with abnormal, or low, serum pepsinogen levels and in 20 (16.3%) of 123 subjects with high levels. The frequency of positive PCA was higher in patients diagnosed on upper gastrointestinal (GI) series as atrophic gastritis than in patients diagnosed as some other gastric disorder. PCA was negative in both of the two cases in whom a definite diagnosis of stomach cancer was established. However, in light of the finding of abnormal Diagnex Blue (DB) tests and positive PCA at a high frequency in the gastritis group and reports that gastritis provides the groundwork for stomach cancer, it is considered that care should be taken in cases with findings of abnormal DB test, abnormal serum pepsinogen levels, and positive PCA. (author)

  9. Self-Regulation, Self-Efficacy and Health Behavior Change in Older Adults.

    Purdie, Nola; McCrindle, Andrea


    Presents an overview of self-regulation models: theory of planned behavior, protection motivation theory, health belief model, action control theory, transtheoretical model of behavior change, health action process, and precaution adoption process. Applies models to health behavior change in older adults with cardiovascular disease or diabetes.…

  10. Electrophysiological evidence for abnormal preparatory states and inhibitory processing in adult ADHD

    Brandeis Daniel


    Full Text Available Abstract Background Attention deficit hyperactivity disorder (ADHD is a common neurodevelopmental disorder that starts in childhood and frequently persists in adults. Several theories postulate deficits in ADHD that have effects across many executive functions or in more narrowly defined aspects, such as response inhibition. Electrophysiological studies on children, however, indicate that ADHD is not associated with a core deficit of response inhibition, as abnormal inhibitory processing is typically preceded or accompanied by other processing deficits. It is not yet known if this pattern of abnormal processing is evident in adult ADHD. Methods The objective of this paper was to investigate event-related potential indices of preparatory states and subsequent response inhibition processing in adults with ADHD. Two cued continuous performance tasks were presented to 21 adults meeting current criteria for adult ADHD and combined type ADHD in childhood, and 20 controls. Results The ADHD group exhibited significantly weaker orienting attention to cues, cognitive preparation processes and inhibitory processing. In addition, we observed a strong correlation between the resources allocated to orienting to cues and the strength of the subsequent response strength control processes, suggesting that orienting deficits partly predict and determine response control deficits in ADHD. Conclusions These findings closely resemble those previously found in children with ADHD, which indicate that there is not a core response inhibition deficit in ADHD. These findings therefore suggest the possibility of developmental stability into adulthood of the underlying abnormal processes in ADHD.