WorldWideScience

Sample records for chronic health conditions

  1. Transition Planning for Students with Chronic Health Conditions. Position Statement

    Science.gov (United States)

    Baszler, Rita; Rochkes, Laura; Dolatowski, Rosemary; Mendes, Irene; Yow, Barbara; Butler, Sarah; Fekaris, Nina

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that all children with chronic health conditions should receive coordinated and deliberate transition planning to maximize lifelong functioning and well-being. Transition planning refers to a coordinated set of activities to assist students with chronic health conditions to…

  2. Chronic Health Conditions Managed by School Nurses. Position Statement. Revised

    Science.gov (United States)

    Morgitan, Judith; Bushmiaer, Margo; DeSisto, Marie C.; Duff, Carolyn; Lambert, C. Patrice; Murphy, M. Kathleen; Roland, Sharon; Selser, Kendra; Wyckoff, Leah; White, Kelly

    2012-01-01

    It is the position of the National Association of School Nurses that students with chronic health conditions have access to a full-time registered professional school nurse (hereinafter referred to as school nurse). School districts should include school nurse positions in their full-time instructional support personnel to provide health services…

  3. Health Service Utilization among Syrian Refugees with Chronic Health Conditions in Jordan

    OpenAIRE

    Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Oweis, Arwa; Al Ward, Nada; Burton, Ann

    2016-01-01

    Introduction The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system, particularly in treating chronic health conditions. This study was undertaken to assess utilization of health services for chronic health conditions among Syrian refugees in non-camp settings. Methods A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care for hypertension, diabetes, cardiovasc...

  4. Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

    Science.gov (United States)

    Härter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jörg

    2013-01-01

    Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and…

  5. Disability Status as an Antecedent to Chronic Conditions: National Health Interview Survey, 2006–2012

    OpenAIRE

    Dixon-Ibarra, Alicia; Horner-Johnson, Willi

    2014-01-01

    Introduction A strong relationship exists between disability and poor health. This relationship could exist as a result of disabilities emerging from chronic conditions; conversely, people with disabilities may be at increased risk of developing chronic conditions. Studying health in relation to age of disability onset can illuminate the extent to which disability may be a risk factor for future poor health. Methods We used data from the 2006–2012 National Health Interview Survey and conducte...

  6. Chronic Conditions Dashboard

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Conditions Dashboard presents statistical views of information on the prevalence, utilization and Medicare spending for Medicare beneficiaries with...

  7. Chronic Conditions PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Chronic Conditions PUFs are aggregated files in which each record is a profile or cell defined by the characteristics of Medicare beneficiaries. A profile is...

  8. Chronic Conditions Chartbook

    Data.gov (United States)

    U.S. Department of Health & Human Services — Chronic Conditions among Medicare Beneficiaries is a chartbook prepared by the Centers for Medicare and Medicaid Services and created to provide an overview of...

  9. Chronic Condition Data Warehouse

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Condition Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across...

  10. Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010

    OpenAIRE

    Ward, Brian W.; Schiller, Jeannine S.

    2013-01-01

    Preventing and ameliorating chronic conditions has long been a priority in the United States; however, the increasing recognition that people often have multiple chronic conditions (MCC) has added a layer of complexity with which to contend. The objective of this study was to present the prevalence of MCC and the most common MCC dyads/triads by selected demographic characteristics. We used respondent-reported data from the 2010 National Health Interview Survey (NHIS) to study the US adult civ...

  11. Teacher Perception of Burden and Willingness to Accommodate Children with Chronic Health Conditions

    Science.gov (United States)

    West, Aimee M.; Denzer, Anna Q.; Wildman, Beth G.; Anhalt, Karla

    2013-01-01

    Children with chronic health conditions need the support of school staff to flourish socially and academically in educational settings. This study explored teacher experiences and knowledge of the following common paediatric conditions: asthma, food allergies, cancer, diabetes, HIV/AIDS, heart disease and seizure disorder. Participants included…

  12. Asymptomatic rheumatic heart disease in South African schoolchildren: Implications for addressing chronic health conditions through a school health service.

    Science.gov (United States)

    Shung-King, Maylene; Zühlke, Liesel; Engel, Mark E; Mayosi, Bongani M

    2016-08-01

    When new evidence comes to light, it compels us to contemplate the implications of such evidence for health policy and practice. This article examines recent research evidence on the prevalence of asymptomatic rheumatic heart disease (RHD) in South Africa and considers the implications for the Integrated School Health Programme (ISHP). RHD is still a major burden of disease in developing countries, and elimination of this preventable condition ranks high among World Heart Federation goals. If left untreated, it becomes a chronic health condition that individuals have to cope with into their adult lives. The ISHP regards the health needs of children with chronic health conditions, which include conditions such as RHD, as a key service component. However, the chronic health component of the ISHP is still poorly developed and can benefit from good evidence to guide implementation. A recent study to ascertain the prevalence of RHD in asymptomatic schoolchildren through mass screening affords an opportunity to reflect on whether, and how, asymptomatic chronic health conditions in schoolchildren could be addressed, and what the implications would be if this were done through a school-based programme such as the ISHP. PMID:27499395

  13. Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions

    Science.gov (United States)

    ... severe illness, and at times can lead to death. Children younger than five, but especially children younger than 2 years old, and children and adolescents with chronic health conditions are at ... in hospital stays and even death. The best way to prevent the flu is ...

  14. Students with Chronic Health Conditions, the Law and Education: A Salutary Lesson from Australia

    Science.gov (United States)

    White, Julie

    2015-01-01

    Australia's legal and policy frameworks serve to exclude from education those children and young people who live with challenging and chronic health conditions. The Australian experience is detailed here because it offers insight for education systems of other nations into the consequences of systemic oversight and complicated legal requirements…

  15. Association of Mental Disorders With Subsequent Chronic Physical Conditions World Mental Health Surveys From 17 Countries

    NARCIS (Netherlands)

    Scott, Kate M.; Lim, Carmen; Al-Hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Florescu, Silvia; de Girolamo, Giovanni; Hu, Chiyi; de Jonge, Peter; Kawakami, Norito; Elena Medina-Mora, Maria; Moskalewicz, Jacek; Navarro-Mateu, Fernando; O'Neill, Siobhan; Piazza, Marina; Posada-Villa, Jose; Torres, Yolanda; Kessler, Ronald C.

    2016-01-01

    IMPORTANCE It is clear that mental disorders in treatment settings are associated with a higher incidence of chronic physical conditions, but whether this is true of mental disorders in the community, and how generalized (across a range of physical health outcomes) these associations are, is less cl

  16. Psychological functioning of siblings in families of children with chronic health conditions: A meta-analysis

    NARCIS (Netherlands)

    Vermaes, I.P.R.; Susante, A.M.J. van; Bakel, H.J.A. van

    2012-01-01

    Objective: The aim of this meta-analysis was to provide an up-to-date review of the literature to enhance our understanding of how chronic health conditions (CHCs) affect siblings, both positively and negatively. Methods: PsycINFO and Medline were systematically searched. Inclusion criteria were as

  17. Prevalence of Chronic Health Conditions in Children with Intellectual Disability: A Systematic Literature Review

    Science.gov (United States)

    Oeseburg, Barth; Dijkstra, Geke J.; Groothoff, Johan W.; Reijneveld, Sijmen A.; Jansen, Danielle E. M. C.

    2011-01-01

    A systematic review of the prevalence rates of chronic health conditions in populations of children with intellectual disability was provided. We identified 2,994 relevant studies by searching Medline, Cinahl, and PsycINFO databases from 1996 to 2008. We included the 31 studies that had sufficient methodological quality. The 6 most prevalent…

  18. The sexual abuse of young people with a disability or chronic health condition

    OpenAIRE

    Kaufman, M.

    2011-01-01

    For several reasons, children and youth with a disability or chronic health condition are at an increased risk of sexual abuse. Health care providers, along with parents and caregivers, need to maintain a high level of suspicion concerning possible sexual abuse of this population. Physicians especially need to advocate for policies to prevent or detect abuse in hospitals, schools and other institutional settings. Such policies include the thorough screening and monitoring of employees and vol...

  19. The Bodies Politic: Chronic Health Conditions and Voter Turnout in the 2008 Election.

    Science.gov (United States)

    Gollust, Sarah E; Rahn, Wendy M

    2015-12-01

    Health policy researchers often evaluate the social and economic consequences of chronic illness, but rarely have they considered the implications of chronic illness on one important form of political participation: voting. However, if chronic illnesses - already unequally distributed in society - are associated with differential rates of voter turnout, then these inequalities in democratic representation could, in turn, produce further health inequity. In this study, we use data from eight states from the 2009 Behavioral Risk Factor Surveillance Survey to examine the associations between having diagnoses of five chronic conditions and turnout in the 2008 US presidential election. After adjusting for sociodemographic characteristics and some health-related confounding factors, we find that individuals with cancer diagnoses are more likely to vote, while those with heart disease diagnoses are less likely to vote. These associations differ by race and educational status; notably, African Americans and those with lower education with cancer are even more likely to turn out to vote than whites and those with more education with cancer. We discuss the implications of our findings in the context of health social movements and the role of health organizations in shaping political processes, important directions for the study of health politics. PMID:26447024

  20. Modelling the Age Dynamics of Chronic Health Conditions: Life-Table-Consistent Transition Probabilities and their Application

    OpenAIRE

    Frank T Denton; Byron G. Spencer

    2014-01-01

    [Background:] Surveys of chronic health conditions provide information about prevalence but not about the incidence and the process of change within the population. [Objective:] We show how the "age dynamics" of chronic conditions - the probabilities of contracting the conditions at different ages, of moving from one chronic conditions state to another, and of dying - can be inferred from prevalence data for those conditions that can be viewed as irreversible. [Methods:] Transition probabilit...

  1. Defining and Measuring Chronic Conditions

    Centers for Disease Control (CDC) Podcasts

    2013-05-20

    This podcast is an interview with Dr. Anand Parekh, U.S. Department of Health and Human Services Deputy Assistant Secretary for Health, and Dr. Samuel Posner, Preventing Chronic Disease Editor in Chief, about the definition and burden of multiple chronic conditions in the United States.  Created: 5/20/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/20/2013.

  2. ls with Chronic Conditions Want More Guidance from Health Professionals in Finding Quality Online Health SourcesIndividua

    Directory of Open Access Journals (Sweden)

    Cari Merkley

    2016-04-01

    Full Text Available Objective – To explore how and when individuals with chronic health conditions seek out health information online, and the challenges they encounter when doing so. Design – Qualitative study employing thematic analysis. Setting – Urban Western Australia. Subjects – 17 men and women between 19 and 85 years of age with at least 1 chronic health condition. Methods – Participants were recruited in late 2013 at nine local pharmacies, through local radio, media channels, and a university's social media channels. Participants were adult English speakers who had looked for information on their chronic health condition(s using the Internet. Semi-structured face-to-face interviews were conducted with each participant, audio recorded, and transcribed. The transcripts were coded in QSR Nvivo using two different processes – an initial data-driven inductive approach to coding, followed by a theory driven analysis of the data. Main Results – Three major themes emerged: trust, patient activation, and relevance. Many of the participants expressed trust both in health professionals and in the efficacy of search engines like Google. However, there was uncertainty about the quality of some of the health information sources found. Searching for information online was seen by some participants as a way to feel more empowered about their condition(s and treatment, but they reported frustration in finding information that was relevant to their specific condition(s given the volume of information available. Low health literacy emerged in participant interviews as an intrinsic barrier to effective online searches for health information, along with low patient motivation and lack of time. The many extrinsic barriers identified included difficulty determining the quality of information found, the accessibility of the information (e.g., journal paywalls, and poor relationships with health care providers. Conclusion – Individuals look for online health

  3. Assessing patient-centered care in patients with chronic health conditions attending chiropractic practice: protocol for a mixed-methods study

    OpenAIRE

    Stuber, Kent Jason; Langweiler, Mark; Mior, Silvano; McCarthy, Peter William

    2016-01-01

    Background The management of chronic health conditions increasingly requires an organized, coordinated, and patient-centered approach to care. The Chronic Care Model (CCM) has been adopted in primary care to improve care delivery for those with chronic health conditions. Chiropractors manage chronic health conditions; however, little is known if such care is patient-centered. The primary aim of this study is to determine to what extent chiropractic patients with chronic health conditions perc...

  4. Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Sarah Huertas

    2011-03-01

    Full Text Available Mildred Vera2,4, María L Reyes-Rabanillo1, Sarah Huertas3, Deborah Juarbe4, Coralee Pérez-Pedrogo4, Aracelis Huertas5, Marisol Peña61Veterans Affairs Caribbean Healthcare System, San Juan, Puerto Rico; 2Department of Health Services Administration, School of Public Health; 3Department of Psychiatry, School of Medicine; 4Center for Evaluation and Sociomedical Research, School of Public Health; 5School of Health Professions; 6Center for Preparedness in Public Health, School of Public Health, Medical Sciences Campus, University of Puerto Rico San Juan, Puerto Rico.Background: Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide.Methods: We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with the suicidality module of the Mini International Neuropsychiatric Interview. Major depression was assessed with the Patient Health Questionnaire depression module. The relationship between sociodemographic factors, depression and suicidal ideation was examined with multiple logistic regression analysis. Among the subgroup that acknowledged suicidal ideation, we used multinomial logistic regression analysis to estimate simultaneously the multivariate associations of depression and sociodemographic factors with suicidality risk levels.Results: Of the 2068 patients screened, 15.4% acknowledged recent suicidal ideation. Among this group, 8.6% reported passive ideation, 3.7% active ideation without a plan, and 3.1% active ideation with a plan or attempt. According to multivariate logistic regression, suicidal ideation was higher among patients with moderately severe depression and severe depression than

  5. Preferences for health care and self-management among Dutch adolescents with chronic conditions: a Q-methodological investigation

    NARCIS (Netherlands)

    Jedeloo, S.; Staa, A.L. van; Latour, J.M.; Exel, N.J. van

    2009-01-01

    Adolescents with chronic conditions have to learn to self-manage their health in preparation for transitioning to adult care. Nurses often struggle with how to approach youth with chronic conditions successfully. Little is known about the preferences and attitudes of these young people themselves.

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

    Science.gov (United States)

    Hand, Carri

    2016-01-01

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

  7. Health-related quality of life (HRQL) for individuals with self-reported chronic physical and/or mental health conditions

    DEFF Research Database (Denmark)

    Bayliss, Martha; Rendas-Baum, Regina; White, Michelle K;

    2012-01-01

    In the US, approximately 53% of adults have at least one chronic condition. Comorbid physical and mental health conditions often have an incremental negative impact on health-related quality of life (HRQL). Primary study objectives were to quantify the impact on HRQL of a) ≥ 1 physical condition...... , b) ≥ 1 comorbid mental health conditions added to a physical one, c) ≥ 1 mental health condition, and d) ≥ 1 comorbid physical conditions added to at least one related to mental health. Decrements were based on a "Healthy" reference group reporting no chronic conditions....

  8. Latino Caregiver Coping With Children's Chronic Health Conditions: An Integrative Literature Review.

    Science.gov (United States)

    Desai, Priti P; Rivera, Abigail Torres; Backes, Emily M

    2016-01-01

    In this study we examined research pertaining to how Latino caregivers cope with their children's chronic health conditions. An understanding of this topic could facilitate appropriate interventions by health care staff to promote optimal child health outcomes. In this integrative review we categorized 21 studies by publication characteristics, methodology, findings, and their focus on emotion-focused and/or problem-focused coping. Thirteen studies used a qualitative design. Five studies included fathers in the sample. Twelve studies investigated coping with child's asthma, primarily in Mexican or Puerto Rican families. Coping strategies utilizing religion/spirituality, alternate healing practices, family support, and education about the child's illness were identified. Language, cultural dissimilarities, receiving inadequate information about the child's health care, differences in health beliefs, and feeling disrespected by providers were frequently cited coping challenges. Addressing these barriers is imperative to enhance coping of caregivers. Inconsistencies in research samples regarding income, education, immigration, and acculturation histories make findings difficult to generalize; recommendations for further research are suggested. PMID:26188357

  9. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  10. Dr Google and the Consumer: A Qualitative Study Exploring the Navigational Needs and Online Health Information-Seeking Behaviors of Consumers With Chronic Health Conditions

    OpenAIRE

    Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery David; Emmerton, Lynne

    2014-01-01

    Background The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literat...

  11. Chronic Condition Public Use File (PUF)

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Chronic Conditions Public Use Files (PUF) with information from Medicare claims. The CMS Chronic Conditions PUF is an aggregated file in...

  12. On-site Basic Health Screening and Brief Health Counseling of Chronic Medical Conditions for Veterans in Methadone Maintenance Treatment.

    Science.gov (United States)

    Fareed, Ayman; Musselman, Dominique; Byrd-Sellers, Johnita; Vayalapalli, Sreedevi; Casarella, Jennifer; Drexler, Karen; Phillips, Lawrence

    2010-09-01

    BACKGROUND: In order to improve the delivery of health services for chronic medical conditions in our methadone clinic, we added an onsite health screening and brief health counseling to the treatment plans for patients receiving methadone maintenance treatment at the Atlanta Veterans Affairs Medical Center (VAMC). We then conducted a follow up retrospective chart review to assess whether this intervention improved health outcome for those patients. METHODS: We reviewed the charts of one hundred and two patients who received treatment at Atlanta VAMC methadone clinic between 2002 and 2008. We sought to determine whether our increased health education and screening intervention was associated with improved: 1) Improved drug addiction outcome (as measured by comparing percentage of opiate and cocaine positive drug screens from admission to most recent). 2) Basic health screening, (as measured by the patient's compliance with primary care physicians (PCP) appointments and current smoking status). 3) Management of co-occurring medical conditions (as measured by levels of LDL cholesterol, hemoglobin A1c, and systolic blood pressure (SBP). 4) Presence of QTc prolongation (difference in QTc between baseline and most recent EKG). RESULTS: Illicit drug use (opiate and cocaine) markedly decreased in patients overall. The effect was more robust for those successfully "retained" (n=55, pCompliance with PCP appointments was high (82% and 88% before and after the onsite intervention, respectively) for "retained" patients. LDL cholesterol level was within normal range for all patients. A1c improved by 40% after the onsite intervention as reflected by the decreased percentage of patients with A1c > 7 % from before to after the intervention (90% vs. 50%, p=0.05). However, the prevalence of uncontrolled hypertension did not significantly improve after the onsite intervention (38% vs. 28%, p=0.34). As might be expected with MMT, the prevalence of QTc prolongation actually increased

  13. Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico

    OpenAIRE

    Vera, Mildred; Reyes-Rabanillo, María L; Huertas, Sarah; Juarbe, Deborah; Pérez-Pedrogo, Coralee; Huertas, Aracelis; Peña, Marisol

    2011-01-01

    Background: Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide. Methods: We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with ...

  14. Frequent Mental Distress, Chronic Conditions, and Adverse Health Behaviors in the Behavioral Risk Factor Surveillance Survey, Jordan, 2007

    Directory of Open Access Journals (Sweden)

    Mohannad Al-Nsour, MD, MSc

    2013-08-01

    Full Text Available Introduction Recent evidence indicates that chronic diseases and mental illness are associated. In the Middle Eastern country of Jordan, chronic diseases and frequent mental distress (FMD are increasing; however, the capacity for mental health care is limited. The objective of this study was to determine the association between FMD, chronic conditions, and adverse health behaviors in Jordan. Methods The third cycle of the Jordan Behavioral Risk Factor Surveillance Survey (2007 served as the data source for this study. The sample consisted of 3,612 noninstitutionalized Jordanian adults aged 18 years or older. Logistic regression was used to obtain odds ratios for the association between chronic conditions, health behaviors, and FMD adjusted for age, sex, marital status, education, income, and employment. Results In the adjusted models, people with hypertension (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.6–2.7, high cholesterol (AOR, 2.3; 95% CI, 1.6–3.2, diabetes (AOR, 1.6; 95% CI, 1.1–2.4, and asthma (AOR, 2.2; 95% CI, 1.5–3.1 and smokers (AOR, 1.5; 95% CI, 1.1–2.0 were more likely to have FMD than people without each of these conditions. Adults who reported vigorous physical activity were less likely to have FMD (AOR, 0.6; 95% CI, 0.4–0.9 than their less active counterparts. Conclusions In Jordan, FMD was associated with several chronic conditions. As a result, we suggest additional research to examine the complex relationship between FMD and chronic conditions. More doctors in the primary health care system should be trained in mental health.

  15. Disability and self-rated health among older women and men in rural Guatemala: The role of obesity and chronic conditions

    OpenAIRE

    Yount, Kathryn M.; Hoddinott, John; Stein, Aryeh D.

    2010-01-01

    Unprecedented population aging in poorer settings is coinciding with the rapid spread of obesity and other chronic conditions. These conditions predict disability and poor self-rated health and often are more prevalent in women than men. Thus, gender gaps in obesity and other chronic conditions may account for older women's greater disability and worse self-rated health in poor, rural populations, where aging, obesity, and chronic conditions are rapidly emerging. In a survey of 604 adults 50 ...

  16. [Chronic disease and health condition prevention in childhood--2nd part: emphases from the 14th Symposium of Preventive Pediatrics].

    Science.gov (United States)

    Batinica, Maja; Grgurić, Josip; Jadrijević-Cvrlje, Filip

    2014-01-01

    Chronically ill children nowdays in developed countries are more prevalent than before, and thanks to modern therapeutic modalities more children are surviving into adulthood. Increased survival cannot be assumed to be associated with increased quality of life. With the chronically ill child holistic approach is important, which incorporates not only realisation of the highest possible standards in diagnostics and treatment, but also special care for disease prevention. All this is very important in so called integrative approach in the care of a chronically ill child, with the aim of achieving as high as possible quality of life and complete social integration. At the 14th Preventive Pediatrics Symposium, which took place in Skrad, June 1' 2013, from preventive standpoint, the following chronic childhood illnesses were discussed: attention deficit hyperactivity disorder--ADHD, migraine, thyroid gland diseases, leukemia, cystic fibrosis, chronic renal disease, chronic inflammatory liver disease, chronic inflammatory bowel disease, juvenile idiopathic arthritis, and chronic otitis media with effusion. It is emphasized that talking about a disease prevention, there are three levels of it--primary, second- ary and tertiary prevention: how to avoid occurrence of disease, how to diagnose and treat existent disease in early stages, before it causes significant morbidity, and finally how to reduce the negative impact of existent disease by restoring function and reducing disease-related complications--how to improve quality of life of children with chronic diseases. Quaternary prevention describes methods to mitigate or avoid results of unnecessary or excessive interventions of the health system. An important process is also transition of care from child-oriented to adult-oriented care. Adults with chronic health conditions should continue to be evaluated periodically for possible late consequences of their childhood illness and previ- ous medical treatments. PMID

  17. Secondary prevention of chronic health conditions in patients with multimorbidity: what can physiotherapists do?

    Directory of Open Access Journals (Sweden)

    Sarah Dennis

    2016-04-01

    Full Text Available Multimorbidity is the co-occurrence of two or more diseases in an individual without a defining index disease [1,2]. In developed countries, the prevalence of multimorbidity has been estimated from both general practice and population data [3,4]. Data from general practices in Scotland found that 23% of patients had multimorbidity [3], whereas the prevalence of multimorbidity in Québec, Canada, was 46–51% in the general practice population and 10–13% in the general population aged over 24 years [4]. Australian data indicate that almost 40% of people aged over 44 years have multimorbidity, and this proportion increases to around 50% of those aged 65–74 years and to 70% of those aged 85 and over [5]. Data from a study of Australian general practice activity reported prevalence estimates for the most common combinations of chronic conditions [6]. Of the 12 most common combinations, the majority included conditions that can be positively impacted by physiotherapy interventions, such as low back pain [7], arthritis [8], chronic obstructive pulmonary disease [9], cardiac disease [10] and type 2 diabetes [11]. However, for some of these conditions, the uptake and access to physiotherapy interventions was suboptimal, especially in the primary care setting, due to poor referral from general practitioners (GPs [12,13] and/or restricted access to physiotherapy associated with workforce shortages, as well as high cost to the patient for private consultation. Journal of Comorbidity 2016;6(2:50–52

  18. Sex Education: Sexuality, Society and Learning: motivational factors in discussing sexual health with young people with chronic conditions or disabilities

    OpenAIRE

    Stege, H.A. van der; Hilberink, S.R.; Visser, A.P.; Staa, A.L. van

    2014-01-01

    The objective of this study was to identify determinants of professionals’ intention to use the new board game SeCZ TaLK to facilitate sexual health discussions with young people with chronic health conditions and disabilities, and to gauge whether intention led to actual use. A cross-sectional web-based survey of 336 professionals before they received the game sought to measure their intention to use SeCZ TaLK, their attitudes towards discussing sexuality, social professional environment, se...

  19. Multiple Chronic Conditions Among Medicare Beneficiaries...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Individuals with multiple chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment....

  20. EFFECT OF NATIVITY AND DURATION OF RESIDENCE ON CHRONIC HEALTH CONDITIONS AMONG ASIAN IMMIGRANTS IN AUSTRALIA: A LONGITUDINAL INVESTIGATION.

    Science.gov (United States)

    Pasupuleti, Samba Siva Rao; Jatrana, Santosh; Richardson, Ken

    2016-05-01

    This study examined the effect of Asian nativity and duration of residence in Australia on the odds of reporting a chronic health condition (cancer, respiratory problems, cardiovascular disease (CVD) and diabetes mellitus). Data were from waves 3, 7 and 9 of the Household Income and Labour Dynamics in Australia (HILDA) longitudinal survey, and multi-level group-mean-centred logistic regression models were used for the analysis. After covariate adjustment, Asian immigrants were less likely to report cancer and respiratory problem compared with native-born Australians. While there was no significant difference in reporting CVD, they were more likely to report diabetes than native-born people. Asian immigrants maintained their health advantage with respect to cancer regardless of duration of residence. However, after 20 years of stay, Asian immigrants lost their earlier advantage and were not significantly different from native-born people in terms of reporting a respiratory problem. In contrast, Asian immigrants were not measurably different from native-born Australians in reporting diabetes if their length of stay in Australia was less than 20 years, but became disadvantaged after staying for 20 years or longer. There was no measurable difference in the odds of reporting CVD between Asian immigrants and native-born Australians for any duration of residence. On the whole this study found that health advantage, existence of healthy immigrant effect and subsequent erosion of it with increasing duration of residence among Asian immigrants depends upon the chronic health condition. PMID:26139212

  1. Building on transformative learning and response shift theory to investigate health-related quality of life changes over time in individuals with chronic health conditions and disability.

    Science.gov (United States)

    Barclay-Goddard, Ruth; King, Judy; Dubouloz, Claire-Jehanne; Schwartz, Carolyn E

    2012-02-01

    A major goal of treatment for people living with chronic illness or disability is self-management leading to optimized health-related quality of life. This change process has been described in the adult education literature as transformative learning, while in health-related quality of life research, response shift has emerged as a key concept. Response shift and transformative learning literature were reviewed, and the theoretical frameworks of the 2 concepts were compared and contrasted. Response shift is described as a change in internal standards, values, or definition of a construct (eg, health-related quality of life) over time, commonly seen in individuals with chronic illness. In the context of chronic illness, transformative learning is described as a complex process of personal change including beliefs, feelings, knowledge, and values. Transformative learning is often triggered by the diagnosis of a chronic illness. This results in a critical reflection of taken-for-granted assumptions and leads to new ways of thinking, influencing personal changes in daily living. Comparing the models of response shift and transformative learning in chronic illness, the catalyst in response shift appears comparable with the trigger in transformational learning; mechanisms to process of changing; and perceived quality of life to outcomes. Both transformative learning and response shift have much to offer health care providers in understanding the learning process for the person living with chronic illness or disability to optimize their quality of life. Suggestions for future research in response shift and transformative learning in individuals with chronic health conditions and disability are proposed. PMID:22289229

  2. Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors.

    Science.gov (United States)

    Yeh, Jennifer M; Hanmer, Janel; Ward, Zachary J; Leisenring, Wendy M; Armstrong, Gregory T; Hudson, Melissa M; Stovall, Marilyn; Robison, Leslie L; Oeffinger, Kevin C; Diller, Lisa

    2016-09-01

    Health utility, a summary measure of quality of life, has not been previously used to compare outcomes among childhood cancer survivors and individuals without a cancer history. We estimated health utility (0, death; 1, perfect health) using the Short Form-6D (SF-6D) in survivors (n = 7105) and siblings of survivors (n = 372) (using the Childhood Cancer Survivor Study cohort) and the general population (n = 12 803) (using the Medical Expenditures Panel Survey). Survivors had statistically significantly lower SF-6D scores than the general population (mean = 0.769, 95% confidence interval [CI] = 0.766 to 0.771, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively, ITALIC! PYoung adult survivors (age 18-29 years) reported scores comparable with general population estimates for people age 40 to 49 years. Among survivors, SF-6D scores were largely determined by number and severity of chronic conditions. No clinically meaningful differences were identified between siblings and the general population (mean = 0.793, 95% CI = 0.782 to 0.805, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively). This analysis illustrates the importance of chronic conditions on long-term survivor quality of life and provides encouraging results on sibling well-being. Preference-based utilities are informative tools for outcomes research in cancer survivors. PMID:27102402

  3. Asthma and allergy: the significance of chronic conditions for individual health behaviour.

    OpenAIRE

    Bolin, Kristian; Lindgren, Björn

    2002-01-01

    BACKGROUND: In health economics, health is regarded as part of an individual's human capital. As such it depreciates over time, and investments in health are made in order to keep the stock of health capital at the desired level. Using this framework for analysis of health-related behaviour and Swedish panel data, we examined whether the presence of asthma or allergy affects perceived health and investments in health. METHODS: A set of panel data for approximately 3800 individuals intervi...

  4. Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act.

    Science.gov (United States)

    Chatterji, Pinka; Brandon, Peter; Markowitz, Sara

    2016-07-01

    We examine the effects of the 2010 Patient Protection and Affordable Care Act's (ACA) prohibition of preexisting conditions exclusions for children on job mobility among parents. We use a difference-in-difference approach, comparing pre-post policy changes in job mobility among privately-insured parents of children with chronic health conditions vs. privately-insured parents of healthy children. Data come from the 2004 and 2008 Survey of Income and Program Participation (SIPP). Among married fathers, the policy change is associated with about a 0.7 percentage point, or 35 percent increase, in the likelihood of leaving an employer voluntarily. We find no evidence that the policy change affected job mobility among married and unmarried mothers. PMID:27060524

  5. Patient-centered activity monitoring in the self-management of chronic health conditions

    OpenAIRE

    Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh

    2015-01-01

    Background As activity tracking devices become smaller, cheaper, and more consumer-accessible, they will be used more extensively across a wide variety of contexts. The expansion of activity tracking and personal data collection offers the potential for patient engagement in the management of chronic diseases. Consumer wearable devices for activity tracking have shown promise in post-surgery recovery in cardiac patients, pulmonary rehabilitation, and activity counseling in diabetic patients, ...

  6. [Chronic disease and health condition prevention in childhood: emphases from the 13th Symposium of Preventive Pediatrics].

    Science.gov (United States)

    Batinica, Maja; Grgurić, Josip; Jadrijević-Cvrlje, Filip

    2013-01-01

    Chronic diseases in childhood have become an important priority, especially in developed countries, because of higher prevalence, relatively and absolutely. Besides that, inappropriate procedures a chronically ill child can result in child's growth and development disorder. According to literature data, 15-20% of children have chronic disease with the impact on their physical, mental and emotional status. Disease prevention strategies are described at the primary, secondary and tertiary level: how to avoid occurrence of disease, how to diagnose and treat existent disease in early stages, before it causes significant morbidity, and finally how to reduce negative impact of existent disease by restoring function and reducing disease-related complications - how to improve quality of life of children with chronic diseases. The new term of quaternary prevention describes methods to mitigate or avoid results of unnecessary or excessive interventions in the health system. In this paper the authors present recent attitudes about chronic diseases prevention modalities in childhood, which, at the beggining of the 21st century, have become more intriguing and represent a new challenge for pediatric health care. Thus, from preventive standpoint, the following chronic illnesses are discussed: asthma, malignant diseases, autism, epilepsy, cerebral palsy, tuberculosis, diabetes type 1, congenital heart diseases, arterial hypertension, celiac disease, and eating disorders. These emphases are from the 13th Preventive Pediatrics Symposium, which took place in Skrad, June 2nd, 2012. Further activities are planned with the aim of continuation of health care furtherance for children with other chronic illnesses. PMID:23991491

  7. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

    DEFF Research Database (Denmark)

    Frølich, Anne

    2012-01-01

    which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved.......The quality of health care services offered to people suffering from chronic diseases often fails to meet standards in Denmark or internationally. The population consisting of people with chronic diseases is large and accounts for about 70% of total health care expenses. Given that resources are...

  8. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis

    OpenAIRE

    Philpott, J; Houghton, K.; Luke, A

    2010-01-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for ‘safe’ physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an...

  9. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions

    OpenAIRE

    Shaw, William S.; Besen, Elyssa; Pransky, Glenn; Boot, Cécile RL; Nicholas, Michael K; McLellan, Robert K.; Tveito, Torill H

    2014-01-01

    Background The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothes...

  10. Sexual Orientation and Sex Differences in Adult Chronic Conditions, Health Risk Factors, and Protective Health Practices, Oregon, 2005–2008

    OpenAIRE

    Garland-Forshee, Rodney Y.; Fiala, Steven C.; Ngo, Duyen L.; Moseley, Katarina

    2014-01-01

    Introduction Research on lesbian, gay, and bisexual (LGB) individuals’ health and health practices has primarily consisted of convenience studies focused on HIV/AIDS, substance use, or mental illness. We examined health-related disparities among Oregon LGB men and women compared with heterosexual men and women using data from a population-based survey. Methods Data from the 2005 through 2008 Oregon Behavioral Risk Factor Surveillance System were used to examine associations between sexual ori...

  11. A Systematic Review Exploring the Social Cognitive Theory of Self-Regulation as a Framework for Chronic Health Condition Interventions.

    Directory of Open Access Journals (Sweden)

    Michelle E Tougas

    Full Text Available Theory is often recommended as a framework for guiding hypothesized mechanisms of treatment effect. However, there is limited guidance about how to use theory in intervention development.We conducted a systematic review to provide an exemplar review evaluating the extent to which use of theory is identified and incorporated within existing interventions. We searched electronic databases PubMed, PsycINFO, CENTRAL, and EMBASE from inception to May 2014. We searched clinicaltrials.gov for registered protocols, reference lists of relevant systematic reviews and included studies, and conducted a citation search in Web of Science. We included peer-reviewed publications of interventions that referenced the social cognitive theory of self-regulation as a framework for interventions to manage chronic health conditions. Two reviewers independently assessed articles for eligibility. We contacted all authors of included studies for information detailing intervention content. We describe how often theory mechanisms were addressed by interventions, and report intervention characteristics used to address theory.Of 202 articles that reported using the social cognitive theory of self-regulation, 52% failed to incorporate self-monitoring, a main theory component, and were therefore excluded. We included 35 interventions that adequately used the theory framework. Intervention characteristics were often poorly reported in peer-reviewed publications, 21 of 35 interventions incorporated characteristics that addressed each of the main theory components. Each intervention addressed, on average, six of eight self-monitoring mechanisms, two of five self-judgement mechanisms, and one of three self-evaluation mechanisms. The self-monitoring mechanisms 'Feedback' and 'Consistency' were addressed by all interventions, whereas the self-evaluation mechanisms 'Self-incentives' and 'External rewards' were addressed by six and four interventions, respectively. The present review

  12. Collaboration between Rehabilitation Psychologists and Special Educators when Working with Children with Chronic Health/Disabling Conditions.

    Science.gov (United States)

    Gordon, Phyllis A.; Feldman, David; Ballard, Ellen M.

    1998-01-01

    Discusses the usefulness of team collaboration when working with students with chronic health and/or other disabilities and the manner in which rehabilitation psychologists function in this process. Notes the values and roles of rehabilitation psychology and ways rehabilitation psychologists can enhance the education process for these students.…

  13. Prevalence of chronic conditions in Australia.

    Directory of Open Access Journals (Sweden)

    Christopher Harrison

    Full Text Available OBJECTIVES: To estimate prevalence of chronic conditions among patients seeing a general practitioner (GP, patients attending general practice at least once in a year, and the Australian population. DESIGN SETTING AND PARTICIPANTS: A sub-study of the BEACH (Bettering the Evaluation and Care of Health program, a continuous national study of general practice activity conducted between July 2008 and May 2009. Each of 290 GPs provided data for about 30 consecutive patients (total 8,707 indicating diagnosed chronic conditions, using their knowledge of the patient, patient self-report, and patient's health record. MAIN OUTCOME MEASURES: Estimates of prevalence of chronic conditions among patients surveyed, adjusted prevalence in patients who attended general practice at least once that year, and national population prevalence. RESULTS: Two-thirds (66.3% of patients surveyed had at least one chronic condition: most prevalent being hypertension (26.6%, hyperlipidaemia (18.5%, osteoarthritis (17.8%, depression (13.7%, gastro-oesophageal reflux disease (11.6%, asthma (9.5% and Type 2 diabetes (8.3%. For patients who attended general practice at least once, we estimated 58.8% had at least one chronic condition. After further adjustment we estimated 50.8% of the Australian population had at least one chronic condition: hypertension (17.4%, hyperlipidaemia (12.7%, osteoarthritis (11.1%, depression (10.5% and asthma (8.0% being most prevalent. CONCLUSIONS: This study used GPs to gather information from their knowledge, the patient, and health records, to provide prevalence estimates that overcome weaknesses of studies using patient self-report or health record audit alone. Our results facilitate examination of primary care resource use in management of chronic conditions and measurement of prevalence of multimorbidity in Australia.

  14. The Engagement in Physical Activity for Middle-Aged and Older Adults with Multiple Chronic Conditions: Findings from a Community Health Assessment

    Directory of Open Access Journals (Sweden)

    Wei-Chen Lee

    2013-01-01

    Full Text Available The current aging trends accompanying the increasing prevalence of multiple chronic conditions (MCCs and decreasing participation in physical activity (PA have swept the United States. In light of the magnitude of this phenomenon, this study seeks to identify the most common MCC combinations and their relationships with PA level. A cross-sectional study, Brazos Valley Health Assessment, was conducted between October 2009 and July 2010. All data analyses were performed by STATA 12.0. The overall sample which met the inclusion criteria is 2,603. Among people older than 45 years, chronic conditions of cardiovascular, endocrine, and musculoskeletal systems were the most prevalent. Participants with three chronic conditions were less likely to meet the PA standard than those with only two chronic conditions. Younger age, women, rural residence, and unsafe environments were related to the lower PA level. After adjusting for seven covariates, all MCCs combinations adversely affect the level of PA (, . People with MCCs were among the least active subgroups despite the health benefits of doing exercise. Given the well-documented benefits of physical activity for delaying the onset or progression of MCCs, public health efforts to enhance regular PA in middle-aged and older adults are recommended.

  15. Prescription Drug Use Among Adults With Chronic Conditions in South Korea: Dual Burden of Health Care Needs and Socioeconomic Vulnerability.

    Science.gov (United States)

    Jung, Youn; Byeon, Jinok; Chung, Haejoo

    2016-01-01

    The aim of this study is to identify the social determinants of prescription drug use among adults with chronic diseases by examining the associations between socioeconomic position and prescription medicine use and perceived burden for pharmaceutical expenditure, using a sample of the Korean population from the 2008 Korea Health Panel, with 4 analytic models. Controlled with health status and the type of health insurance, the probability of using prescription drugs and overall spending on drugs significantly increased with rising income level, while perceived burden for out-of-pocket payment significantly decreased. These results imply that the poor are likely to underuse prescription drugs compared with their wealthier counterparts with the same need for health care, probably due to economic barriers. PMID:26512028

  16. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis.

    Science.gov (United States)

    Philpott, J; Houghton, K; Luke, A

    2010-04-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for 'safe' physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an experienced physician for activity counselling and for identifing any contraindications to participation. The present statement reviews the benefits and risks of participation in sport and exercise for children with juvenile arthritis, hemophilia, asthma and cystic fibrosis. Guidelines for participation are included. PMID:21455465

  17. Chronic conditions in adults with cerebral palsy

    OpenAIRE

    Peterson, MD; Ryan, JM; Hurvitz, EA; E Mahmoudi

    2015-01-01

    Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP.

  18. Measuring health-related problem solving among African Americans with multiple chronic conditions: application of Rasch analysis.

    Science.gov (United States)

    Fitzpatrick, Stephanie L; Hill-Briggs, Felicia

    2015-10-01

    Identification of patients with poor chronic disease self-management skills can facilitate treatment planning, determine effectiveness of interventions, and reduce disease complications. This paper describes the use of a Rasch model, the Rating Scale Model, to examine psychometric properties of the 50-item Health Problem-Solving Scale (HPSS) among 320 African American patients with high risk for cardiovascular disease. Items on the positive/effective HPSS subscales targeted patients at low, moderate, and high levels of positive/effective problem solving, whereas items on the negative/ineffective problem solving subscales mostly targeted those at moderate or high levels of ineffective problem solving. Validity was examined by correlating factor scores on the measure with clinical and behavioral measures. Items on the HPSS show promise in the ability to assess health-related problem solving among high risk patients. However, further revisions of the scale are needed to increase its usability and validity with large, diverse patient populations in the future. PMID:25319236

  19. Multiple Chronic Conditions Among US Adults: A 2012 Update

    OpenAIRE

    Ward, Brian W.; Schiller, Jeannine S.; Goodman, Richard A.

    2014-01-01

    The objective of this research was to update earlier estimates of prevalence rates of single chronic conditions and multiple (>2) chronic conditions (MCC) among the noninstitutionalized, civilian US adult population. Data from the 2012 National Health Interview Survey (NHIS) were used to generate estimates of MCC for US adults and by select demographic characteristics. Approximately half (117 million) of US adults have at least one of the 10 chronic conditions examined (ie, hypertension, coro...

  20. Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Castrén Johanna

    2008-01-01

    Full Text Available Abstract Background The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service. Methods Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030 of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153. Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ2 test was used. Results 12% (n = 370 of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ2, P = .03. The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ2, P = .03. There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor. Conclusion Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of

  1. Medicare Payments, How Much Do Chronic Conditions Matter

    Data.gov (United States)

    U.S. Department of Health & Human Services — There has been a growing interest in understanding the utilization patterns of patients with chronic conditions. Even though there is a lack of standard definition...

  2. Impact of Chronic Conditions on the Cost of Cancer Care...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries, published in Volume 2, Issue 4 of the Medicare...

  3. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions.

    Science.gov (United States)

    Darkins, Adam; Ryan, Patricia; Kobb, Rita; Foster, Linda; Edmonson, Ellen; Wakefield, Bonnie; Lancaster, Anne E

    2008-12-01

    Between July 2003 and December 2007, the Veterans Health Administration (VHA) introduced a national home telehealth program, Care Coordination/Home Telehealth (CCHT). Its purpose was to coordinate the care of veteran patients with chronic conditions and avoid their unnecessary admission to long-term institutional care. Demographic changes in the veteran population necessitate VHA increase its noninstitutional care (NIC) services 100% above its 2007 level to provide care for 110,000 NIC patients by 2011. By 2011, CCHT will meet 50% of VHA's anticipated NIC provision. CCHT involves the systematic implementation of health informatics, home telehealth, and disease management technologies. It helps patients live independently at home. Between 2003 and 2007, the census figure (point prevalence) for VHA CCHT patients increased from 2,000 to 31,570 (1,500% growth). CCHT is now a routine NIC service provided by VHA to support veteran patients with chronic conditions as they age. CCHT patients are predominantly male (95%) and aged 65 years or older. Strict criteria determine patient eligibility for enrollment into the program and VHA internally assesses how well its CCHT programs meet standardized clinical, technology, and managerial requirements. VHA has trained 5,000 staff to provide CCHT. Routine analysis of data obtained for quality and performance purposes from a cohort of 17,025 CCHT patients shows the benefits of a 25% reduction in numbers of bed days of care, 19% reduction in numbers of hospital admissions, and mean satisfaction score rating of 86% after enrolment into the program. The cost of CCHT is $1,600 per patient per annum, substantially less than other NIC programs and nursing home care. VHA's experience is that an enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings. PMID:19119835

  4. World Trade Center Health Program; Addition of New-Onset Chronic Obstructive Pulmonary Disease and WTC-Related Acute Traumatic Injury to the List of WTC-Related Health Conditions. Final rule.

    Science.gov (United States)

    2016-07-01

    The World Trade Center (WTC) Health Program conducted a review of published, peer-reviewed epidemiologic studies regarding potential evidence of chronic obstructive pulmonary disease (COPD) and acute traumatic injury among individuals who were responders to or survivors of the September 11, 2001, terrorist attacks. The Administrator of the WTC Health Program (Administrator) found that these studies provide substantial evidence to support a causal association between each of these health conditions and 9/11 exposures. As a result, the Administrator is publishing a final rule to add both new-onset COPD and WTC-related acute traumatic injury to the List of WTC-Related Health Conditions eligible for treatment coverage in the WTC Health Program. PMID:27382662

  5. Theory in Chronic Disease Prevention and Health Promotion

    Science.gov (United States)

    Hall, Michael; Elise, Eifert

    2016-01-01

    Morbidity and mortality related to chronic diseases are a primary concern of health professionals, including Health Educators. According to the Centers for Disease Control and Prevention, over one half of the adult population in the United States suffer from one or more chronic conditions. Understanding the health risk behaviors that contribute to…

  6. Multiple chronic conditions and life expectancy

    DEFF Research Database (Denmark)

    DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine; Leff, Bruce; Anderson, Gerard F

    2014-01-01

    BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. RESEARCH DESIGN: A retrospective cohort...... study using single-decrement period life tables. SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer......, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index. RESULTS: Life expectancy decreases with each additional chronic...

  7. Physiotherapy students’ perspectives of online e-learning for interdisciplinary management of chronic health conditions: a qualitative study

    OpenAIRE

    Gardner, Peter; Slater, Helen; Jordan, Joanne E.; Fary, Robyn E.; Chua, Jason; Briggs, Andrew

    2016-01-01

    Background To qualitatively explore physiotherapy students’ perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL). Methods Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore...

  8. Community Care for People with Chronic Conditions: An Analysis of Nine Studies of Health and Social Service Utilization in Ontario

    OpenAIRE

    Watt, Susan; Browne, Gina; Gafni, Amiram; Roberts, Jacqueline; Byrne, Carolyn

    1999-01-01

    A series of studies conducted in the same region found that programmatic, community-based health and social service interventions have a positive impact on client well-being. These proactive interventions, designed to address the full range of health and social needs, were usually provided at the same–or even lower–costs as uncoordinated, illness-focused care. The results of this series suggest that across-the-board health care reduction, atleast in a system of national health insurance, will...

  9. Chronic Illness & Mental Health

    Science.gov (United States)

    ... factors include a personal or family history of depression or loss of family members to suicide. However, there are some risk factors directly related to having another illness. For example, conditions ... role in depression. Illness-related anxiety and stress can also trigger ...

  10. Using the new board game SeCZ TaLK to stimulate the communication on sexual health for adolescents with chronic conditions

    NARCIS (Netherlands)

    Stege, H.A. van der; Staa, A.L. van; Hilberink, S.R.; Visser, A.

    2010-01-01

    This study evaluated the feasibility and appreciation of a new educational board game (SeCZ TaLK) that stimulates communication on sexuality and intimate relationships in youth with chronic conditions.

  11. The chronic disease management in community health service institutions based on Innovative Care for the Chronic Conditions Framework%基于ICCC框架的社区卫生服务机构慢性病管理研究

    Institute of Scientific and Technical Information of China (English)

    袁莎莎; 王芳; 李陈晨; 刘利群; 周巍; 衡驰; 杨婷

    2015-01-01

    Objective:To study the chronic disease management’s key factors in community health service insti-tution based on the Innovative Care for Chronic Conditions Framework ( ICCC ) . Methods: The purposive sampling method was adopted. Twelve community health service centers were selected as the field survey sites in Beijing, Shanghai, Zhengzhou and Chengdu. During the key factors description at macro-, meso-and micro-level in the IC-CC framework, thematic framework analysis was used to describe the key factors at maro-, meso-and micro level in the ICCC framework. Results:From the community health institutions’ perspective, the key factors at meso level in the ICCC framework played a better role in the management of chronic conditions while the key factors in both macro and micro level still lacked. Conclusion:Based on the ICCC framework, the management of chronic diseases needs to emphasize the cooperation with relevant departments outside the health area and legislative strategies at macro level, the ability of community supporters to mobilize and coordinate resources at meso level and the improvement of self-management skills for the patients with chronic diseases.%目的::以世界卫生组织提出的慢性病创新照护框架( Innovative Care for Chronic Conditions Frame-work, ICCC)为理论基础,从社区卫生服务机构角度出发,分析慢性病管理相关要素的实现现状。方法:采取目的抽样,选取北京市、上海市、郑州市、成都市共12家社区卫生服务中心进行现场调查。采用主题框架法,围绕ICCC框架提出的宏观—中观—微观三层面的关键要素展开分析。结果:基于ICCC框架,从社区卫生服务机构角度来看,以卫生保健组织为代表的中观层面要素功能发挥较好,宏观和微观层面要素缺乏。结论:基于ICCC框架,慢性病管理需在宏观层面加强与卫生系统外相关部门的协作及相关立法;中观层面需加强社区资源或社区

  12. Integration of healthcare rehabilitation in chronic conditions

    DEFF Research Database (Denmark)

    Frølich, Anne; Høst, Dorte; Schnor, Helle;

    2010-01-01

    during the project period. The chronic care model was used as a framework for support of implementing and integration of the four rehabilitation programmes. CONCLUSION AND DISCUSSION: The chronic care model provided support for implementing rehabilitation programmes for four chronic conditions in...... rehabilitation programmes in four conditions. DESCRIPTION OF CARE PRACTICE: FOUR MULTIDISCIPLINARY REHABILITATION INTERVENTION PROGRAMMES, ONE FOR EACH CHRONIC CONDITION: chronic obstructive pulmonary disease, type 2 diabetes, chronic heart failure, and falls in elderly people were developed and implemented...... Bispebjerg University Hospital, the City of Copenhagen, and GPs' offices. New management practices were developed, known practices were improved to support integration, and known practices were used for implementation purposes. Several barriers to integrated care were identified....

  13. Selected Diagnosed Chronic Conditions by Sexual Orientation: A National Study of US Adults, 2013

    OpenAIRE

    Ward, Brian W.; Joestl, Sarah S.; Adena M. Galinsky; Dahlhamer, James M.

    2015-01-01

    Introduction Research is needed on chronic health conditions among lesbian, gay, and bisexual populations. The objective of this study was to examine 10 diagnosed chronic conditions, and multiple (≥2) chronic conditions (MCC), by sexual orientation among US adults. Methods The 2013 National Health Interview Survey was used to generate age-adjusted prevalence rates and adjusted odds ratios of diagnosed chronic conditions and MCC for civilian, noninstitutionalized US adults who identified as ga...

  14. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales

    OpenAIRE

    Burwinkle Tasha M; Limbers Christine A; Varni James W

    2007-01-01

    Abstract Background Advances in biomedical science and technology have resulted in dramatic improvements in the healthcare of pediatric chronic conditions. With enhanced survival, health-related quality of life (HRQOL) issues have become more salient. The objectives of this study were to compare generic HRQOL across ten chronic disease clusters and 33 disease categories/severities from the perspectives of patients and parents. Comparisons were also benchmarked with healthy children data. Meth...

  15. Extending employment beyond the pensionable age: a cohort study of the influence of chronic diseases, health risk factors, and working conditions.

    Directory of Open Access Journals (Sweden)

    Marianna Virtanen

    Full Text Available In response to the economic consequences of ageing of the population, governments are seeking ways with which people might work into older age. We examined the association of working conditions and health with extended employment (defined as >6 months beyond the pensionable age in a cohort of older, non-disabled employees who have reached old-age retirement.A total of 4,677 Finnish employees who reached their old-age pensionable date between 2005 and 2011 (mean age 59.8 years in 2005, 73% women had their survey responses before pensionable age linked to national health and pension registers, resulting in a prospective cohort study.In all, 832 participants (17.8% extended their employment by more than 6 months beyond the pensionable date. After multivariable adjustment, the following factors were associated with extended employment: absence of diagnosed mental disorder (OR 1.25, 95% confidence interval = 1.01-1.54 and psychological distress (OR 1.68; 1.35-2.08 and of the work characteristics, high work time control (OR 2.31; 1.88-2.84. The projected probability of extended employment was 21.3% (19.5-23.1 among those free of psychiatric morbidity and with high work time control, while the corresponding probability was only 9.2% (7.4-11.4 among those with both psychiatric morbidity and poor work time control. The contribution of chronic somatic diseases was modest.In the present study, good mental health in combination with the opportunity to control work time seem to be key factors in extended employment into older age. In addition, high work time control might promote work life participation irrespective of employees' somatic disease status.

  16. Role of physical activity, physical fitness, and chronic health conditions on the physical independence of community-dwelling older adults over a 5-year period.

    Science.gov (United States)

    Pereira, Catarina; Baptista, Fátima; Cruz-Ferreira, Ana

    2016-01-01

    The variability in the individual characteristics and habits could help determine how older adults maintain independence. The impact of the variability in physical activity, physical fitness, body composition, and chronic health conditions (co-morbidities) on the independence of older adults, especially over time, is seldom examined. This study aims to analyze quantitatively the impact of baseline values and changes in physical activity, physical fitness, body composition, and co-morbidities on the physical independence of community-dwelling, older adults over a 5-year period. Data from 106 and 85 community-dwelling adults (≥60 years) were collected at baseline and after five years, respectively. Linear regression selected the main predictors of changes in physical independence as follows: the baseline physical independence (β=0.032, R(2)=9.9%) and co-morbidities (β=-0.191, R(2)=6.3%) and the changes in co-morbidities (β=-0.244, R(2)=10.8%), agility (β=-0.288, R(2)=6.7%), aerobic endurance (β=0.007, R(2)=3.2%), and walking expenditure (β=0.001, R(2)=5.1%) (pindependence, baseline co-morbidities, and changes in co-morbidities, walking, agility, and aerobic endurance predicted physical independence over five years regardless of age and gender. Gains of up to 8.3% in physical independence were associated with improvements in these variables, which corresponds to regaining independence for performing one or two activities of daily living. PMID:26966842

  17. Concordance of Chronic Conditions in Older Mexican American Couples

    Directory of Open Access Journals (Sweden)

    Jim P. Stimpson, PhD

    2005-07-01

    Full Text Available Introduction There is substantial evidence that marriage is beneficial to health, but evidence on whether the health status of one spouse is similar, or concordant, with the other spouse is limited. This study assessed whether a chronic condition of one spouse is a risk factor for the same chronic condition in the other spouse. Methods The study used baseline data from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly on 553 couples (1106 individuals who are representative of approximately 500,000 older (≥65 years Mexican Americans living in the southwestern United States. Logistic regression was used to predict six chronic conditions among couples: heart condition, stroke, hypertension, diabetes, arthritis, and cancer. Analyses were adjusted for age, education, U.S. nativity, blood pressure, body mass index, smoking, and alcohol consumption. Results The wife’s history of hypertension, diabetes, arthritis, and cancer was associated with higher odds that the husband would have these conditions. A history of hypertension, arthritis, and cancer in the husband was associated with higher odds that the wife would have these conditions. Conclusion These results provide preliminary evidence that chronic conditions in one spouse are associated with an increased risk of developing like conditions in the other spouse among older Mexican American couples. We propose that the reciprocal influence that marital partners have on each other may be caused by shared living arrangements and shared health risks. Health promotion activities should target family systems. In particular, health providers should gather health histories not only from patients and their genetic family members but also from spouses.

  18. What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review

    Science.gov (United States)

    Amann, Julia; Zanini, Claudia; Rubinelli, Sara

    2016-01-01

    Background In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. Objectives The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. Methods A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. Results A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. Conclusion The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them. PMID:27272912

  19. What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review.

    Directory of Open Access Journals (Sweden)

    Julia Amann

    Full Text Available In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented.The objectives of this study were 1 to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2 to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions.A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process.A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research.The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them.

  20. Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: a population-based survey in Shaanxi Province, China.

    Directory of Open Access Journals (Sweden)

    Zhijun Tan

    Full Text Available INTRODUCTION: The aim of this study was to examine health-related quality of life (HRQoL as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. METHODS: A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. RESULTS: The most frequently reported problems involved pain/discomfort (8.8% and anxiety/depression (7.6%. Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. CONCLUSION: The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs.

  1. iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions

    OpenAIRE

    Parmanto, Bambang; Pramana, Gede; Yu, Daihua Xie; Fairman, Andrea D.; Dicianno, Brad E.; McCue, Michael P

    2013-01-01

    Background Individuals with chronic conditions are vulnerable to secondary complications that can be prevented with adherence to self-care routines. They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments. One such population is individuals with spina bifida (SB), the most common permanently disabling birth defect in the United States. A Wellness Program at the University of Pittsburgh...

  2. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales

    Directory of Open Access Journals (Sweden)

    Burwinkle Tasha M

    2007-07-01

    Full Text Available Abstract Background Advances in biomedical science and technology have resulted in dramatic improvements in the healthcare of pediatric chronic conditions. With enhanced survival, health-related quality of life (HRQOL issues have become more salient. The objectives of this study were to compare generic HRQOL across ten chronic disease clusters and 33 disease categories/severities from the perspectives of patients and parents. Comparisons were also benchmarked with healthy children data. Methods The analyses were based on over 2,500 pediatric patients from 10 physician-diagnosed disease clusters and 33 disease categories/severities and over 9,500 healthy children utilizing the PedsQL™ 4.0 Generic Core Scales. Patients were recruited from general pediatric clinics, subspecialty clinics, and hospitals. Results Pediatric patients with diabetes, gastrointestinal conditions, cardiac conditions, asthma, obesity, end stage renal disease, psychiatric disorders, cancer, rheumatologic conditions, and cerebral palsy self-reported progressively more impaired overall HRQOL than healthy children, respectively, with medium to large effect sizes. Patients with cerebral palsy self-reported the most impaired HRQOL, while patients with diabetes self-reported the best HRQOL. Parent proxy-reports generally paralleled patient self-report, with several notable differences. Conclusion The results demonstrate differential effects of pediatric chronic conditions on patient HRQOL across diseases clusters, categories, and severities utilizing the PedsQL™ 4.0 Generic Core Scales from the perspectives of pediatric patients and parents. The data contained within this study represents a larger and more diverse population of pediatric patients with chronic conditions than previously reported in the extant literature. The findings contribute important information on the differential effects of pediatric chronic conditions on generic HRQOL from the perspectives of children and

  3. Working Conditions, Lifestyles and Health

    DEFF Research Database (Denmark)

    Cottini, Elena; Ghinetti, Paolo

    The aim of this paper is to investigate whether employee health is affected by the environment in which the individual works - in terms of both physical and psychosocial working conditions - and by his or her lifestyle. Health measures are computed from Danish data, and refer to both self assessed...... general health and two more objective health measures: mental health specific to work-related problems, and physical health. We find that both bad working conditions and bad lifestyles reduce health, especially in its self-assessed component. The impact of lifetsyle indicators have a more modest health...

  4. Integration of healthcare rehabilitation in chronic conditions

    OpenAIRE

    2010-01-01

    Introduction: Quality of care provided to people with chronic conditions does not often fulfil standards of care in Denmark and in other countries. Inadequate organisation of healthcare systems has been identified as one of the most important causes for observed performance inadequacies, and providing integrated healthcare has been identified as an important organisational challenge for healthcare systems. Three entities—Bispebjerg University Hospital, the City of Copenhagen, and the GPs in C...

  5. Care of Adult Refugees with Chronic Conditions.

    Science.gov (United States)

    Terasaki, Genji; Ahrenholz, Nicole Chow; Haider, Mahri Z

    2015-09-01

    Refugees share a common experience of displacement from their country of origin, migration, and resettlement in an unfamiliar country. More than 17 million people have fled their home countries due to war, generalized violence, and persecution. US primary care physicians must care for their immediate and long-term medical needs. Challenges include (1) language and cultural barriers, (2) high rates of mental health disorders, (3) higher prevalence of latent infections, and (4) different explanatory models for chronic diseases. This article discusses management strategies for common challenges that arise in the primary care of refugees. PMID:26320045

  6. Legal Preemption and the Prevention of Chronic Conditions.

    Science.gov (United States)

    Hodge, James G; Corbett, Alicia

    2016-01-01

    State and local legal innovations to address chronic conditions are an ongoing source of public health improvements. For decades, some of the most ingenious law and policy ideas to address the underlying causes of chronic conditions and their contributing factors have emerged from state or local public sector grassroots initiatives in diverse areas, including tobacco use, safe housing and transportation, and environmental hazards. These reforms, however, are susceptible to invalidation through the legal doctrine of preemption. Embedded throughout our constitutional system, preemption refers to how state or local laws may be averted, displaced, or negated by conflicting laws at a higher level of government. Preemption can be complex in concept and application, leading to considerable confusion among public health leaders seeking to generate meaningful policy proposals. The objective of this article is to unravel the legal concept of preemption, explain its use as a tool to both thwart or further public health interventions, and offer practical guidance for how to legally navigate around it to address factors underlying chronic conditions. PMID:27362933

  7. Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey

    Directory of Open Access Journals (Sweden)

    Lorraine Johnson

    2014-03-01

    Full Text Available Overview. The Centers for Disease Control and Prevention (CDC health-related quality of life (HRQoL indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD and compares the severity of CLD to other chronic conditions. Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods. Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs. Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs

  8. "What we want": Chronically ill adolescents' preferences and priorities for improving health care

    NARCIS (Netherlands)

    A.L. van Staa (AnneLoes); S. Jedeloo (Susan); H.A. van der Stege (Heleen)

    2011-01-01

    textabstractBackground: As important users of health care, adolescents with chronic conditions deserve to be consulted about their experiences and expectations. This study aimed to explore chronically ill adolescents' preferences regarding providers' qualities, and outpatient and inpatient care. Fur

  9. Medical Transport of Children with Complex Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Carlos F. Lerner

    2012-01-01

    Full Text Available One of the most notable trends in child health has been the increase in the number of children with special health care needs, including those with complex chronic conditions. Care of these children accounts for a growing fraction of health care resources. We examine recent developments in health care, especially with regard to medical transport and prehospital care, that have emerged to adapt to this remarkable demographic trend. One such development is the focus on care coordination, including the dissemination of the patient-centered medical home concept. In the prehospital setting, the need for greater coordination has catalyzed the development of the emergency information form. Training programs for prehospital providers now incorporate specific modules for children with complex conditions. Another notable trend is the shift to a family-centered model of care. We explore efforts toward regionalization of care, including the development of specialized pediatric transport teams, and conclude with recommendations for a research agenda.

  10. Use of the Internet for Health Information by the Chronically Ill

    OpenAIRE

    Wagner, Todd H.; Baker, Laurence C.; M. Kate Bundorf; Sara Singer

    2004-01-01

    Introduction Chronic conditions are among the leading causes of death and disability in the United States. The Internet is a source of health information and advice for individuals with chronic conditions and shows promise for helping individuals manage their conditions and improve their quality of life. Methods We assessed Internet use for health information by people who had one or more of five common chronic conditions. We conducted a national survey of adults aged 21 and older, then...

  11. Social Processes That Can Facilitate and Sustain Individual Self-Management for People with Chronic Conditions

    OpenAIRE

    Elizabeth Kendall; Foster, Michele M.; Carolyn Ehrlich; Wendy Chaboyer

    2012-01-01

    Recent shifts in health policy direction in several countries have, on the whole, translated into self-management initiatives in the hope that this approach will address the growing impact of chronic disease. Dominant approaches to self-management tend to reinforce the current medical model of chronic disease and fail to adequately address the social factors that impact on the lives of people with chronic conditions. As part of a larger study focused on outcomes following a chronic disease, t...

  12. Encounters with medicines among ethnic minorities with chronic conditions

    DEFF Research Database (Denmark)

    Mygind, Anna

    Background: The Danish healthcare sector, including community pharmacies, faces a modern challenge: a new and growing population group consisting of ethnic minorities with chronic conditions, associated with the prevalence of multiple conditions, poly-pharmacy and adherence issues. Aim: The aim of...... interviews with poly-pharmacy patients with non-Western immigrant background focusing on perceptions of disease aetiology and the effect of own behaviour on health. Results: Eight different constructions of ethnic minorities at risk of vitamin D deficiency were found in the ten policy documents identified in...

  13. Intermittent Oxygen Inhalation with Proper Frequency Improves Overall Health Conditions and Alleviates Symptoms in a Population at High Risk of Chronic Mountain Sickness with Severe Symptoms

    Institute of Scientific and Technical Information of China (English)

    Bin Feng; Wei-Hao Xu; Yu-Qi Gao; Fu-Yu Liu; Peng Li; Shan-Jun Zheng; Lu-Yue Gai

    2016-01-01

    group:Z =4.263,3.890,4.040,both P < 0.05/3 vs.before intake) index decreased significantly also for oxygen inhalation method A at all the 3 time points.Cyanosis index decreased significantly 30 days after oxygen intake only in the group of participants administered the D method (Z=2.701,P =0.007).Tinnitus index decreased significantly in group A and D at 15 days (A group:Z =3.377,P =0.001,D group:Z =3.150,P =0.002),30 days after oxygen intake (A group:Z =2.836,P =0.005,D group:Z =5.963,P < 0.0001) and 15 days after termination (A group:Z =2.734,P =0.006,D group:Z =4.049,P =0.0001),and decreased significantly in the group B and C at 15 days after termination (B group:Z=2.611,P =0.009;C group:Z =3.302,P =0.001).In the population at high risk of CMS with severe symptoms,oxygen intake 7 times/week significantly improved total symptom scores of severe symptoms at 15 days (4 [2,5] vs.5.5 [4,7],Z =2.890,P =0.005) and 30 days (3 [1,5] vs.5.5 [2,7],Z=3.270,P =0.001) after oxygen intake compared to no oxygen intake.In the population at high risk of CMS with mild symptoms,compared to no oxygen intake,oxygen intake 2 or 4 times/week did not improve the total symptom scores at 15 days (2 [1,3],3 [1,4] vs.3 [1.5,5];χ2 =2.490,P =0.288),and at 30 days (2 [0,4],2 [1,4.5] vs.3 [2,5];χ2 =3.730,P =0.155) after oxygen intake.In the population at low risk of CMS,oxygen intake did not significantly change the white cell count and red cell count compared to no oxygen intake,neither in the severe symptomatic population nor in the mild symptomatic population.Conclusions:Intermittent oxygen inhalation with proper frequency might alleviate symptoms in residents at high altitude by improving their overall health conditions.Administration of oxygen inhalation therapy 2-4 times/week might not benefit populations at high risk of CMS with mild CMS symptoms while administration of therapy 7 times/week might benefit those with severe symptoms.Oxygen inhalation therapy is not recommended for low

  14. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions

    OpenAIRE

    A. Fattori; Neri, L.; Aguglia, E.; Bellomo, A.; Bisogno, A.; Camerino, D.; Carpiniello, B.; Cassin, A.; Costa, G.; P. Fazio; Di Sciascio, G; Favaretto, G.; C. Fraticelli; Giannelli, R; Leone, S.

    2015-01-01

    Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Met...

  15. Chronic Diseases and Health Promotion

    Science.gov (United States)

    ... GA: Centers for Disease Control and Prevention, US Dept. of Health and Human Services; 2013. http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf. [PDF - 4. ...

  16. Health care 2020: reengineering health care delivery to combat chronic disease.

    Science.gov (United States)

    Milani, Richard V; Lavie, Carl J

    2015-04-01

    Chronic disease has become the great epidemic of our times, responsible for 75% of total health care costs and the majority of deaths in the US. Our current delivery model is poorly constructed to manage chronic disease, as evidenced by low adherence to quality indicators and poor control of treatable conditions. New technologies have emerged that can engage patients and offer additional modalities in the treatment of chronic disease. Modifying our delivery model to include team-based care in concert with patient-centered technologies offers great promise in managing the chronic disease epidemic. PMID:25460529

  17. Relational Systems: How Older Women with Chronic Health Problems Construct Close Relationships

    Science.gov (United States)

    McCann, Brandy Renee; Roberto, Karen A.

    2012-01-01

    Close relationships are important throughout life, but their dynamics may change as chronic health conditions permeate the lives of older women. To understand how older women (N = 36) manage their close relationships, this study was guided by two research questions: How do older women with chronic health conditions define meaningful relationships?…

  18. Legal Regulation of Sodium Consumption to Reduce Chronic Conditions.

    Science.gov (United States)

    Hodge, James G; Barraza, Leila F

    2016-01-01

    In the United States, tens of thousands of Americans die each year of heart disease, stroke, or other chronic conditions tied to hypertension from long-term overconsumption of sodium compounds. Major strides to lower dietary sodium have been made over decades, but the goal of reducing Americans' daily consumption is elusive. The Food and Drug Administration (FDA) has been urged to consider stronger regulatory limits on sodium, especially in processed and prepared foods. Still, FDA categorizes salt (and many other sodium compounds) as "generally recognized as safe," meaning they can be added to foods when ingested in reasonable amounts. Legal reforms or actions at each level of government offer traditional and new routes to improving chronic disease outcomes. However, using law as a public health tool must be assessed carefully, given potential trade-offs and unproven efficacy. PMID:26890409

  19. Health behaviour changes and onset of chronic health problems in later life

    Directory of Open Access Journals (Sweden)

    Marijke Veenstra

    2012-11-01

    Full Text Available Objectives: To assess five-year changes in health behaviours in later life and associations with onset of chronic health problems. The results may inform policy and interventions to promote healthy life years in ageing populations.Methods: Data are derived from the Norwegian study on Life-course, Ageing and Generation (NorLAG, a five-year (2002-2007 panel survey comprising a nation wide community sample. The present analyses include a sample of 1,019 respondents aged 60 years and older. Five-year changes in smoking, alcohol use, physical exercise and Body Mass Index (BMI are assessed according to prevalent and incident chronic health problems. Multivariate logistic analyses of “healthy” behavioural changes are conducted.Results: A total of 453 respondents (45% reported at least one chronic condition and 13% (N=133 reported onset of chronic conditions in the course of the past five years. Over a five-year period, there was an overall reduction in smoking rates and a decrease in regular physical activity. Alcohol consumption in older people slightly increased over time, but the incidence of chronic health problems tended to reduce alcohol intake. Older persons experiencing chronic health problems were less likely to initiate physical activity.Conclusions: The results provide limited support for the assumption that the onset of a chronic health condition triggers improved health behaviours. This suggests that the health care system could do more in targeting a potential “window of opportunity” for individuals to adopt new healthy behaviours in later life.

  20. Prevalence of chronic conditionsChronic Airflow Obstruction

    OpenAIRE

    Ireland and Northern Ireland Population Health Observatory (INIsPHO)

    2012-01-01

    IPH has estimated and forecast clinical diagnosis rates of CAO among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007. The data describe the number of people who report that they have experienced doctor-diagnosed chronic bronchitis, chronic obstructive lung (pulmonary) disease, or emphysema in the previous 12 months (annual clinical diagnosis). Data is available by age and sex for each Loca...

  1. Child and Parent Attributions in Chronic Pediatric Conditions: Phenylketonuria (PKU) as an Exemplar

    Science.gov (United States)

    Antshel, Kevin M.; Brewster, Scott; Waisbren, Susan E.

    2004-01-01

    Background: Attribution theory, self-regulation, self-handicapping and sick role theories all suggest that children with chronic disease may be held to different standards. This study assesses child and parent attributions in pediatric chronic health conditions and addresses how attributional style may be related to treatment adherence. Methods:…

  2. Responsiveness of five condition-specific and generic outcome assessment instruments for chronic pain

    OpenAIRE

    Verra Martin L; Angst Felix; Lehmann Susanne; Aeschlimann André

    2008-01-01

    Abstract Background Changes of health and quality-of-life in chronic conditions are mostly small and require specific and sensitive instruments. The aim of this study was to determine and compare responsiveness, i.e. the sensitivity to change of five outcome instruments for effect measurement in chronic pain. Methods In a prospective cohort study, 273 chronic pain patients were assessed on the Numeric Rating Scale (NRS) for pain, the Short Form 36 (SF-36), the Multidimensional Pain Inventory ...

  3. What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain?

    OpenAIRE

    Dean, E.; Söderlund, Anne

    2015-01-01

    Background: Other than activity and exercise, lifestyle practices such as not smoking and healthy nutrition, well established for preventing and managing lifestyle-related non-communicable diseases (i.e., heart disease, cancer, hypertension, stroke, obstructive lung disease, diabetes, and obesity), are less emphasized in the physical therapy guidelines for addressing chronic pain, e.g., back pain. This state-of-the-art review examines the relationships between lifestyle behaviours and musculo...

  4. Growing up with a Chronic Condition: Challenges for Self-management and Self-management Support

    OpenAIRE

    Sattoe, Jane

    2015-01-01

    markdownabstract__Abstract__ Becoming an adult often proves extra challenging for those who grow up with chronic conditions, because adaptive tasks related to living with a chronic condition can clash with normal developmental milestones. Finding a good balance and integrating these tasks in daily life is also referred to as self-management. This thesis deals with three major themes. First, the concept of self-management and self-management support in current health care for young people with...

  5. Causal inference regarding infectious aetiology of chronic conditions: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sofia Orrskog

    Full Text Available BACKGROUND: The global burden of disease has shifted from communicable diseases in children to chronic diseases in adults. This epidemiologic shift varies greatly by region, but in Europe, chronic conditions account for 86% of all deaths, 77% of the disease burden, and up to 80% of health care expenditures. A number of risk factors have been implicated in chronic diseases, such as exposure to infectious agents. A number of associations have been well established while others remain uncertain. METHODS AND FINDINGS: We assessed the body of evidence regarding the infectious aetiology of chronic diseases in the peer-reviewed literature over the last decade. Causality was assessed with three different criteria: First, the total number of associations documented in the literature between each infectious agent and chronic condition; second, the epidemiologic study design (quality of the study; third, evidence for the number of Hill's criteria and Koch's postulates that linked the pathogen with the chronic condition. We identified 3136 publications, of which 148 were included in the analysis. There were a total of 75 different infectious agents and 122 chronic conditions. The evidence was strong for five pathogens, based on study type, strength and number of associations; they accounted for 60% of the associations documented in the literature. They were human immunodeficiency virus, hepatitis C virus, Helicobacter pylori, hepatitis B virus, and Chlamydia pneumoniae and were collectively implicated in the aetiology of 37 different chronic conditions. Other pathogens examined were only associated with very few chronic conditions (≤ 3 and when applying the three different criteria of evidence the strength of the causality was weak. CONCLUSIONS: Prevention and treatment of these five pathogens lend themselves as effective public health intervention entry points. By concentrating research efforts on these promising areas, the human, economic, and societal

  6. An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: who should the clinician believe?

    Directory of Open Access Journals (Sweden)

    Vetter Thomas R

    2012-07-01

    Full Text Available Abstract Background Previous pediatric studies have observed a cross-informant variance in patient self-reported health-related quality of life (HRQoL versus parent proxy-reported HRQoL. This study assessed in older children and adolescents with a variety of chronic pain conditions: 1 the consistency and agreement between pediatric patients’ self-report and their parents’ proxy-report of their child’s HRQoL; 2 whether this patient-parent agreement is dependent on additional demographic and clinical factors; and 3 the relationship between pediatric patient HRQoL and parental reported HRQoL. Methods The 99 enrolled patients (mean age 13.2 years, 71% female, 81% Caucasian and an accompanying parent completed the PedsQLTM 4.0 and 36-Item Short-Form Health Survey Version 2 (SF-36v2 at the time of their initial appointment in a pediatric chronic pain medicine clinic. Patients’ and parents’ total, physical, and psychosocial HRQoL scores were analyzed via an intra-class correlation coefficient, Spearman’s correlation coefficient, Wilcoxon signed rank test, and Bland-Altman plot. A multivariable linear regression model was used to evaluate the association between clinical and demographic variables and the difference in patient and proxy scores for the Total Scale Score on the PedsQL™. Results With the exception of the psychosocial health domain, there were no statistically significant differences between pediatric patients’ self-report and their parents’ proxy-report of their child’s HRQoL. However, clinically significant patient-parent variation in pediatric HRQoL was observed. Differences in patient-parent proxy PedsQL™ Total Scale Score Scores were not significantly associated with patient age, gender, race, intensity and duration of patient’s pain, household income, parental marital status, and the parent’s own HRQoL on the SF-36v2. No significant relationship existed among patients’ self-reported HRQoL (Peds

  7. Condition based payment: improving care of chronic illness

    OpenAIRE

    DiPiero, Albert; Sanders, David G

    2005-01-01

    Fee-for-service is more than a payment method; it defines the method of care. Fee-for-condition—a payment method that rewards superior results and encourages innovation—could greatly improve care for chronic conditions

  8. [Chronic diseases and employment: impact on social health inequalities].

    OpenAIRE

    Dray-Spira, Rosemary

    2013-01-01

    International audience BACKGROUND: Differential consequences of ill health according to individuals' position on the social scale may constitute an important pathway underlying social health inequalities. In the current context, chronic diseases have major consequences on employment. These consequences may play a substantial role in the process of social health inequalities. Understanding the employment consequences of chronic diseases and their socially differentiated nature constitutes a...

  9. Prevalence of chronic conditions – Stroke

    OpenAIRE

    Ireland and Northern Ireland's Population Health Observatory (INIsPHO)

    2012-01-01

    IPH has estimated and forecast clinical diagnosis rates of stroke among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007. The data describe the number of adults who report that they have experienced doctor-diagnosed stroke in the previous 12 months. Data are available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the Republic of Ireland. In Northern Ir...

  10. Prevalence of chronic conditions – Diabetes

    OpenAIRE

    Ireland and Northern Ireland's Population Health Observatory (INIsPHO)

    2012-01-01

    IPH has estimated and forecast clinical diagnosis rates of diabetes among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007. The data describe the number of people who report that they have experienced doctor-diagnosed diabetes in the previous 12 months (annual clinical diagnosis).  Data are available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the...

  11. Relationship between continuity of care and adverse outcomes varies by number of chronic conditions among older adults with diabetes

    OpenAIRE

    DuGoff, Eva H.; Bandeen-Roche, Karen; Anderson, Gerard F.

    2016-01-01

    Background: Continuity of care is a basic tenant of primary care practice. However, the evidence on the importance of continuity of care for older adults with complex conditions is mixed. Objective: To assess the relationship between measurement of continuity of care, number of chronic conditions, and health outcomes. Design: We analyzed data from a cohort of 1,600 US older adults with diabetes and ≥1 other chronic condition in a private Medicare health plan from July 2010 to December 2011. M...

  12. Health Conditions Prior to Imprisonment and the Impact of Prison on Health: Views of Detained Women.

    Science.gov (United States)

    Alves, Joana; Maia, Ângela; Teixeira, Filipa

    2016-05-01

    Detained women have certain health conditions prior to incarceration and these conditions can improve, worsen, or remain the same in prison, depending on the prisoner's background, the characteristics of the prison, and the arrest experience. This study investigated the health of detained women and the influence of incarceration from their perspective. Three focus groups were conducted among 15 inmates, and data were analyzed according to thematic analysis procedures. Detainer's health backgrounds varied with regard to their level of health concerns, contact with health services, and health behaviors. A positive influence of incarceration was described by patients with chronic illness, patients with drug addiction, and victims of interpersonal violence. Among women with mental illnesses or those without previous health problems, reports do not reveal benefits of imprisonment for mental health. These data emphasize the importance of specialized health care and the need to invest in mental health care in corrective institutions. PMID:26631680

  13. Approaching ADHD as a chronic condition: implications for long-term adherence.

    Science.gov (United States)

    Van Cleave, Jeanne; Leslie, Laurel K

    2008-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic conditions of childhood. Although evidence-based treatments for ADHD, including stimulant medication and behavior modification, have long been established, and guidelines for care of ADHD in primary care settings have been developed, adherence to long-term therapy is poor among youth with ADHD. This article proposes use of the Chronic Care Model for Child Health, the purpose of which is to develop informed, activated patients who will interact with a prepared, proactive health care team. Six "pillars" make up the model: decision support, delivery system design, clinical information systems, family and self-management support, community resources and policies, and health care organizations. Each of these is discussed, and an individual example is described. Adopting the Chronic Care Model for Child Health has the potential to improve the quality of care for ADHD. PMID:18777966

  14. Preconception care: screening and management of chronic disease and promoting psychological health

    OpenAIRE

    Lassi, Zohra S; Imam, Ayesha M; Dean, Sohni V; Bhutta, Zulfiqar A.

    2014-01-01

    Introduction A large proportion of women around the world suffer from chronic diseases including mental health diseases. In the United States alone, over 12% of women of reproductive age suffer from a chronic medical condition, especially diabetes and hypertension. Chronic diseases significantly increase the odds for poor maternal and newborn outcomes in pregnant women. Methods A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconceptio...

  15. Health conditions of young and old elderly

    Directory of Open Access Journals (Sweden)

    Cibelle Barbosa Reis

    2016-02-01

    Full Text Available Objective: to evaluate the elderly about the socio-demographic profile and health conditions in the age groups from 60 to 75 years old (“young” elderly and above 76 years (“old” elderly. Methods: this is a cross-sectional study and home based. The data were collected applying a questionnaire based on the model developed by the Older Americans Resources and Services. Results: 118 elderly participated in the study, being 68.6% “young”, 58% illiterate, 85.2% with income less than two minimum wages and 70.4% with non-white skin. The “old” elderly had a higher proportion of loss of the companion (p=0.002, non-communicable chronic diseases (p=0.023 and dependence to perform activities of daily living (p=0.036. Both age groups had low physical activity, excessive consumption of medicaments and chewing problems. Conclusion: the model of health facing the elderly, should not be restricted to treatment of diseases but cover their functional capacity.

  16. Multiple Chronic Conditions in Older Adults with Acute Coronary Syndromes.

    Science.gov (United States)

    Alfredsson, Joakim; Alexander, Karen P

    2016-05-01

    Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults. In general, higher comorbidity burden increases mortality following MI, reduces utilization of ACS treatments, and increases the importance of developing individualized treatment plans. PMID:27113147

  17. Absence from school related to cancer and other chronic conditions.

    OpenAIRE

    Charlton, A.; Larcombe, I J; Meller, S T; Morris Jones, P H; Mott, M G; Potton, M W; Tranmer, M D; Walker, J J

    1991-01-01

    Absence from school during the first year after starting major treatment for cancer or chronic or orthopaedic conditions was examined. Retrospective data were collected on 72 children and obtained from hospital records, school registers, and interviews with parents and teachers. Median initial absences caused by treatment were 91, 29-5, and 15 days for cancer, chronic, and orthopaedic patients respectively. The mean proportions of the remaining school time in the year occupied by absences cau...

  18. Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo.

    Science.gov (United States)

    Toci, Ervin; Burazeri, Genc; Jerliu, Naim; Sørensen, Kristine; Ramadani, Naser; Hysa, Bajram; Brand, Helmut

    2015-09-01

    The aim was to describe health literacy among the older population of Kosovo, an Albanian speaking post-war country in the Western Balkans, in the context of self-perceived health status and self-reported chronic morbidity. A cross-sectional study was conducted in Kosovo in 2011 including 1753 individuals aged ≥ 65 years (886 men, 867 women; mean age 73.4 ± 6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access, understanding, appraisal and application of health information. Sub-scale scores and an overall health literacy score were calculated for each participant. Information on self-perceived health status, presence and number of chronic diseases and socioeconomic characteristics was also collected. Mean values of the overall health literacy score and all sub-scale scores (access, understanding, appraisal and application) were lower among older people who reported a poorer health status or at least one chronic condition compared with individuals who perceived their health status as good or had no chronic conditions (p < 0.001 for all). Our findings provide valuable evidence on the independent and inverse association between health literacy levels and self-perceived health and chronic morbidity in this post-war European population. The putative link with chronic morbidity and lower adherence to health services is hard to establish through this cross-sectional study. Prospective population-based studies should be conducted in Kosovo and other transitional settings to replicate these findings and properly address the causal relationship between health literacy and health status. PMID:24604915

  19. Physical fitness and training in chronic childhood conditions

    NARCIS (Netherlands)

    van Brussel, M.

    2008-01-01

    Chapter 1 is a general introduction with background information about physical fitness and training in healthy children and children with a chronic condition. Chapter 2 describes a systematic review on the physical fitness in survivors of acute lymphoblastic leukaemia (ALL). The analysis showed that

  20. Health Conditions Associated with Psoriasis

    Science.gov (United States)

    ... Zipcode Comorbidities Associated with Psoriatic Disease People with psoriasis and psoriatic arthritis are at an elevated risk ... conditions. Psoriasis and Psoriatic Arthritis Psoriasis Psoriatic Arthritis Psoriasis and Psoriatic Arthritis Cancer A number of studies ...

  1. Perceived conflict in the couple and chronic illness management: Preliminary analyses from the Quebec Health Survey

    Directory of Open Access Journals (Sweden)

    Hudon Catherine

    2006-10-01

    Full Text Available Abstract Background The quality of the relationship with the spouse/partner appears crucial among patients with multiple chronic conditions where illness management is complex and multifaceted. This study draws on data from the Quebec Health Survey (QHS to examine, among patients with one or more chronic conditions, the relation between marital status, the perceived conflict with the spouse/partner, and what the patients do to manage their illness as well as how they perceive their health. Methods Data from the QHS 1998 were used. The sample included 7547 coupled adults who had one or more chronic health problems lasting more than 6 months. Independent variables included marital status, perceived conflict with the spouse/partner, and the number of chronic conditions. Illness management was defined broadly as a measure of the patient's efforts at self-care and an illness status indicator, including visits to the generalist and the specialist, the use of telephone health line in the last 12 months, self-rated general health, mental health, and a measure of psychological distress. Linkages between the independent variables and illness management were assessed for males and females separately with logistic regressions, while accounting for the survey sampling design and household clustering. Results Female patients who did not live with their partner and had never been married were more likely to report a negative perception of their general health and a higher psychological distress than those who were married. Perceived conflict with the partner was linked to a negative perception of mental health and a higher psychological distress among both men and women. Compared to patients with only one chronic condition, males who reported more than one chronic condition were more likely to have consulted a generalist prior to the survey and used the telephone health line, whereas females were more likely to have consulted a specialist. Both males and

  2. What do health interview surveys tell us about the prevalences of somatic chronic diseases?: a study into concurrent validity.

    NARCIS (Netherlands)

    Velden, J. van der; Abrahamse, H.P.H.; Donker, G.; Steen, J. van der; Sonsbeek, J.L.A. van; Bos, G.A.M. van den

    1998-01-01

    This study examines the concurrent validity of a list of chronic conditions used in health interview surveys. The results regarding the prevalence of chronic diseases from three health interview surveys, carried out in The Netherlands during the 1980s, were compared. In addition, the results for chr

  3. Validation of the Danish version of the Patient Assessment of Care for Chronic Conditions questionnaire (PACIC)

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Maindal, Helle Terkildsen; Vedsted, Peter

    Objective: To evaluate the level of chronic care patients must be involved. The Danish version of the 20-item Patient Assessment of Care for Chronic Conditions PACIC questionnaire consisting of 5 scales and an overall summary score measuring patient reported assessment of structured chronic care...... has not been evaluated with regard to psychometric properties. This study aims to assess data quality and internal consistency and to validate the proposed factorial structure. Materials and methods: Setting: Diabetes population receiving chronic care in Denmark. Subjects: A total of 624 patients aged...... same questionnaire is constructed and applied to different countries with diverse cultural backgrounds and health care systems. It is decisive, that translated questionnaires are validated in country they are used....

  4. Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine

    Directory of Open Access Journals (Sweden)

    Gianluca Castelnuovo

    2015-04-01

    Full Text Available Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of ehealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the chronic care management challenge in both traditional and mHealth settings.

  5. Perceived chronic stress, health and cognition

    OpenAIRE

    Öhman, Lena

    2006-01-01

    The aim of this licentiate thesis was to examine consequences of chronic stress for stressrelated diseases and to investigate the chronic stress – cognition relationship. In the first study data covering ten years was used from the Betula Prospective Cohort Study (Nilsson et al., 1997). Based on the ratings on a stress scale, matched samples between 40 and 65 years of age were divided into a high and low stress group. The reported incidence of cardiovascular, diabetes, psychiatric, tumor, and...

  6. A Logic Model for the Integration of Mental Health Into Chronic Disease Prevention and Health Promotion

    Directory of Open Access Journals (Sweden)

    James Lando, MD, MPH

    2006-03-01

    Full Text Available Mental illnesses such as depression or anxiety affect an individual’s ability to undertake health-promoting behaviors. Chronic diseases can have a profound impact on an individual’s mental health; in turn, mental health status affects an individual’s ability to participate in treatment and recovery. A group of mental health and public health professionals convened to develop a logic model for addressing mental health as it relates to chronic disease prevention and health promotion. The model provides details on inputs, activities, and desired outcomes, and the designers of the model welcome input from other mental health and public health practitioners.

  7. Using Health Utility Index (HUI for Measuring the Impact on Health-Related Quality of Life (HRQL Among Individuals with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Frank Mo

    2004-01-01

    Full Text Available Quality of life is an important indicator in assessing the burden of disease, especially for chronic conditions. The Health Utilities Index (HUI is a recently developed system for measuring the overall health status and health-related quality of life (HRQL of individuals, clinical groups, and general populations. Using the HUI (constructed based on eight attributes: vision, hearing, speech, mobility, dexterity, cognition, emotion, and pain/discomfort to measure the HRQL for chronic disease patients and to detect possible associations between HUI system and various chronic conditions, this study provides information to improve the management of chronic diseases.This study is of interest to data analysts, policy makers, and public health practitioners involved in descriptive clinical studies, clinical trials, program evaluation, population health planning, and assessments. Based on the Canadian Community Health Survey (CCHS for 2000–01, the HUI was used to measure the quality of life for individuals living with various chronic conditions (Alzheimer/other dementia, effects of stroke, urinary incontinence, arthritis/rheumatism, bowel disorder, cataracts, back problems, stomach/intestinal ulcers, emphysema/COPD, chronic bronchitis, epilepsy, heart disease, diabetes, migraine headaches, glaucoma, asthma, fibromyalgia, cancers, high blood pressure, multiple sclerosis, thyroid condition, and other remaining chronic diseases. Logistic Regression Model was employed to estimate the associations between the overall HUI scores and various chronic conditions. The HUI scores ranged from 0.00 (corresponding to a state close to death to 1.00 (corresponding to perfect health; negative scores reflect health states considered worse than death. The mean HUI score by sex and age group indicated the typical quality of life for persons with various chronic conditions. Logistic Regression results showed a strong relationship between low HUI scores (≤ 0.5 and 0.06

  8. Audiometry and ossicular condition in chronic otitis media

    OpenAIRE

    mohsen Rajati Haghi; Mohamad Mahdi Ghasemi; Mehdi Bakhshaee; Atefeh Taghati; Atefeh Shahabipour

    2009-01-01

      Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM). Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA) findings of COM patients with the ossicular condition determined during surgery. M...

  9. Co-Occurrence of Leading Lifestyle-Related Chronic Conditions Among Adults in the United States, 2002-2009

    OpenAIRE

    Ford, Earl S.; Croft, Janet B.; Posner, Samuel F.; Goodman, Richard A.; Giles, Wayne H.

    2013-01-01

    Introduction Public health and clinical strategies for meeting the emerging challenges of multiple chronic conditions must address the high prevalence of lifestyle-related causes. Our objective was to assess prevalence and trends in the chronic conditions that are leading causes of disease and death among adults in the United States that are amenable to preventive lifestyle interventions. Methods We used self-reported data from 196,240 adults aged 25 years or older who participated in the Nat...

  10. Chronic wounds should be one of Australia's National Health Priority Areas.

    Science.gov (United States)

    Kapp, Suzanne; Santamaria, Nick

    2015-11-01

    Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A $2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Areas, and to establish a profile of chronic wounds as a chronic disease of national significance in its own right. This approach has the potential to raise awareness of the significance of chronic wounds and garner support from the public, healthcare sector, research funders and policy makers to improve the outcomes for people who are living with or at risk of developing this condition and to potentially reduce expenditure in this area. PMID:26072695

  11. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions

    Directory of Open Access Journals (Sweden)

    A. Fattori

    2015-01-01

    Full Text Available Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N=1717 with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p<0.01; SF-12 MCS: 59.4% versus 74.3%, p<0.01. The adjusted marginal overall productivity cost of workplace bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP 2010 US$ 4182–5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers’ quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions.

  12. From Heart Health Promotion to Chronic Disease Prevention: Contributions of the Canadian Heart Health Initiative

    Directory of Open Access Journals (Sweden)

    Kerry Robinson, MA

    2007-04-01

    Full Text Available Background The Canadian Heart Health Initiative began in 1987 as an 18-year undertaking to address the epidemic of cardiovascular disease in Canada. There is growing recognition in Canada of the need for an integrated approach to prevention that addresses common risks for many chronic diseases. Context Research and intervention activities of the Canadian Heart Health Initiative have shifted toward chronic disease prevention and health promotion. This study explores the contributions of the Canadian Heart Health Initiative to document how single-disease strategies can evolve into integrated chronic disease prevention efforts. Methods Key informant interviews were conducted with project researchers and health system stakeholders from seven Canadian Heart Health Initiative provincial projects. A review of provincial health policy documents was also performed.Consequences Findings indicate that the Canadian Heart Health Initiative projects contributed to public health capacity development, including coalition and partnership building, and development of health knowledge and resource infrastructure. The Canadian Heart Health Initiative projects helped put chronic disease prevention issues onto local and provincial health agendas and provided community-based models to help develop public health policies. Interpretation Experience with the Canadian Heart Health Initiative shows the need for integrated health programs to build on existing infrastructure. Other requirements for integrated chronic disease prevention programs include shared goals, partnerships at various policy levels and in multiple sectors, ongoing information sharing, and funding that is flexible and long-term.

  13. Use of the Internet for Health Information by the Chronically Ill

    Directory of Open Access Journals (Sweden)

    Todd H. Wagner

    2004-10-01

    Full Text Available Introduction Chronic conditions are among the leading causes of death and disability in the United States. The Internet is a source of health information and advice for individuals with chronic conditions and shows promise for helping individuals manage their conditions and improve their quality of life. Methods We assessed Internet use for health information by people who had one or more of five common chronic conditions. We conducted a national survey of adults aged 21 and older, then analyzed data from 1980 respondents who had Internet access and who reported that they had hypertension, diabetes, cancer, heart problems, and/or depression. Results Adjusted rates for any Internet use for health information ranged from 33.8% (heart problems only to 52.0% (diabetes only. A sizable minority of respondents — particularly individuals with diabetes — reported that the Internet helped them to manage their condition themselves, and 7.9% said information on the Internet led them to seek care from a different doctor. Conclusion Use of the Internet for health information by chronically ill patients is moderate. Self-reported effects on choice of treatment or provider are small but noteworthy.

  14. Innovations in health information technologies for chronic pulmonary diseases

    OpenAIRE

    Himes, Blanca E; Weitzman, Elissa R

    2016-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are common chronic obstructive lung disorders in the US that affect over 49 million people. There is no cure for asthma or COPD, but clinical guidelines exist for controlling symptoms that are successful in most patients that adhere to their treatment plan. Health information technologies (HITs) are revolutionizing healthcare by becoming mainstream tools to assist patients in self-monitoring and decision-making, and subsequently, driving...

  15. A Meta-Analysis of Health Status, Health Behaviors, and Health Care Utilization Outcomes of the Chronic Disease Self-Management Program

    OpenAIRE

    Brady, Teresa J; Murphy, Louise; O’Colmain, Benita J.; Beauchesne, Danielle; Daniels, Brandy; Greenberg, Michael; House, Marnie; Chervin, Doryn

    2013-01-01

    Introduction The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions; it has been implemented worldwide. The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program’s effects on health behaviors, physical and psychological healt...

  16. Work Disability Associated with Cancer Survivorship and Other Chronic Conditions

    OpenAIRE

    Short, Pamela Farley; Vasey, Joseph J; Belue, Rhonda

    2008-01-01

    The long-term effects of cancer and its treatment on employment and productivity are a major concern for the 40% of cancer survivors in the U.S. who are working age. This study’s objectives were (1) to quantify the increase in work disability attributable to cancer in a cohort of adult survivors who were an average of 46 months post-diagnosis and (2) to compare disability rates in cancer survivors to individuals with other chronic conditions. Data from the Penn State Cancer Survivor Study (PS...

  17. Chronic Low-Back Pain and Complementary Health Approaches: What the Science Says

    Science.gov (United States)

    ... NCCIH Clinical Digest for health professionals Chronic Low-Back Pain and Complementary Health Approaches: What the Science Says ... Guidelines, Scientific Literature, Info for Patients: Chronic Low-Back Pain and Complementary Health Approaches Spinal Manipulation The term ...

  18. Telephone-based health coaching for chronically ill patients: study protocol for a randomized controlled trial

    OpenAIRE

    Dwinger, Sarah; Dirmaier, Jörg; Herbarth, Lutz; König, Hans-Helmut; Eckardt, Matthias; Kriston, Levente; Bermejo, Isaac; Härter, Martin

    2013-01-01

    Background The rising prevalence of chronic conditions constitutes a major burden for patients and healthcare systems and is predicted to increase in the upcoming decades. Improving the self-management skills of patients is a strategy to steer against this burden. This could lead to better outcomes and lower healthcare costs. Health coaching is one method for enhancing the self-management of patients and can be delivered by phone. The effects of telephone-based health coaching are promising, ...

  19. Responsiveness of five condition-specific and generic outcome assessment instruments for chronic pain

    Directory of Open Access Journals (Sweden)

    Verra Martin L

    2008-04-01

    Full Text Available Abstract Background Changes of health and quality-of-life in chronic conditions are mostly small and require specific and sensitive instruments. The aim of this study was to determine and compare responsiveness, i.e. the sensitivity to change of five outcome instruments for effect measurement in chronic pain. Methods In a prospective cohort study, 273 chronic pain patients were assessed on the Numeric Rating Scale (NRS for pain, the Short Form 36 (SF-36, the Multidimensional Pain Inventory (MPI, the Hospital Anxiety and Depression Scale (HADS, and the Coping Strategies Questionnaire (CSQ. Responsiveness was quantified by effect size (ES and standardized response mean (SRM before and after a four week in-patient interdisciplinary pain program and compared by the modified Jacknife test. Results The MPI measured pain more responsively than the SF-36 (ES: 0.85 vs 0.72, p = 0.053; SRM: 0.72 vs 0.60, p = 0.027 and the pain NRS (ES: 0.85 vs 0.62, p Conclusion The MPI was most responsive in all comparable domains followed by the SF-36. The pain-specific MPI and the generic SF-36 can be recommended for comprehensive and specific bio-psycho-social effect measurement of health and quality-of-life in chronic pain.

  20. Social Processes That Can Facilitate and Sustain Individual Self-Management for People with Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Elizabeth Kendall

    2012-01-01

    Full Text Available Recent shifts in health policy direction in several countries have, on the whole, translated into self-management initiatives in the hope that this approach will address the growing impact of chronic disease. Dominant approaches to self-management tend to reinforce the current medical model of chronic disease and fail to adequately address the social factors that impact on the lives of people with chronic conditions. As part of a larger study focused on outcomes following a chronic disease, this paper explores the processes by which a chronic disease self-management (CDSM course impacted on participants. Five focus groups were conducted with participants and peer leaders of the course in both urban and rural regions of Queensland, Australia. The findings suggested that outcomes following CDSM courses depended on the complex interplay of four social factors, namely, social engagement, the development of a collective identity, the process of building collaborative coping capacity, and the establishment of exchange relationships. This study highlights the need for an approach to self-management that actively engages consumers in social relationships and addresses the context within which their lives (and diseases are enacted. This approach extends beyond the psychoeducational skills-based approach to self-management into a more ecological model for disease prevention.

  1. Physical activity as a mediator of the impact of chronic conditions on quality of life in older adults

    Directory of Open Access Journals (Sweden)

    Miller William C

    2007-12-01

    Full Text Available Abstract Background Chronic conditions could negatively affect the quality of life of older adults. This may be partially due to a relative lack of physical activity. We examined whether physical activity mediates the relationship between different chronic conditions and several health outcomes that are important to the quality of life of older adults. Methods The data were taken from the Canadian Community Health Survey (cycle 1.1, a cross-section survey completed in 2001. Only respondents who were 65 years or older were included in our study (N = 22,432. The Health Utilities Index Mark 3 (HUI3 was used to measure overall quality of life, and to measure selected health outcomes (dexterity, mobility, pain, cognition, and emotional wellbeing that are considered to be of importance to the quality of life of older adults. Leisure-time physical activity was assessed by determining weekly energy expenditure (Kcal per week based on the metabolic equivalents of self-reported leisure activities. Linear and logistic regression models were used to determine the mediating effect of leisure-time physical activity while controlling for demographic variables (age and sex, substance use (tobacco use and alcohol consumption, and obesity. Results Having a chronic condition was associated with a relative decrease in health utility scores and a relative increase in mobility limitations, dexterity problems, pain, emotional problems (i.e., decreased happiness, and cognitive limitations. These negative consequences could be partially attributed to a relative lack of physical activity in older adults with a chronic condition (14% mediation for the HUI3 score. The corresponding degree of mediation was 18% for mobility limitations, 5% for pain, and 13% for emotional wellbeing (statistically significant mediation was not observed for the other health attributes. These values varied with respect to the different chronic conditions examined in our study. Conclusion Older

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

    Science.gov (United States)

    Ronis, D L

    1992-01-01

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

  3. Inadequate Palliative Care in Chronic Lung Disease. An Issue of Health Care Inequality.

    Science.gov (United States)

    Brown, Crystal E; Jecker, Nancy S; Curtis, J Randall

    2016-03-01

    Patients with chronic lung diseases suffer higher symptom burden, lower quality of life, and greater social isolation compared with patients with other diagnoses, such as cancer. These conditions may be alleviated by palliative care, yet palliative care is used less by patients with chronic lung disease compared with patients with cancer. Underuse is due, in part, to poor implementation of primary palliative care and inadequate referral to specialty palliative care. Lack of primary and specialty palliative care in patients with chronic lung disease falls short of the minimum standard of competent health care, and represents a disparity in health care and a social injustice. We invoke the ethical principles of justice and sufficiency to highlight the importance of this issue. We identify five barriers to implementing palliative care in patients with chronic lung disease: uncertainty in prognosis; lack of provider skill to engage in discussions about palliative care; fear of using opioids among patients with chronic lung disease; fear of diminishing hope; and perceived and implicit bias against patients with smoking-related lung diseases. We propose mechanisms for improving implementation of palliative care for patients with chronic lung disease with the goal of enhancing justice in health care. PMID:26730490

  4. Integrating structural health and condition monitoring

    DEFF Research Database (Denmark)

    May, Allan; Thöns, Sebastian; McMillan, David

    2015-01-01

    There is a large financial incentive to minimise operations and maintenance (O&M) costs for offshore wind power by optimising the maintenance plan. The integration of condition monitoring (CM) and structural health monitoring (SHM) may help realise this. There is limited work on the integration of...

  5. Changing living conditions, life style and health

    DEFF Research Database (Denmark)

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    . The aim of the paper is to illustrate the influence of environmental change on living conditions and life style and some of the mechanisms through which such changes affect physical and mental health. The interrelationship between environmental and societal change is illustrated by an example from a small...... community in Greenland, where changing environmental conditions have influenced fishing and employment opportunities to the extent that the size of the population has changed dramatically. The link between social change and health is shown with reference to studies on education, housing and occupation...... as well as life style changes. The paper further illustrates the relationship between the rapid socio-cultural and economic change and the health of the population. Psychosocial stress is reflected in problems such as alcohol abuse, violence and suicide, and these factors have been shown in studies...

  6. Associations of physical and mental health problems with chronic cough in a representative population cohort

    Science.gov (United States)

    2009-01-01

    Background Although chronic cough is a common problem in clinical practice, data on the prevalence and characteristics of cough in the general population are scarce. Our aim was to determine the prevalence of chronic cough that is not associated with diagnosed respiratory conditions and examine the impact on health status and psychological health, in a representative adult population cohort Methods North West Adelaide Health Study (n stage 1 = 4060, stage 2 = 3160) is a representative population adult cohort. Clinical assessment included spirometry, anthropometry and skin tests. Questionnaires assessed demographics, lifestyle risk factors, quality of life, mental health and respiratory symptoms, doctor diagnosed conditions and medication use. Results Of the 3355 people without identified lung disease at baseline, 18.2% reported chronic cough. In multiple logistic regression models, at follow-up, dry chronic cough without sputum production was significantly more common in males (OR 1.5, 95% CI 1.1, 1.9), current smokers (OR 4.9, 95% CI 3.4, 7.2), obesity (OR 1.9, 95% CI 1.3, 2.9), use of ACE inhibitors (OR 1.8, 95% CI 1.1, 2.9), severe mental health disturbance (OR 2.1, 95% CI 1.4, 3.1) and older age (40-59 years OR 1.7 95% CI 1.2, 2.4; ≥ 60 years OR 2.1 95% CI 1.3, 3.5). Among non-smokers only, all cough was significantly more common in men, those with severe mental health disturbance and obesity. Conclusions Chronic cough is a major cause of morbidity. Attention to cough is indicated in patients with obesity, psychological symptoms or smokers. Inquiring about cough in those with mental health problems may identify reversible morbidity. PMID:20003540

  7. Monitoring the prevalence of chronic conditions: which data should we use?

    Directory of Open Access Journals (Sweden)

    Orueta Juan F

    2012-10-01

    Full Text Available Abstract Background Chronic diseases are an increasing threat to people’s health and to the sustainability of health organisations. Despite the need for routine monitoring systems to assess the impact of chronicity in the population and its evolution over time, currently no single source of information has been identified as suitable for this purpose. Our objective was to describe the prevalence of various chronic conditions estimated using routine data recorded by health professionals: diagnoses on hospital discharge abstracts, and primary care prescriptions and diagnoses. Methods The ICD-9-CM codes for diagnoses and Anatomical Therapeutic Chemical (ATC codes for prescriptions were collected for all patients in the Basque Country over 14 years of age (n=1,964,337 for a 12-month period. We employed a range of different inputs: hospital diagnoses, primary care diagnoses, primary care prescriptions and combinations thereof. Data were collapsed into the morbidity groups specified by the Johns Hopkins Adjusted Clinical Groups (ACGs Case-Mix System. We estimated the prevalence of 12 chronic conditions, comparing the results obtained using the different data sources with each other and also with those of the Basque Health Interview Survey (ESCAV. Using the different combinations of inputs, Standardized Morbidity Ratios (SMRs for the considered diseases were calculated for the list of patients of each general practitioner. The variances of the SMRs were used as a measure of the dispersion of the data and were compared using the Brown-Forsythe test. Results The prevalences calculated using prescription data were higher than those obtained from diagnoses and those from the ESCAV, with two exceptions: malignant neoplasm and migraine. The variances of the SMRs obtained from the combination of all the data sources (hospital diagnoses, and primary care prescriptions and diagnoses were significantly lower than those using only diagnoses. Conclusions The

  8. Social participation and healthy ageing: a neglected, significant protective factor for chronic non communicable conditions

    Directory of Open Access Journals (Sweden)

    Joseph Jennifer

    2011-10-01

    Full Text Available Abstract Background Low and middle income countries are ageing at a much faster rate than richer countries, especially in Asia. This is happening at a time of globalisation, migration, urbanisation, and smaller families. Older people make significant contributions to their families and communities, but this is often undermined by chronic disease and preventable disability. Social participation can help to protect against morbidity and mortality. We argue that social participation deserves much greater attention as a protective factor, and that older people can play a useful role in the prevention and management of chronic conditions. We present, as an example, a low-cost, sustainable strategy that has increased social participation among elders in Sri Lanka. Discussion Current international policy initiatives to address the increasing prevalence of non-communicable chronic diseases are focused on cardiovascular disease, diabetes, respiratory disease and cancers, responsible for much premature mortality. Interventions to modify their shared risk factors of high salt and fat diets, inactivity, smoking and alcohol use are advocated. But older people also suffer chronic conditions that primarily affect quality of life, and have a wider range of risk factors. There is strong epidemiological and physiological evidence that social isolation, in particular, is as important a risk factor for chronic diseases as the 'lifestyle' risk factors, yet it is currently neglected. There are useful experiences of inexpensive and sustainable strategies to improve social participation among older people in low and lower middle income countries. Our experience with forming Elders' Clubs with retired tea estate workers in Sri Lanka suggests many benefits, including social support and participation, inter-generational contact, a collective voice, and facilitated access to health promotion activities, and to health care and social welfare services. Summary Policies to

  9. Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis

    Science.gov (United States)

    Buffel du Vaure, Céline; Ravaud, Philippe; Baron, Gabriel; Barnes, Caroline; Gilberg, Serge; Boutron, Isabelle

    2016-01-01

    Objectives To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines. Design Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach. Data sources National Guideline Clearinghouse index of US clinical practice guidelines. Study selection We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression). Data extraction From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45–64 years with moderate severity of conditions. Simulation modelling approach For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions. Results Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions. PMID:27006342

  10. Public Health Burden of Chronic Stress in a Transforming Society

    Directory of Open Access Journals (Sweden)

    Mária S. Kopp

    2007-12-01

    Full Text Available In this paper chronic stress is proposed as an integrating model that can be applied to the explanation of the suddenly changing patterns of premature mortality rates in transforming societies of Central-Eastern-Europe, especially in Hungary. The temporal factor in existing stress models is often neglected. Chronic stress has been shown to lead to typical pathogenetic results in animal experiments. Literature and the different models in the field of psychology, behavioural sciences, and epidemiology are reviewed in terms of the chronic stress theory. There are several conceptual bridges between psychological alterations and the risks, onset and prognosis of chronic disorders of great epidemiological significance. Depending on the field of research there are several parallel concepts which analyse practically the same phenomena. These are the stress theories in physiology, learned helplessness and control theory in psychology, depression research in psychiatry, the concept of vital exhaustion and the psychosocial risk research in sociology. Because chronic stress results in adverse health effects through biological, social and behavioural pathways, this theory might also havethe best explanatory power to understand the premature male morbidity and mortality crisis in Central and Eastern Europe in the last decades. The special features of premature mortality and morbidity crisis in Hungary might be regarded as an experimental model to understand better the human consequences of chronic stress and those processes where psychology meets physiology.

  11. Gendered work conditions, health, and work outcomes.

    Science.gov (United States)

    Bond, Meg A; Punnett, Laura; Pyle, Jean L; Cazeca, Dianne; Cooperman, Manuela

    2004-01-01

    This cross-sectional study of nonfaculty university employees examined associations among gendered work conditions (e.g., sexism and discrimination), job demands, and employee job satisfaction and health. Organizational responsiveness and social support were examined as effect modifiers. Comparisons were made by gender and by the male-female ratio in each job category. The relationship of gendered conditions of work to outcomes differed on the basis of respondents' sex and the job sex ratio. Although the same predictors were hypothesized for job satisfaction, physical health, and psychological distress, there were some differing results. The strongest correlate of job satisfaction was social support; perceived sexism in the workplace also contributed for both men and women. Organizational factors associated with psychological distress differed between female- and male-dominated jobs. PMID:14700456

  12. Impact of health literacy in patients with chronic musculoskeletal disease--systematic review.

    Directory of Open Access Journals (Sweden)

    Yoon K Loke

    Full Text Available OBJECTIVES: To estimate the prevalence of low health literacy, and evaluate the impact of low health literacy on outcomes in patients with chronic musculoskeletal conditions. DATA SOURCES: We searched Embase, Pubmed, PsycInfo, and CINAHL in January 2011 for relevant studies, restricted to English-language articles. STUDY SELECTION AND DATA EXTRACTION: Studies were included if they measured health literacy and/or reported on the link between outcomes and health literacy levels in patients with osteoporosis, osteoarthritis, or rheumatoid arthritis. We assessed risk of bias from participant selection, methods of measuring health literacy and functional outcomes, missing data, and potential for confounding. DATA SYNTHESIS: We reviewed 1863 citations and judged 8 studies to be relevant. Most were cross-sectional in nature, and five were based in the United States. Diversity in measurements, participant characteristics, and settings meant that results had to be synthesized narratively. Prevalence of low health literacy varied from 7% to 42%. Of the five studies that reported on musculoskeletal outcomes, only one showed an association (unadjusted between low health literacy and greater pain and limitations in physical functioning. However, other studies, including those with multivariate analyses, found no significant relationship between health literacy and measures of pain or disease specific questionnaires. One clinical trial found short-term improvements in the mental health of patients with musculoskeletal conditions after an intervention to improve health literacy. LIMITATIONS: Most of the studies were cross-sectional in nature, which precludes interpretation of a causal relationship. The sample sizes may not have been sufficiently large to enable detection of significant associations. CONCLUSIONS: The current evidence does not show a consistent association between low health literacy and poorer functional outcomes in patients with chronic

  13. Processing Conditions, Rice Properties, Health and Environment

    OpenAIRE

    Roy, Poritosh; Orikasa, Takahiro; Okadome, Hiroshi; Nakamura, Nobutaka; Shiina, Takeo

    2011-01-01

    Rice is the staple food for nearly two-thirds of the world’s population. Food components and environmental load of rice depends on the rice form that is resulted by different processing conditions. Brown rice (BR), germinated brown rice (GBR) and partially-milled rice (PMR) contains more health beneficial food components compared to the well milled rice (WMR). Although the arsenic concentration in cooked rice depends on the cooking methods, parboiled rice (PBR) seems to be relatively prone to...

  14. Health condition of forests; 1 : 500 000

    International Nuclear Information System (INIS)

    The map was produced in the Forestry Research Institute in Zvolen in collaboration with the Slovak Environmental Agency in Banska Bystrica. Health condition of forests is mapped at scale 1 : 50 000 based on the Landsat Thematic Mapper satellite data (4 satellite scenes from 1996 and one from 1995). In classification stage the data of 453 terrestrial monitoring plots where heath condition of forest was evaluated in the years 1995 - 1996 were used. Classification was processed on the basis of the two-phase regression selection between the 1st phase of selection (satellite image) and the 2nd phase (terrestrial evaluation). 220 terrestrial plots with defoliation lower than 20 % or higher then 35 % were used for classification. The accuracy of classification for homogeneous growths is about 80 % and 50 % for not homogeneous growths. Amount of needles highly influences the result of classification of health condition of coniferous growths by satellite images. In case of broad-leaved growths apart from amount of leafs, the quantification of damage is greatly influenced by site, water regime, withering of the particular locality and the current phenological phase of the broad-leaved growth. This is the reason why the dynamics of the changes of health condition of broad-leaved growths is higher than that of coniferous growths and it can vary even in the course of one year. The method of evaluation of health condition by satellite images though, is limited. One of the greatest influences on the correctness of classification is the canopy. With decreasing canopy the spectral characteristics of the growth is increasingly influenced by its undergrowth or substrate. Overestimation or underestimation of health condition depends on their quality. In case of severely damaged or dead growths it is almost impossible to discern them from not forested areas. Distortion of evaluation also occurs in cases when the forest growths are located at the dividing lines between the forested and

  15. Depressive symptoms in people with chronic physical conditions: prevalence and risk factors in a Hong Kong community sample

    Directory of Open Access Journals (Sweden)

    Nan Hairong

    2012-11-01

    Full Text Available Abstract Background Depression is predicted to become one of the two most burdensome diseases worldwide by 2020 and is common in people with chronic physical conditions. However, depression is relatively uncommon in Asia. Family support is an important Asian cultural value that we hypothesized could protect people with chronic physical conditions from developing depression. We investigated depressive symptom prevalence and risk factors in a Chinese sample with chronic medical conditions, focusing on the possible protective role of family relationships. Methods Data were obtained from the Hong Kong Jockey Club FAMILY Project cohort study in 2009–2011, which included 6,195 participants (age ≥15 with self-reported chronic conditions. Depressive symptoms were recorded using the Patient Health Questionnaire-9 (PHQ-9. Demographic and lifestyle variables, stressful life events, perceived family support and neighborhood cohesion were assessed. Factors associated with a non-somatic (PHQ-6 depression score were also examined. Results The prevalence of depressive symptoms (PHQ-9 scores ≥5 was 17% in those with one or more chronic conditions, and was more prevalent in women than in men (19.7% vs. 13.9%; p p p  Conclusions Acute life stress and the number of chronic conditions, together with socio-demographic factors, explain most variance in depressive symptoms among chronically ill Chinese individuals. Somatic items in the PHQ-9 increased the depression scores but they did not alter the pattern of predictors. Family support appears to be an important protective factor in Chinese cultures for individuals with chronic conditions.

  16. Laboratory medicine and mobile health technologies at crossroads: Perspectives for the management of chronic diseases.

    Science.gov (United States)

    Gruson, Damien; Ko, Gabriel

    2016-10-01

    Management of chronic diseases represents a leading health and economic issue worldwide. Biomarkers are critical for the diagnosis and management of both communicable and non-communicable chronic diseases, and mobile health (mHealth) technologies are about to change the "game" with regard to the management of patients with such chronic diseases. The development of efficient, accurate and interactive solutions that integrate biomarkers and mHealth opens new perspectives for caregivers for the management of chronic illness. PMID:26983900

  17. Audiometry and ossicular condition in chronic otitis media

    Directory of Open Access Journals (Sweden)

    mohsen Rajati Haghi

    2009-07-01

    Full Text Available   Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM. Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA findings of COM patients with the ossicular condition determined during surgery. Materials and Methods: 97 Patients with COM who underwent ear surgery for the first time were included in the study. A checklist of preoperative clinical findings, audiometric parameters and intraoperative findings was filled out for all patients. Results: Mean amount of Air-Bone Gap (ABG, Bone Conduction threshold (BC and Air Conduction threshold (AC of 97 Patients were 35.17, 13.13 and 48.30 respectively. In ears with or without cholesteatoma, granulation tissue, or otorrhea, mean of AC, BC, and ABG were not significantly different. In ossicular erosion and discontinuity (OD, mean of AC and BC thresholds increased significantly but ABG didn’t change significantly. Conclusion: According to the results of this study, in preoperative assessment of COM patients to predict ossicular condition we recommend considering AC, BC and ABG levels together instead of using ABG alone as is routine in our daily practice.

  18. Public assessment of key performance indicators of healthcare in a Canadian province: the effect of age and chronic health problems.

    Science.gov (United States)

    Nurullah, Abu Sadat; Northcott, Herbert C; Harvey, Michael D

    2014-01-15

    This study explores the effect of age and chronic conditions on public perceptions of the health system, as measured by the Key Performance Indicators (KPIs) of healthcare, in the province of Alberta in Canada. Drawing from data collected by Government of Alberta's Department of Health and Wellness, this research examines two key questions: (1) Do people in the 65+ age group rate the KPIs of healthcare (i.e., availability, accessibility, quality, outcome, and satisfaction) more favorably compared to people in younger age groups in Alberta? (2) Does the rating of KPIs of healthcare in Alberta vary with different chronic conditions (i.e., no chronic problem, chronic illnesses without pain, and chronic pain)? The findings indicate that people in the older age group tend to rate the KPIs of healthcare more favorably compared to younger age groups in Alberta, net of socio-demographic factors, self-reported health status, and knowledge and utilization of health services. However, people experiencing chronic pain are less likely to rate the KPIs of healthcare favorably compared to people with no chronic health problem in Alberta. Discussion includes implications of the findings for the healthcare system in the province. PMID:24455471

  19. Elevated neutrophil to lymphocyte ratio predicts mortality in medical inpatients with multiple chronic conditions.

    Science.gov (United States)

    Isaac, Vivian; Wu, Chia-Yi; Huang, Chun-Ta; Baune, Bernhard T; Tseng, Chia-Lin; McLachlan, Craig S

    2016-06-01

    Neutrophil to lymphocyte ratio (NLR) is an easy measurable laboratory marker used to evaluate systemic inflammation. Elevated NLR is associated with poor survival and increased morbidity in cancer and cardiovascular disease. However, the usefulness of NLR to predict morbidity and mortality in a hospital setting for patients with multiple chronic conditions has not been previously examined. In this study, we investigate the association between NLR and mortality in multimorbid medical inpatients. Two hundred thirty medical in-patients with chronic conditions were selected from a single academic medical center in Taiwan. Retrospective NLRs were calculated from routine full blood counts previously obtained during the initial hospital admission and at the time of discharge. Self-rated health (using a single-item question), medical disorders, depressive symptoms, and medical service utilization over a 1-year period were included in the analyses. Mortality outcomes were ascertained by reviewing electronic medical records and follow-up. The mortality rate at 2-year follow-up was 23%. Depression (odds ratio [OR] 1.9 [95% CI 1.0-3.7]), poor self-rated health (OR 2.1 [95% CI 1.1-3.9]), being hospitalized 2 or more times in the previous year (OR 2.3 [95% CI 1.2-4.6]), metastatic cancer (OR 4.7 [95% CI 2.3-9.7]), and chronic liver disease (OR 4.3 [95% CI 1.5-12.1]) were associated with 2-year mortality. The median (interquartile range) NLR at admission and discharge were 4.47 (2.4-8.7) and 3.65 (2.1-6.5), respectively. Two-year mortality rates were higher in patients with an elevated NLR at admission (NLR 3 = 27.6%) and discharge (NLR 3 = 29.1%). Multivariate logistic regression demonstrated that an elevated NLR >3.0 at admission (OR 2.3 [95% CI 1.0-5.2]) and discharge (OR 2.3 [95% CI 1.1-5.0]) were associated with mortality independent of baseline age, sex, education, metastatic cancer, liver disease, depression, and previous hospitalization. Increased NLR is associated

  20. Stress, Health Behavior, and Sleep as Mediators of the Association between Loneliness and Adverse Health Conditions among Older People

    DEFF Research Database (Denmark)

    Christiansen, Julie

    Prior research has established an association between loneliness and a variety of negative health conditions among older people. However, little is known about the mechanisms underlying the association. The Loneliness Model seeks to explain the mechanisms through which chronic loneliness might...

  1. Iterative Design and Usability Testing of the Imhere System for Managing Chronic Conditions and Disability.

    Science.gov (United States)

    Fairman, Andrea D; Yih, Erika T; McCoy, Daniel F; Lopresti, Edmund F; McCue, Michael P; Parmanto, Bambang; Dicianno, Brad E

    2016-01-01

    A novel mobile health platform, Interactive Mobile Health and Rehabilitation (iMHere), is being developed to support wellness and self-management among people with chronic disabilities. The iMHere system currently includes a smartphone app with six modules for use by persons with disabilities and a web portal for use by medical and rehabilitation professionals or other support personnel. Our initial clinical research applying use of this system provides insight into the feasibility of employing iMHere in the development of self-management skills in young adults (ages 18-40 years) with spina bifida (SB) (Dicianno, Fairman, et al., 2015). This article describes the iterative design of the iMHere system including usability testing of both the app modules and clinician portal. Our pilot population of persons with SB fostered the creation of a system appropriate for people with a wide variety of functional abilities and needs. As a result, the system is appropriate for use by persons with various disabilities and chronic conditions, not only SB. In addition, the diversity of professionals and support personnel involved in the care of persons with SB also enabled the design and implementation of the iMHere system to meet the needs of an interdisciplinary team of providers who treat various conditions. The iMHere system has the potential to foster communication and collaboration among members of an interdisciplinary healthcare team, including individuals with chronic conditions and disabilities, for a client-centered approach to support self-management skills. PMID:27563387

  2. ‘Keeping going’: chronic joint pain in older people who describe their health as good

    OpenAIRE

    Richardson, Jane C.; GRIME, JANET C.; Ong, Bie Nio

    2013-01-01

    It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellnes...

  3. IFN-γ differentially modulates memory-related processes under basal and chronic stressor conditions.

    Science.gov (United States)

    Litteljohn, Darcy; Nelson, Eric; Hayley, Shawn

    2014-01-01

    Cytokines are inflammatory messengers that orchestrate the brain's response to immunological challenges, as well as possibly even toxic and psychological insults. We previously reported that genetic ablation of the pro-inflammatory cytokine, interferon-gamma (IFN-γ), attenuated some of the corticosteroid, cytokine, and limbic dopaminergic variations induced by 6 weeks of exposure to an unpredictable psychologically relevant stressor. Presently, we sought to determine whether a lack of IFN-γ would likewise modify the impact of chronic stress on hippocampus-dependent memory function and related neurotransmitter and neurotrophin signaling systems. As predicted, chronic stress impaired spatial recognition memory (Y-maze task) in the wild-type animals. In contrast, though the IFN-γ knockouts (KOs) showed memory disturbances in the basal state, under conditions of chronic stress these mice actually exhibited facilitated memory performance. Paralleling these findings, while overall the KOs displayed altered noradrenergic and/or serotonergic activity in the hippocampus and locus coeruleus, norepinephrine utilization in both of these memory-related brain regions was selectively increased among the chronically stressed KOs. However, contrary to our expectations, neither IFN-γ deletion nor chronic stressor exposure significantly affected nucleus accumbens dopaminergic neurotransmission or hippocampal brain-derived neurotrophic factor protein expression. These findings add to a growing body of evidence implicating cytokines in the often differential regulation of neurobehavioral processes in health and disease. Whereas in the basal state IFN-γ appears to be involved in sustaining memory function and the activity of related brain monoamine systems, in the face of ongoing psychologically relevant stress the cytokine may, in fact, act to restrict potentially adaptive central noradrenergic and spatial memory responses. PMID:25477784

  4. [Health lips beautiful smile: Conditions to know].

    Science.gov (United States)

    Czerninski, R

    2016-04-01

    Diagnosis and management of lip pathologies should be part of the dentists' responsibilities. Lip pathologies might affect patient's function, appearance and quality of life. The routine clinical examination of the oral cavity includes lip examination--changes in lip color, size or texture should be recognized during the examination, as well as noticing any habit such as lip licking or mouth breathing.The aim of the review is to present common external lip lesions. Color changes--oral melanotic macule is a localized benign pigmented lesion. It might be similar to early melanoma therefore if it is a new lesion, growing or large it should be excised. White and red changes are usually seen at the lower lip which is exposed to the sun light mainly among light skin individuals. The color changes are showing epithelial and subepithlial permanent changes and is called Solar cheilitis. As a potentially malignant disorder the patient should be carefully examined and under follow- ups. These patients are also advised to reduce sun exposure and use sun screen lipsticks. Lichen planus of the lip can be seen as red and white changes the lips are less prevalent site of the disease and usually the patients will have in intra oral involvement as well. Size changes--angioedema is a quick enlargement of the lip sometimes the face as well. It is an allergic reaction to food drugs and other antigens and resolves spontaneously with 72 hours, but when the upper airway is involved an immediate emergency treatment should be given. A chronic swelling of the lip/lips may be a sign of orofacial granulomatosis--a complicated condition with an unknown etiology, diagnosed by a biopsy and elimination of other diagnoses. Treatment includes steroids in various forms or a combination of surgery. Changes of the epithelial surface of the lip can be a result of dry lips in a hot or dry environment or due to mouth breathing. Lip licking might worsen the situation by secondary infection. Angular

  5. Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

    Science.gov (United States)

    Slomka, Jacquelyn; Prince-Paul, Maryjo; Webel, Allison; Daly, Barbara J

    2016-01-01

    People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. Overall, participants were unfamiliar with the term palliative care, confused concepts of palliative care and hospice, and/or associated hospice care with dying. Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population. PMID:27053406

  6. Processing Conditions, Rice Properties, Health and Environment

    Directory of Open Access Journals (Sweden)

    Nobutaka Nakamura

    2011-06-01

    Full Text Available Rice is the staple food for nearly two-thirds of the world’s population. Food components and environmental load of rice depends on the rice form that is resulted by different processing conditions. Brown rice (BR, germinated brown rice (GBR and partially-milled rice (PMR contains more health beneficial food components compared to the well milled rice (WMR. Although the arsenic concentration in cooked rice depends on the cooking methods, parboiled rice (PBR seems to be relatively prone to arsenic contamination compared to that of untreated rice, if contaminated water is used for parboiling and cooking. A change in consumption patterns from PBR to untreated rice (non-parboiled, and WMR to PMR or BR may conserve about 43–54 million tons of rice and reduce the risk from arsenic contamination in the arsenic prone area. This study also reveals that a change in rice consumption patterns not only supply more food components but also reduces environmental loads. A switch in production and consumption patterns would improve food security where food grains are scarce, and provide more health beneficial food components, may prevent some diseases and ease the burden on the Earth. However, motivation and awareness of the environment and health, and even a nominal incentive may require for a method switching which may help in building a sustainable society.

  7. Role of chronic health disorders in perimenopausal fractures.

    Science.gov (United States)

    Huopio, Jukka; Honkanen, Risto; Jurvelin, Jukka; Saarikoski, Seppo; Alhava, Esko; Kröger, Heikki

    2005-11-01

    Only a few studies have examined the risk of individual chronic health disorders on perimenopausal (i.e., around menopause) fractures in a single study. We evaluated the effect of chronic illnesses on fracture rate in a prospective cohort study of 3,078 women. These women were a stratified sample from the population base of 14,220 women aged 47-56 years and residing in the province of Kuopio in eastern Finland in 1989. Data on physician-diagnosed chronic diseases were collected by a baseline questionnaire in 1989. For certain diseases, questionnaire information of self-reported chronic disorders were compared with drug reimbursement data provided by the Social Insurance Institution of Finland. Axial bone mineral density (BMD) measurements from the femoral neck and lumbar spine were performed in 1989-91. Two hundred sixty-five (265) women experienced at least one fracture during the follow-up period of 3.6 years (SD+/-0.78). The first fracture during the follow-up period was taken to be the end-point event. The risk of follow-up fracture for an individual health disorder was estimated with the Cox's proportional hazards model. Several chronic health disorders increased the fracture risk in perimenopausal women. However, hypertension was a statistically significant (p=0.018) risk factor for fracture (adjusted hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.9), especially in overweight and obese (body mass index > or =28) women (HR, 2.0; 95% CI, 1.4-3.0). In addition, coronary heart disease (adjusted HR, 1.76; 95% CI, 1.13-2.76), hyperthyroidism (adjusted HR, 1.7; 95% CI, 1.0-2.9), epilepsy (adjusted HR, 2.0; 95% CI, 1.1-3.6), alcoholism (adjusted HR, 3.5; 95% CI, 1.3-9.5) and chronic hepatic disease (adjusted HR, 5.2; 95% CI, 1.7-16.4) predicted fracture. BMD was either normal or even elevated in disease groups. However, women with a fracture during the follow-up usually had decreased bone density, although the difference was statistically significant

  8. A game plan: Gamification design principles in mHealth applications for chronic disease management.

    Science.gov (United States)

    Miller, Aaron S; Cafazzo, Joseph A; Seto, Emily

    2016-06-01

    Effective chronic disease management is essential to improve positive health outcomes, and incentive strategies are useful in promoting self-care with longevity. Gamification, applied with mHealth (mobile health) applications, has the potential to better facilitate patient self-management. This review article addresses a knowledge gap around the effective use of gamification design principles, or mechanics, in developing mHealth applications. Badges, leaderboards, points and levels, challenges and quests, social engagement loops, and onboarding are mechanics that comprise gamification. These mechanics are defined and explained from a design and development perspective. Health and fitness applications with gamification mechanics include: bant which uses points, levels, and social engagement, mySugr which uses challenges and quests, RunKeeper which uses leaderboards as well as social engagement loops and onboarding, Fitocracy which uses badges, and Mango Health, which uses points and levels. Specific design considerations are explored, an example of the efficacy of a gamified mHealth implementation in facilitating improved self-management is provided, limitations to this work are discussed, a link between the principles of gaming and gamification in health and wellness technologies is provided, and suggestions for future work are made. We conclude that gamification could be leveraged in developing applications with the potential to better facilitate self-management in persons with chronic conditions. PMID:24986104

  9. Family Functioning and the Well-Being of Children With Chronic Conditions: A Meta-Analysis.

    Science.gov (United States)

    Leeman, Jennifer; Crandell, Jamie L; Lee, Anna; Bai, Jinbing; Sandelowski, Margarete; Knafl, Kathleen

    2016-08-01

    For children with chronic conditions, well-being is closely related to how well their families function. Most prior research syntheses on family functioning and child well-being have focused on children with a single condition, thereby limiting the potential to aggregate and build on what is known across conditions. To address this challenge, research reports were reviewed and meta-analyses conducted of findings on the relationship between family functioning and child well-being across a range of chronic physical conditions. The sample was derived from a larger systematic review study that included 1,028 reports published between January 1, 2000 and March 31, 2014. The current review includes 53 studies in which a relationship between family functioning and child well-being was analyzed using one of four family measures: Family Adaptability and Cohesion Evaluation Scales, Family Environment Scale, Family Relationship Index, or Family Assessment Device. Most studies were cross-sectional and observational (n = 43, 81%). The most frequently studied conditions were diabetes, cancer, sickle cell disease, and asthma. In 37 studies, findings were sufficiently comparable to conduct meta-analyses. Significant correlations were identified between children's psychological health and seven of nine dimensions of family functioning. Significant correlations also were found between dimensions of family functioning and children's problem behaviors, social competence, quality of life, and, to a lesser extent, adherence and physical health. Of the family dimensions, cohesion and conflict were associated most strongly with child outcomes. Understanding the specific family variables, such as conflict, linked to varied child outcomes is key for intervention development. © 2016 Wiley Periodicals, Inc. PMID:27128982

  10. Impact Evaluation of a System-Wide Chronic Disease Management Program on Health Service Utilisation: A Propensity-Matched Cohort Study.

    OpenAIRE

    Laurent Billot; Kate Corcoran; Alina McDonald; Gawaine Powell-Davies; Anne-Marie Feyer

    2016-01-01

    The New South Wales Health (NSW Health) Chronic Disease Management Program (CDMP) delivers interventions to adults at risk of hospitalisation for five target chronic conditions that respond well to ambulatory care: diabetes, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and coronary artery disease. The intervention consists of two main components: (1) care coordination across sectors (acute, ambulatory, and community care from both public and private sectors) ...

  11. The HHS Strategic Framework on multiple chronic conditions: genesis and focus on research

    Directory of Open Access Journals (Sweden)

    Anand K. Parekh

    2013-12-01

    Full Text Available Among the 21st century’s major emerging health issues, one of the most critical is the increasing prevalence of individuals with comorbidities, or multiple chronic conditions (MCCs, and the myriad challenges this poses for public health, healthcare, social services, and other sectors. Given the increasing prevalence of individuals with MCCs and the paramount role of MCCs as a healthcare cost driver, in 2008 the U.S. Department of Health and Human Services (HHS launched an initiative to strengthen efforts by the HHS to address the effects of MCCs on health status, quality of life, and cost. In this paper, we first provide an overview of the HHS initiative with a particular focus on the approach used in developing the initiative’s centerpiece, the HHS Strategic Framework on Multiple Chronic Conditions; we next describe progress in implementing one of the framework’s four major goal areas (Goal 4 on facilitating research to fill knowledge gaps about, and interventions and systems to benefit, individuals with MCCs; and we conclude by suggesting additional potential priorities for research on MCCs. Although considerable research on MCCs has been reported over the past decade, the HHS Strategic Framework’s goal on research provides a set of priority areas and a plan for systematically strengthening the evidence and information foundation necessary to address the challenges of MCCs in the USA. More broadly, the Strategic Framework provides a roadmap to help improve coordination between HHS operating divisions and enhance collaboration with external stakeholders to improve the quality of life for those with MCCs.

  12. Chronic care management of globesity: promoting healthier lifestyles in traditional and mHealth based settings

    Directory of Open Access Journals (Sweden)

    Gianluca eCastelnuovo

    2015-10-01

    Full Text Available Obesity and being overweight could be real chronic conditions above all if there are other complications such as type 2 diabetes, cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer and various psychosocial and psychopathological disorders,. Due to the multifactorial etiology of obesity, evidence-based interventions to improve weight loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. There are significant limitations in this multidisciplinary chronic care management of obesity, most notably those regarding costs and long-term adherence and efficacy. Programs including eHealth platforms and new technologies could overcome limitations connected to the traditional in-patient chronic care management of obesity, thus providing promising opportunities in enhancing weight reduction and reducing complications in terms of long-term efficacy and effectiveness across clinical, organizational, and economic perspectives.

  13. Staying Engaged: The Role of Teachers and Schools in Keeping Young People with Health Conditions Engaged in Education

    Science.gov (United States)

    Hopkins, Liza; Green, Julie; Henry, John; Edwards, Brian; Wong, Shanti

    2014-01-01

    It is well known that having a chronic or traumatic health condition can seriously impact on a young person's educational trajectory, as well as placing the young person at higher risk of experiencing mental health conditions such as depression and anxiety, and increasing their likelihood of participation in risky behaviours. This paper…

  14. Comparing the Relationship Between Age and Length of Disability Across Common Chronic Conditions

    OpenAIRE

    Jetha, Arif; Besen, Elyssa; Smith, Peter M

    2016-01-01

    Objective: The aim of this study was to compare the association between age and disability length across common chronic conditions. Methods: Analysis of 39,915 nonwork-related disability claims with a diagnosis of arthritis, diabetes, hypertension, coronary artery disease, depression, low back pain, chronic pulmonary disease, or cancer. Ordinary least squares regression models examined age-length of disability association across chronic conditions. Results: Arthritis (76.6 days), depression (...

  15. Role of Protein Carbonylation in Skeletal Muscle Mass Loss Associated with Chronic Conditions

    OpenAIRE

    Esther Barreiro

    2016-01-01

    Muscle dysfunction, characterized by a reductive remodeling of muscle fibers, is a common systemic manifestation in highly prevalent conditions such as chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), cancer cachexia, and critically ill patients. Skeletal muscle dysfunction and impaired muscle mass may predict morbidity and mortality in patients with chronic diseases, regardless of the underlying condition. High levels of oxidants may alter function and structure of ...

  16. Symptoms of anxiety and depression: A comparison among patients with different chronic conditions

    OpenAIRE

    Noushin Bayat; Gholam Hossein Alishiri; Ahmad Salimzadeh; Morteza Izadi; Davoud Kazemi Saleh; Maryam Moghani Lankarani; Shervin Assari

    2011-01-01

    Background: Although patients with chronic diseases are at high-risk for symptoms of anxiety and depression, few studies have compared patients with different chronic conditions in this regard. This study aimed to compare patients with different chronic medical conditions in terms of anxiety and depression symptoms after controlling for the effects of socio-demographic and clinical data. Methods: This cross-sectional study enrolled 2234 adults, either healthy (n = 362) or patients with ch...

  17. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W; Hendriks, Eric H; Winter, Jobst B; Denollet, Johan

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether...... Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics....

  18. Co-ordination and management of chronic conditions in Europe : the role of primary care.

    NARCIS (Netherlands)

    Gress, S.; Baan, C.A.; Calnan, M.; Dedeu, T.; Groenewegen, P.P.; Howson, H.

    2009-01-01

    Healthcare systems in Europe struggle with inadequate co-ordination of care for people with chronic conditions. Moreover, there is a considerable evidence gap in the treatment of chronic conditions, lack of self-management, variation in quality of care, lack of preventive care, increasing costs for

  19. Growing up with a Chronic Condition : Challenges for Self-management and Self-management Support

    NARCIS (Netherlands)

    J.N.T. Sattoe (Jane)

    2015-01-01

    markdownabstract__Abstract__ Becoming an adult often proves extra challenging for those who grow up with chronic conditions, because adaptive tasks related to living with a chronic condition can clash with normal developmental milestones. Finding a good balance and integrating these tasks in daily

  20. Cognitive function in community-dwelling elderly with chronic medical conditions

    NARCIS (Netherlands)

    Jelicic, M; Kempen, GIJM

    1997-01-01

    Objectives. The aim of this study was to examine the effect of chronic medical conditions on cognitive function in a sample of community-dwelling elderly (N = 4528). Methods. A checklist of 18 chronic medical conditions was used to determine whether respondents were suffering from specific disease s

  1. Improving Population Health by Incorporating Chronic Disease and Injury Prevention Into Value-Based Care Models.

    Science.gov (United States)

    Petersen, Ruth; Rushing, Jill; Nelson, Sharon; Rhyne, Sharon

    2016-01-01

    Today's health system transformation provides a prime opportunity to leverage the capacity of public health to reduce the burden of chronic disease and injury, improve population health, and contain health care costs. Health care settings and organizations should support public health capacity as a key investment in population health. PMID:27422946

  2. Management of insomnia in patients with chronic pain conditions.

    Science.gov (United States)

    Stiefel, Frederic; Stagno, Daniele

    2004-01-01

    The management of insomnia in patients experiencing chronic pain requires careful evaluation, good diagnostic skills, familiarity with cognitive-behavioural interventions and a sound knowledge of pharmacological treatments. Sleep disorders are characterised by a circular interrelationship with chronic pain such that pain leads to sleep disorders and sleep disorders increase the perception of pain. Sleep disorders in individuals with chronic pain remain under-reported, under-diagnosed and under-treated, which may lead--together with the individual's emotional, cognitive and behavioural maladaptive responses--to the frequent development of chronic sleep disorders. The moderately positive relationship between pain severity and sleep complaints, and the specificity of pain-related arousal and mediating variables such as depression, illustrate that insomnia in relation to chronic pain is multifaceted and poorly understood. This may explain the limited success of the available treatments. This article discusses the evaluation of patients with chronic pain and insomnia and the available pharmacological and nonpharmacological interventions to manage the sleep disorder. Non-pharmacological interventions should not be considered as single interventions, but in association with one another. Some non-pharmacological interventions especially the cognitive and behavioural approaches, can be easily implemented in general practice (e.g. stimulus control, sleep restriction, imagery training and progressive muscle relaxation). Hypnotics are routinely prescribed in the medically ill, regardless of their adverse effects; however, their long-term efficacy is not supported by robust evidence. Antidepressants provide an interesting alternative to hypnotics, since they can improve pain perception as well as sleep disorders in selected patients. Sedative antipsychotics can be considered for sleep disturbances in those patients exhibiting psychotic features, or for those with

  3. CHRONIC DISEASE PREVENTION (CDP) BIBLIOGRAPHIC DATABASE HEALTH PROMOTION AND PREVENTION (HP) DATABASE

    Science.gov (United States)

    This database focuses on chronic disease prevention, health promotion, and health education emphasizing the methodology and application of effective programs and risk reduction interventions. The materials cover such topics as community health education, self-care, maternal and i...

  4. What Health Issues or Conditions Are Specific to Women Only?

    Science.gov (United States)

    ... health issues or conditions are specific to women only? Skip sharing on social media links Share this: ... disorders. The health topics listed below affect women only. Some other conditions affect men too but affect ...

  5. Screening for pre-malignant conditions in the oral cavity of chronic tobacco chewers

    Directory of Open Access Journals (Sweden)

    Priyanka Mahawar, Shweta Anand, Umesh Sinha, Madhav Bansal, Sanjay Dixit

    2011-01-01

    Full Text Available Oral cancer is a major health problem in tobacco users all over the world. It is one of the ten most common cancers in the world. Oral cancer is almost always preceded by some type of precancerous lesion. The precancerous lesions can be detected upto 15years, prior to their change to an invasive carcinoma. It usually affects between the ages of 15 and 40 years. It may be triggered by factors like frequency and duration of tobacco consumption, alcohol, poor oral hygiene etc. This study was conducted primarily to screen chronic tobacco chewers for the presence of oral pre-malignant conditions and secondly to educate them about the hazards of tobacco and motivate them to quit the habit. This was a cross sectional study conducted at Badi gawaltoli area of Indore. Tobacco chewers using tobacco for more than 5yrs were included in the study. Chronic tobacco chewers were screened for oral pre-malignant lesions followed by an educational intervention about the harmful effects of tobacco. Two follow ups were made to motivate them to quit the habit and to get treatment for their lesions. An open ended semi-structured questionnaire was administered to chronic tobacco chewers to assess their habit of tobacco chewing, smoking, their knowledge regarding lesions in their mouth, hazards of tobacco and any cessation efforts. Among the 80 identified chronic tobacco chewers, 60 were males and 20 were females. Lesions such as leukoplakia, erythroplakia and oral sub-mucosal fibrosis were found in 10 females (50% and 24 males (40%.

  6. Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study 

    OpenAIRE

    Koyanagi, Ai; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Haro, Josep Maria

    2014-01-01

    BACKGROUND: Data on the association between chronic conditions or the number of chronic conditions and sleep problems in low- or middle-income countries is scarce, and global comparisons of these associations with high-income countries have not been conducted. METHODS: Data on 42116 individuals 50 years and older from nationally-representative samples of the Collaborative Research on Ageing in Europe (Finland, Poland, Spain) and the World Health Organization's Study on Global Ageing and Adult...

  7. Health literacy and beliefs among a community cohort with and without chronic low back pain.

    Science.gov (United States)

    Briggs, Andrew M; Jordan, Joanne E; Buchbinder, Rachelle; Burnett, Angus F; O'Sullivan, Peter B; Chua, Jason Y Y; Osborne, Richard H; Straker, Leon M

    2010-08-01

    Health literacy, the ability to seek, understand and utilise health information, is important for good health. Suboptimal health literacy has been associated with poorer health outcomes in many chronic conditions although this has not been studied in chronic low back pain (CLBP). We examined the health literacy of individuals with CLBP using a mixed methods approach. One-hundred and seventeen adults, comprising 61 with no history of CLBP and 56 with CLBP (28 with low and high disability, respectively, as determined by a median split in Oswestry scores) participated. Data regarding severity of pain, LBP-related disability, fear avoidance, beliefs about LBP and pain catastrophizing were collected using questionnaires. Health literacy was measured using the Short-form Test of Functional Health Literacy in Adults (S-TOFHLA). A sub-sample of 36 participants with CLBP also participated in in-depth interviews to qualitatively explore their beliefs about LBP and experiences in seeking, understanding and using information related to LBP. LBP-related beliefs and behaviours, rather than pain intensity and health literacy skills, were found to be important correlates of disability related to LBP. Individuals with CLBP-high disability had poorer back pain beliefs and increased fear avoidance behaviours relating to physical activity. Health literacy (S-TOFHLA) was not related to LBP beliefs and attitudes. Qualitatively, individuals with CLBP-high disability adopted a more passive coping style and had a pathoanatomic view of their disorder compared to individuals with CLBP-low disability. While all participants with CLBP had adequate health literacy scores (S-TOFHLA), qualitative data highlighted difficulties in seeking, understanding and utilising LBP information. PMID:20603025

  8. County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: How does place affect use?

    OpenAIRE

    Chi, Donald L.; Leroux, Brian

    2012-01-01

    Little is known about how place affects childrens’ access to dental care. We analyzed data for 25,908 Iowa Medicaid-enrolled children with chronic conditions to identify the county-level determinants of dental utilization. Our analyses suggest that higher levels of poverty and designation as a dental health professional shortage area at the county-level are associated with lower probability of child-level dental use. There are significant interactions between child-level race/ethnicity and co...

  9. Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

    OpenAIRE

    Goeppel, Christine; Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

    2016-01-01

    Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or u...

  10. Multimorbidity in chronic disease: impact on health care resources and costs

    Science.gov (United States)

    McPhail, Steven M

    2016-01-01

    Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person

  11. Multimorbidity in chronic disease: impact on health care resources and costs.

    Science.gov (United States)

    McPhail, Steven M

    2016-01-01

    Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person

  12. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Directory of Open Access Journals (Sweden)

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  13. Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Yves Lacasse

    1997-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

  14. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

    OpenAIRE

    Sevgi Akarsu; Turna İlknur; Özlem Özbağçıvan; Emel Fetil

    2015-01-01

    Background and Design: Chronic spontaneous urticaria (CSU), the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV) is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patie...

  15. Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Cuesta-Vargas Antonio Ignacio

    2013-02-01

    Full Text Available Abstract Background Musculoskeletal disorders are major causes of morbidity in the world, and these conditions have a strong negative influence in terms of health-related quality of life. The purpose of this study was to evaluate the effect of an 8-week multimodal physical therapy program on general health state and health-related quality of life in patients with chronic musculoskeletal disorders. Methods There were 244 participants in this prospective cohort analysis with 8-week follow-up. The primary outcome was general health state (physical and mental components, determined with the Short Form-12 Health Survey (SF-12. The secondary outcome was health related quality of life, determined with the EuroQoL-5D and VAS. The intervention was evaluated by comparing pre- and post-outcome measurements. T-tests were performed for paired data. Results Differences were statistically significant for physical health state: +1.68 (p  Conclusions Eight weeks of a Multimodal Physical Therapy Program seemed to moderately enhance the general health state and HRQoL of patients with chronic musculoskeletal diseases. This kind of therapeutic exercise can be recommended to patients with chronic low back pain, chronic neck pain and osteoarthritis, at least in the short term.

  16. Time to Talk: 5 Things To Know About Chronic Low-Back Pain and Complementary Health Practices

    Science.gov (United States)

    ... Z 5 Things To Know About Chronic Low-Back Pain and Complementary Health Practices Share: Low-back pain is a very common condition, but often the cause is unknown. Most people have significant acute back pain at least once in their lives. Usually it ...

  17. Contribution of Chronic Conditions to the Disability Burden across Smoking Categories in Middle-Aged Adults, Belgium

    Science.gov (United States)

    Yokota, Renata Tiene de Carvalho; Nusselder, Wilma Johanna; Robine, Jean-Marie; Tafforeau, Jean; Deboosere, Patrick; Van Oyen, Herman

    2016-01-01

    Introduction Smoking is considered the single most important preventable cause of morbidity and mortality worldwide, contributing to increased incidence and severity of disabling conditions. The aim of this study was to assess the contribution of chronic conditions to the disability burden across smoking categories in middle-aged adults in Belgium. Methods Data from 10,224 individuals aged 40 to 60 years who participated in the 1997, 2001, 2004, or 2008 Health Interview Surveys in Belgium were used. Smoking status was defined as never, former (cessation ≥2 years), former (cessation <2 years), occasional light (<20 cigarettes/day), daily light, and daily heavy (≥20 cigarettes/day). To attribute disability to chronic conditions, binomial additive hazards models were fitted separately for each smoking category adjusted for gender, except for former (cessation <2 years) and occasional light smokers due to the small sample size. Results An increasing trend in the disability prevalence was observed across smoking categories in men (never = 4.8%, former (cessation ≥2 years) = 5.8%, daily light = 7.8%, daily heavy = 10.7%) and women (never = 7.6%, former (cessation ≥2 years) = 8.0%, daily light = 10.2%, daily heavy = 12.0%). Musculoskeletal conditions showed a substantial contribution to the disability burden in men and women across all smoking categories. Other important contributors were depression and cardiovascular diseases in never smokers; depression, chronic respiratory diseases, and diabetes in former smokers (cessation ≥2 years); chronic respiratory diseases, cancer, and cardiovascular diseases in daily light smokers; cardiovascular diseases and chronic respiratory diseases in men and depression and diabetes in women daily heavy smokers. Conclusions Beyond the well-known effect of smoking on mortality, our findings showed an increasing trend of the disability prevalence and different contributors to the disability burden across smoking categories. This

  18. Health condition of children irradiated in utero

    International Nuclear Information System (INIS)

    Among the children exposed to ionizing radiation, the ones irradiated in utero constitute a group under special surveillance. The greatest sensitivity of the organism to the effects of radiative factors occurs in the neonatal period of development and the forthcoming life span with irradiation effects is the longest for these children. Children with acute exposure, with chronic exposure and control group were encompassed by this study - 1144 children altogether. 9 figs, 2 tabs

  19. Forest health conditions in North America

    International Nuclear Information System (INIS)

    Some of the greatest forest health impacts in North America are caused by invasive forest insects and pathogens (e.g., emerald ash borer and sudden oak death in the US), by severe outbreaks of native pests (e.g., mountain pine beetle in Canada), and fires exacerbated by changing climate. Ozone and N and S pollutants continue to impact the health of forests in several regions of North America. Long-term monitoring of forest health indicators has facilitated the assessment of forest health and sustainability in North America. By linking a nationwide network of forest health plots with the more extensive forest inventory, forest health experts in the US have evaluated current trends for major forest health indicators and developed assessments of future risks. Canada and Mexico currently lack nationwide networks of forest health plots. Development and expansion of these networks is critical to effective assessment of future forest health impacts. - The forests of North America continue to face many biotic and abiotic stressors including fragmentation, fires, native and invasive pests, and air pollution

  20. Stakeholders’ perception on the organization of chronic care: a SWOT analysis to draft avenues for health care reforms

    Science.gov (United States)

    2014-01-01

    Background Adequate care for individuals living with chronic illnesses calls for a healthcare system redesign, moving from acute, disease-centered to patient-centered models. The aim of this study was to identify Belgian stakeholders’ perceptions on the strengths, weaknesses, opportunities and threats of the healthcare system for people with chronic diseases in Belgium. Methods Four focus groups were held with stakeholders from the micro and meso level, in addition to two interviews with stakeholders who could not attend the focus group sessions. Data collection and the discussion were based on the Chronic Care model. Thematic analysis of the transcripts allowed for the identification of the strengths, weaknesses, opportunities and threats of the current health care system with focus on chronic care. Results Informants stressed the overall good quality of the acute health care system and the level of reimbursement of care as an important strength of the current system. In contrast, the lack of integration of care was identified as one of the biggest weaknesses of today’s health care system, along with the unclear definitions of the roles and functions of health professionals involved in care processes. Patient education to support self-management exists for patients with diabetes and/or terminal kidney failure but not for those living with other or multiple chronic conditions. The current overall fee-for-service system is a barrier to integrated care, as are the lack of incentives for integrated care. Attending multidisciplinary meetings, for example, is underfinanced to date. Finally, clinical information systems lack interoperability, which further impedes the information flow across settings and disciplines. Conclusion Our study’s methods allowed for the identification of problematic domains in the health system for people living with chronic conditions. These findings provided useful insights surrounding perceived priorities. This methodology may inspire

  1. [Chronic renal insufficiency. A permanent public health problem].

    Science.gov (United States)

    Legrain, M; Jacobs, C

    1999-01-01

    Chronic renal insufficiency raises an ever-increasing public-health problem due to its permanent growth among the general population and the escalating cost of renal replacement therapies. By the end of 1995 there were close to 33,700 patients with end-stage renal failure maintained alive with renal replacement methods in France. About 11,200 had a functioning kidney graft, whereas 22,500 were treated with various dialysis techniques, in and out-of-center hemodialysis and peritoneal dialysis. An optimal health policy should contribute both to prevent renal insufficiency and offer each patient his/her best specific mode of treatment at the lowest cost for the community. Renal transplantation should be much more widely promoted and utilized through measures aiming at reducing the too high refusal rates of organ donation in subjects with brain-death. Promotion and extension of out-of-center dialysis techniques are also necessary. Design of reliable epidemiological studies dealing not only with end-stage renal failure patients but with the early stage and time-course of renal insufficiency is also mandatory. A deeper investigation in the area of renal-risk factors and a qualified follow-up of patients with mild/moderate renal insufficiency are essential to avoid or delay an evolution towards end-stage renal failure. Prevention of renal fibrosis has a central role in such a long-term public health-policy. PMID:10371761

  2. 29 CFR 825.113 - Serious health condition.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Serious health condition. 825.113 Section 825.113 Labor... AND MEDICAL LEAVE ACT OF 1993 Coverage Under the Family and Medical Leave Act § 825.113 Serious health condition. (a) For purposes of FMLA, “serious health condition” entitling an employee to FMLA leave means...

  3. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  4. Multiple Chronic Conditions among Adults Aged 45 and Over: Trends Over the Past 10 Years

    Science.gov (United States)

    ... needs and use for Medicare and other payers. Keywords: hypertension, diabetes, cancer, prevalence The percentage of adults ... with two or more chronic conditions had increasing difficulty obtaining needed medical care and prescription drugs because ...

  5. THE EFFECTS OF CHRONIC EXERCISE CONDITIONING ON THERMOREGULATORY RESPONSE TO CHLORPYRIFOS IN FEMALE RATS.

    Science.gov (United States)

    Chronic exercise conditioning has been shown to alter basal thermoregulatory processes (change in thermoregulatory set-point) as well as the response to infectious fever. Chlorpyrifos (CHP), an organophosphate pesticide, causes an acute period of hypothermia followed by a delaye...

  6. Quality of life in individuals with chronic foot conditions: a cross sectional observational study.

    LENUS (Irish Health Repository)

    Groarke, Patrick

    2012-06-01

    Chronic foot conditions have been reported to be a significant cause of impairment and disability to individuals affected. However, studies to date have particularly focussed on patient satisfaction with outcomes following surgery.

  7. The Relevance of Value Net Integrator and Shared Infrastructure Business Models in Managing Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Susan Lambert

    2005-11-01

    Full Text Available There is widespread support for chronic condition management (CCM programs that require a multi-disciplinary, care-team approach. Implementation of such programs represents a paradigm shift in primary care service delivery and has significant resource implications for the general practice. Integral to the widespread uptake of care-team based CCM is information collection, storage and dissemination amongst the care-team members. This paper looks to ebusiness models for assistance in understanding the requirements of general practitioners (GPs in providing multi-disciplinary team care to patients with chronic conditions. The role required of GPs in chronic condition management is compared to that of a value net integrator. The essential characteristics of value net integrators are identified and compared to those of GPs providing multi-disciplinary team care to patients with chronic conditions. It is further suggested that a shared infrastructure is required.

  8. Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions

    Directory of Open Access Journals (Sweden)

    Eton DT

    2015-03-01

    % were coping with multiple chronic conditions. A preliminary conceptual framework using data from the first 32 interviews was evaluated and was modified using narrative data from 18 additional interviews with a racially and socioeconomically diverse sample of patients. The final framework features three overarching themes with associated subthemes. These themes included: 1 work patients must do to care for their health (eg, taking medications, keeping medical appointments, monitoring health; 2 challenges/stressors that exacerbate perceived burden (eg, financial, interpersonal, provider obstacles; and 3 impacts of burden (eg, role limitations, mental exhaustion. All themes and subthemes were subsequently confirmed in focus groups. Conclusion: The final conceptual framework can be used as a foundation for building a patient self-report measure to systematically study treatment burden for research and analytical purposes, as well as to promote meaningful clinic-based dialogue between patients and providers about the challenges inherent in maintaining complex self-management of health. Keywords: treatment burden, conceptual framework, adherence, questionnaire, self-management, multi-morbidity

  9. Participation and Well-Being Among Older Adults Living with Chronic Conditions

    OpenAIRE

    Anaby, D.; Miller, W C; Jarus, T.; Eng, J. J.; Noreau, L

    2011-01-01

    This study explored the unique contribution of participation (daily activities and social roles) in explaining well-being of older adults living with chronic conditions and examined which aspect of participation (accomplishment of participation or satisfaction with participation) was more important in describing their well-being. Two hundred older adults with chronic conditions completed the following assessments: Satisfaction with Life Scale to measure well-being; Assessment of Life Habits t...

  10. Enhancement of Latent Inhibition by Chronic Mild Stress in Rats Submitted to Emotional Response Conditioning

    OpenAIRE

    Liana Lins Melo; de Moraes Ferrari, Elenice A.; Nancy Airoldi Teixeira; Guy Sandner

    2003-01-01

    This work evaluated the influence of chronic mild stress on latent inhibition (LI) in rats, using a conditioned emotional response (CER) procedure. Rats were assigned to four groups: a non pre-exposed control group (NPC), a non pre-exposed stressed group (NPS), a preexposed control group (PC), and a pre-exposed stressed group (PS). Stressed animals were submitted to a chronic mild stress (CMS) regimen for three weeks. The off-baseline conditioned emotional response procedure had four phases: ...

  11. Impact of appropriate pharmaceutical therapy for chronic conditions on direct medical costs and workplace productivity: a review of the literature.

    Science.gov (United States)

    Goldfarb, Neil; Weston, Christine; Hartmann, Christine W; Sikirica, Mirko; Crawford, Albert; He, Hope; Howell, Jamie; Maio, Vittorio; Clarke, Janice; Nuthulaganti, Bhaskar; Cobb, Nicole

    2004-01-01

    This paper presents the findings of a literature review investigating the economic impact of appropriate pharmaceutical therapy in treating four prevalent chronic conditions - asthma, diabetes, heart failure, and migraine. The goal of the review was to identify high-quality studies examining the extent to which appropriate pharmaceutical therapy impacts overall medical expenditure (direct costs) and workplace productivity (indirect costs). The working hypothesis in conducting the review was that the costs of pharmaceuticals for the selected chronic conditions are offset by savings in direct and indirect costs in other areas. The literature provides evidence that appropriate drug therapy improves the health status and quality of life of individuals with chronic illnesses while reducing costs associated with utilization of emergency room, inpatient, and other medical services. A growing body of evidence also suggests that workers whose chronic conditions are effectively controlled with medications are more productive. For employers, the evidence translates into potential direct and indirect cost savings. The findings also confirm the importance of pharmaceutical management as a cornerstone of disease management. PMID:15035834

  12. Using Family Health History for Chronic Disease Prevention in the Age of Genomics: Translation to Health Education Practice

    Science.gov (United States)

    Hanson, Carl; Novilla, Lelinneth; Barnes, Michael; De La Cruz, Natalie; Meacham, Aaron

    2007-01-01

    Advances in the field of human genomics have important implications for the prevention of chronic disease. In response to these advancements, public health professionals--including health educators--must become competent in the principles underlying the interface between genomics and the use of family health history. Family health history captures…

  13. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil

    Directory of Open Access Journals (Sweden)

    L.S.C. Coelho

    2014-09-01

    Full Text Available The objective of the present study was to estimate the prevalence of chronic pelvic pain in the community of São Luís, capital of the State of Maranhão, Northeastern Brazil, and to identify independent conditions associated with it. A cross-sectional study was conducted, including a sample of 1470 women older than 14 years predominantly served by the public health system. The interviews were held in the subject's home by trained interviewers not affiliated with the public health services of the municipality. The homes were visited at random according to the city map and the prevalence of the condition was estimated. To identify the associated conditions, the significant variables (P=0.10 were selected and entered in a multivariate analysis model. Data are reported as odds ratio and 95% confidence interval, with the level of significance set at 0.05. The prevalence of chronic pelvic pain was 19.0%. The independent conditions associated with this diagnosis were: dyspareunia (OR=3.94, premenopausal status (OR=2.95, depressive symptoms (OR=2.33, dysmenorrhea (OR=1.77, smoking (OR=1.72, irregular menstrual flow (OR=1.62, and irritative bladder symptoms (OR=1.90. The prevalence of chronic pelvic pain in Sao Luís is high and is associated with the conditions cited above. Guidelines based on prevention and/or early identification of risk factors may reduce the prevalence of chronic pelvic pain in São Luís, Brazil.

  14. Short report: Chronic medical conditions and life satisfaction in the elderly

    OpenAIRE

    Jelicic, M.; Kempen, GIJM

    1999-01-01

    The aim of this study was to examine the effect of chronic disease on life satisfaction in community dwelling elderly. A total of 5279 research participants, mean age 69.57 (SD = 8.04) yrs, were asked to judge their life satisfaction on the Seven Point Satisfaction Rating Scale. They were also administered a checklist of 18 chronic medical conditions. The results indicate that the more chronic conditions elderly people have, the lower their life satisfaction gets. It is argued that these find...

  15. Influence of pro-algesic foods on chronic pain conditions.

    Science.gov (United States)

    Cairns, Brian Edwin

    2016-04-01

    This paper examines current knowledge about putative "pro-algesic" dietary components, and discusses whether limiting the intake of these substances can help improve chronic pain. Although there is a common impression that numerous food components, natural and synthetic, can cause or worsen pain symptoms, very few of these substances have been investigated. This article focuses on four substances, monosodium glutamate, aspartame, arachidonic acid, and caffeine, where research shows that overconsumption may induce or worsen pain. For each substance, the mechanism whereby it may act to induce pain is examined, and any clinical trials examining the effectiveness of reducing the intake of the substance discussed. While all four substances are associated with pain, decreased consumption of them does not consistently reduce pain. PMID:26900907

  16. Health Conditions Common in African American Women

    Science.gov (United States)

    ... of knowledge about the importance of tests to screen for major health problems. For some diseases, genetics ... cell anemia Smoking Stroke Tuberculosis (TB) Uterine fibroids Violence Content last updated: March 01, 2012. Print Return ...

  17. OSTEOPAThic Health outcomes In Chronic low back pain: The OSTEOPATHIC Trial

    OpenAIRE

    Licciardone, John C; King, Hollis H.; Hensel, Kendi L.; Williams, Daniel G.

    2008-01-01

    Background Osteopathic manipulative treatment (OMT) and ultrasound physical therapy (UPT) are commonly used for chronic low back pain. Although there is evidence from a systematic review and meta-analysis that OMT generally reduces low back pain, there are no large clinical trials that specifically assess OMT efficacy in chronic low back pain. Similarly, there is a lack of evidence involving UPT for chronic low back pain. Methods The OSTEOPAThic Health outcomes In Chronic low back pain (OSTEO...

  18. The development of health literacy in patients with a long-term health condition: the health literacy pathway model

    OpenAIRE

    Edwards Michelle; Wood Fiona; Davies Myfanwy; Edwards Adrian

    2012-01-01

    Abstract Background Inadequate health literacy has been associated with poor management of long-term health conditions and has been identified as a key social determinant of health outcomes. However, little is understood about how health literacy might develop over time or the processes by which people may become more health literate. Our objectives were to describe how patients with a long-term condition practice health literacy in the management of their health and communication with health...

  19. Information and Communication Technology–Enabled Person-Centered Care for the “Big Five” Chronic Conditions: Scoping Review

    Science.gov (United States)

    Simonse, Lianne WL

    2015-01-01

    Background Person-centered information and communication technology (ICT) could encourage patients to take an active part in their health care and decision-making process, and make it possible for patients to interact directly with health care providers and services about their personal health concerns. Yet, little is known about which ICT interventions dedicated to person-centered care (PCC) and connected-care interactions have been studied, especially for shared care management of chronic diseases. The aim of this research is to investigate the extent, range, and nature of these research activities and identify research gaps in the evidence base of health studies regarding the “big 5” chronic diseases: diabetes mellitus, cardiovascular disease, chronic respiratory disease, cancer, and stroke. Objective The objective of this paper was to review the literature and to scope the field with respect to 2 questions: (1) which ICT interventions have been used to support patients and health care professionals in PCC management of the big 5 chronic diseases? and (2) what is the impact of these interventions, such as on health-related quality of life and cost efficiency? Methods This research adopted a scoping review method. Three electronic medical databases were accessed: PubMed, EMBASE, and Cochrane Library. The research reviewed studies published between January 1989 and December 2013. In 5 stages of systematic scanning and reviewing, relevant studies were identified, selected, and charted. Then we collated, summarized, and reported the results. Results From the initial 9380 search results, we identified 350 studies that qualified for inclusion: diabetes mellitus (n=103), cardiovascular disease (n=89), chronic respiratory disease (n=73), cancer (n=67), and stroke (n=18). Persons with one of these chronic conditions used ICT primarily for self-measurement of the body, when interacting with health care providers, with the highest rates of use seen in chronic

  20. The growing caseload of chronic life-long conditions calls for a move towards full self-management in low-income countries

    Directory of Open Access Journals (Sweden)

    Kegels Guy

    2011-10-01

    Full Text Available Abstract Background The growing caseload caused by patients with chronic life-long conditions leads to increased needs for health care providers and rising costs of health services, resulting in a heavy burden on health systems, populations and individuals. The professionalised health care for chronic patients common in high income countries is very labour-intensive and expensive. Moreover, the outcomes are often poor. In low-income countries, the scarce resources and the lack of quality and continuity of health care result in high health care expenditure and very poor health outcomes. The current proposals to improve care for chronic patients in low-income countries are still very much provider-centred. The aim of this paper is to show that present provider-centred models of chronic care are not adequate and to propose 'full self-management' as an alternative for low-income countries, facilitated by expert patient networks and smart phone technology. Discussion People with chronic life-long conditions need to 'rebalance' their life in order to combine the needs related to their chronic condition with other elements of their life. They have a crucial role in the management of their condition and the opportunity to gain knowledge and expertise in their condition and its management. Therefore, people with chronic life-long conditions should be empowered so that they become the centre of management of their condition. In full self-management, patients become the hub of management of their own care and take full responsibility for their condition, supported by peers, professionals and information and communication tools. We will elaborate on two current trends that can enhance the capacity for self-management and coping: the emergence of peer support and expert-patient networks and the development and distribution of smart phone technology both drastically expand the possibilities for full self-management. Conclusion Present provider-centred models

  1. Ambivalent connections. Improving community mental health care for non-psychotic chronic patients perceived as 'difficult'

    OpenAIRE

    Koekkoek, Bauke

    2011-01-01

    Depression is a widespread psychiatric disorder, which becomes chronic in 25-30% of cases. When psychiatric and psychological treatments are ineffective, chronic depressive patients are often assigned to long-term care which is mostly provided by mental health nurses. Due to factors strongly associated with chronicity (like dependency, demoralization and hopelessness) long-term care is a difficult undertaking both for patients and mental health nurses. Areas in which major problems occur are ...

  2. Chronic Exercise Increases Sensitivity to the Conditioned Rewarding Effects of Cocaine

    OpenAIRE

    Smith, Mark A.; Gergans, Samantha R.; Iordanou, Jordan C.; Lyle, Megan A.

    2008-01-01

    The purpose of this study was to determine whether chronic exercise alters sensitivity to the conditioned rewarding effects of cocaine. Female rats were obtained at weaning and randomly assigned to either sedentary or exercise conditions. After 6 weeks under these conditions, the effects of cocaine were examined in the conditioned place preference procedure. Cocaine produced a dose-dependent conditioned place preference in both groups of rats. Exercising rats were more sensitive than sedentar...

  3. State and Regional Prevalence of Diagnosed Multiple Chronic Conditions Among Adults Aged ≥18 Years - United States, 2014.

    Science.gov (United States)

    Ward, Brian W; Black, Lindsey I

    2016-01-01

    The prevalence and care management of multiple (two or more) chronic conditions (MCC) are important public health concerns (1). Approximately 25% of U.S. adults have diagnoses of MCC (2). Care management of MCC presents a challenge to both patients and providers because of the substantial costs associated with treating more than one condition and the traditional care strategies that focus on single conditions as opposed to enhanced care coordination (3,4). Maintaining surveillance, targeting service delivery, and projecting resources are all important to meet this challenge, and these actions can be informed by identifying state and other regional variations in MCC prevalence (5,6). Data from the 2014 National Health Interview Survey (NHIS) were used to estimate prevalence of MCC (defined as two or more of 10 diagnosed chronic conditions) for each U.S. state and region by age and sex. Significant state and regional variation in MCC prevalence was found, with state-level estimates ranging from 19.0% in Colorado to 38.2% in Kentucky. MCC prevalence also varied by region, ranging from 21.4% in the Pacific region to 34.5% in the East South Central region. The prevalence of MCC was higher among women than among men within certain U.S. regions, and was higher in older persons in all regions. Such findings further the research and surveillance objectives stated in the U.S. Department of Health and Human Services (HHS) publication, Multiple Chronic Conditions: A Strategic Framework (1). Furthermore, geographic disparities in MCC prevalence can inform state-level surveillance programs and groups targeting service delivery or allocating resources for MCC prevention activities. PMID:27467707

  4. Sexuality Issues in Adolescents with a Chronic Neurological Condition

    OpenAIRE

    Sawin, Kathleen J.; Buran, Constance F; Brei, Timothy J.; Fastenau, Philip S.

    2002-01-01

    Substantial progress in the medical treatment of individuals with spina bifida (SB) has increased the numbers who survive into adolescence and adulthood. However, sexual health in this population has not received much attention. This study explored the knowledge (SB Sexuality Knowledge Scale), worries (SB Worries Scale), romantic appeal (from Harter's Self-Perception Scale), and access to sexuality information of a sample of 60 adolescents from a midwestern state. Study participants reported ...

  5. ROMANIAN FOOD CONSUMPTION AND ITS EFFECTS ON POPULATION'S HEALTH CONDITION

    Directory of Open Access Journals (Sweden)

    Mihaela CONSTANDACHE

    2014-04-01

    Full Text Available Public health is a top priority for the European Union. The main factor in ensuring population health is food consumption and in particular food quality. The present paper aims at analyzing Romanian population food consumption during the 1990-2012 periods, its evolution in time; it identifies its main features and their effects on population health. Amid the economic crisis the purchasing power of population is impaired leading to insufficient consumption of fresh fruits and vegetables and a low intake of vitamins, calcium, phosphorous and iron (especially in children, women and elderly people, which could be an important risk factor in the development of chronic diseases.

  6. Spanning boundaries and creating strong patient relationships to coordinate care are strategies used by experienced chronic condition care coordinators.

    Science.gov (United States)

    Ehrlich, Carolyn; Kendall, Elizabeth; Muenchberger, Heidi

    2012-08-01

    People with complex chronic conditions frequently need to navigate their own way through and around a fragmented and siloed health care system. Care coordination is a defining principle of primary care and is frequently proposed as a solution to this problem. However, care coordination requires more time and effort than primary care physicians alone have the capacity to deliver. Although registered nurses (RNs) are skilled team members who can be included in the delivery of coordinated patient care, any model of care coordination that involves RNs needs to fit within the existing health care delivery system. In this study, which used qualitative techniques based on grounded theory and included face-to-face interviews and open coding and theoretical sampling until data saturation was achieved, and which was one component of a larger action research study, we aimed to gain an understanding of the difference between usual chronic condition care and the work of chronic condition care coordination. The researchers interviewed general practitioners and RNs from various general practice sites who were actively coordinating care. Four unique processes were found to define care coordination implementation, namely: (1) moving beyond usual practice by spanning boundaries; (2) relationship-based care; (3) agreed roles and routines among relevant parties; and (4) committing to chronic condition care coordination. The findings suggested that existing professional and organisational cultures required negotiation before care coordination could be integrated into existing contexts. The challenge, however, seems to be in acknowledging and overcoming professional practice boundaries that define existing care through reflective practice and shared resourcing. PMID:23050573

  7. Contextual factors related to chronic condition in portuguese adolescents: highlights from the HBSC/WHO study

    Directory of Open Access Journals (Sweden)

    Teresa Santos

    2016-01-01

    Full Text Available Abstract Adolescence’s changes may become more pronounced when living with a chronic condition (CC. This study aims to examined the differences in satisfaction with family life, perception of school competence and “pressure with homework” of Portuguese adolescents’ 1 living with CC; 2 how living with CC affects school participation; taking into account age, gender and family socioeconomic status (SES. Five thousand fifty Portuguese adolescents (mean age 14 ± 1.85 of the Health Behaviour in School-aged Children (HBSC/WHO were included. Results showed increased vulnerability in adolescents living with CC, presenting a lower satisfaction with family life and poor school outcomes. Younger boys, having a higher SES and not having CC are significantly associated with satisfaction with family life. Older girls, having a lower SES and living with CC were associated with more stress related to school work. Future interventions should include these features combined with ‘listening’ to adolescents and their needs, allowing their participation in the promotion of personal health.

  8. Improving Preclinic Preparation for Patients with Chronic Conditions in Quito, Ecuador: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    K. Rodriguez

    2015-01-01

    Full Text Available Objectives. As in many settings, patients in community health centers in Ecuador do not complete previsit forms or receive assistance to identify questions and concerns they would like to address in brief clinic visits with physicians. We examined the comparative effectiveness of providing (1 a previsit form to complete; (2 a previsit form along with assistance in completing the form; and (3 usual care. Methods. Parallel, three-arm randomized controlled trial in two health centers serving indigent to low-income communities in Quito, Ecuador, among 199 adult patients who took medications for at least one chronic condition. Outcome measures were self-reported satisfaction with the visit, confidence in asking questions, and extent to which patients’ objectives were met. Results. Patients who received assistance in completing a previsit form were more than twice as likely as participants in usual care to report achieving everything they wanted during their visit (AOR 2.2, P=0.039. There were no differences in any outcomes between the groups who received the previsit form with no assistance and usual care. Conclusions. For high-quality patient-centered primary care, it is important to develop and test innovative and scalable interventions for patients and physicians to make the best use of limited clinic time.

  9. Associations and Synergistic Effects for Psychological Distress and Chronic Back Pain on the Utilization of Different Levels of Ambulatory Health Care. A Cross-Sectional Study from Austria

    OpenAIRE

    Hoffmann, Kathryn; Peersman, Wim; George, Aaron; Dorner, Thomas Ernst

    2015-01-01

    The aim of this analysis was to assess the impact of chronic back pain and psychological distress on the utilization of primary and secondary levels of care in the ambulatory health care sector in Austria - a country without a gatekeeping system. Additionally, we aimed to determine if the joint effect of chronic back pain and psychological distress was higher than the impact of the sum of the two single conditions. The database used for this analysis was the Austrian Health Interview Survey, ...

  10. Achalasia and chronic opiate use: innocent bystanders or associated conditions?

    Science.gov (United States)

    Ravi, K; Murray, J A; Geno, D M; Katzka, D A

    2016-01-01

    High-resolution manometry identifies three subtypes of achalasia. However, type 3 differs from classic achalasia. Although opiates affect esophageal motility, opiate use and achalasia have not been studied. Patients with a new diagnosis of achalasia at Mayo Clinic Rochester between June 1, 2012 and January 3, 2014 were identified. Clinical records were reviewed to assess symptoms, opiate use, and therapy. Fifty-six patients with achalasia were identified, 14 (25%) were on opiates. Opiate prescription was unrelated to achalasia in all cases, with chronic back and joint pain constituting the majority. Of patients on opiates, five (36%) had type 3 achalasia compared with four (10%) not on opiates (P = 0.02). No patients on opiates had type 1 achalasia. Clinical presentation did not differ with opiates, although those on opiates were more likely to report chest pain (39 vs. 14%, P = 0.05) and less likely to have esophageal dilation (62 vs. 82%, P = 0.13), none with greater than 5-cm diameter. Contractile vigor was greater with opiate use, with distal contractile integral of 7149 versus 2615.5 mmHg/cm/second (P = 0.08). Treatment response was inferior on opiates, with persistent symptoms in 22% compared with 3% without opiates (P = 0.06). Opiate use is common in type 3 achalasia, with the majority of patients on opiates. No patients on opiates were diagnosed with type 1 achalasia. Manometric findings of type 3 achalasia mimic those induced by opiates, suggesting a physiologic mechanism for opiate induced type 3 achalasia. Treatment outcome is inferior with opiates, with opiate cessation perhaps preferable. Further studies assessing opiate use and achalasia are needed. PMID:25604060

  11. Experiences of patients with chronic gastrointestinal conditions: in their own words

    Directory of Open Access Journals (Sweden)

    McCormick Jennifer B

    2012-03-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS and inflammatory bowel disease (IBD are chronic conditions affecting millions of individuals in the United States. The symptoms are well-documented and can be debilitating. How these chronic gastrointestinal (GI conditions impact the daily lives of those afflicted is not well documented, especially from a patient's perspective. Methods Here we describe data from a series of 22 focus groups held at three different academic medical centers with individuals suffering from chronic GI conditions. All focus groups were audio recorded and transcribed. Two research team members independently analyzed transcripts from each focus group following an agreed upon coding scheme. Results One-hundred-thirty-six individuals participated in our study, all with a chronic GI related condition. They candidly discussed three broad themes that characterize their daily lives: identification of disease and personal identity, medications and therapeutics, and daily adaptations. These all tie to our participants trying to deal with symptoms on a daily basis. We find that a recurrent topic underlying these themes is the dichotomy of experiencing uncertainty and striving for control. Conclusions Study participants' open dialogue and exchange of experiences living with a chronic GI condition provide insight into how these conditions shape day-to-day activities. Our findings provide fertile ground for discussions about how clinicians might best facilitate, acknowledge, and elicit patients' stories in routine care to better address their experience of illness.

  12. Self-rated health, chronic diseases and health service utilisation in Hong Kong

    OpenAIRE

    Xu, Fang; 徐方

    2015-01-01

    Introduction Self-rated health (SRH) is a widely used indicator of health service utilisation and reflects self-perceived objective health condition. Poorer non-comparative SRH was shown to be related to higher inpatient and outpatient utilisation in Western and elderly populations. Little is known about how healthcare utilisation relates to SRH in non-Western settings, such as Hong Kong and in adult populations. The association of age- and time- comparative SRH with healthcare utilisation is...

  13. Clinical studies on health conditions of medical diagnostic X-ray workers

    Energy Technology Data Exchange (ETDEWEB)

    Liu Liqun

    1984-10-01

    The results of investigations on general health conditions of 2484 medical X-ray workers and 1718 controls were reported. It was shown that the incidences of neurasthenic syndrome, loss of appetite, baldness etc. in X-ray workers were statistically higher than those in controls. Chronic rhinitis, pharyngitis, and paranasal sinusitis also occurred more frequently in the former group. The blood pressure, pulse rate, capillary resistance and past medical history showed no significant difference between these two groups. (Author).

  14. Managing chronic conditions: economic analysis can help mitigate costs of diabetic ulcers.

    Science.gov (United States)

    Amir, Leah

    2014-05-01

    Hospital finance leaders should perform economic analyses of emerging treatments for chronic conditions that could provide cost-effective alternatives to generally accepted standards of care. One such treatment for diabetic foot ulcers (DFUs) is noncontact low-frequency ultrasound, which has been shown to reduce both costs and healing times associated with these conditions. By reviewing results of clinical trials to understand the costs and treatment considerations for DFUs and other chronic conditions, finance leaders can engage in informed conversations with physicians on how best to manage costs. PMID:24851459

  15. Chronic forced exercise during adolescence decreases cocaine conditioned place preference in Lewis rats

    OpenAIRE

    Thanos, Panayotis K.; Tucci, Andrew; Stamos, Joshua; Robison, Lisa; Wang, Gene-Jack; Anderson, Brenda J.; Volkow, Nora D

    2010-01-01

    Chronic physical activity (exercise) may be beneficial in the prevention of substance use disorders; however, the extent to which physical activity can interfere with the reinforcing effects of drugs during the adolescent period, which is one of great vulnerability for drug experimentation, has not been fully evaluated. Here, we assess the effects of chronic forced exercise during adolescence on preference for cocaine using the conditioned place preference (CPP) paradigm in male and female Le...

  16. The impact of newly diagnosed chronic paediatric conditions on parental quality of life

    OpenAIRE

    Goldbeck, Lutz

    2006-01-01

    Objective: Parental functioning and well-being are important aspects of a family’s adaptation to chronic paediatric conditions. This study investigates the effects of diagnosis (cancer vs. diabetes/epilepsy) and time since diagnosis on parental quality of life (PQL). Methods: 122 parents (66 mothers, 56 fathers), whose children were diagnosed and treated for one chronic disease, filled in the Ulm Quality of Life Inventory for Parents twice within the first three months after the initial ...

  17. Interaction of stressful life events and chronic strains on community mental health

    Energy Technology Data Exchange (ETDEWEB)

    Evans, G.W.; Jacobs, S.V.; Dooley, D.; Catalano, R.

    1987-02-01

    One of the possible adaptive costs of coping with stress is diminished capacity to respond to subsequent adaptive demands. This paper examined the complex interplay between major life events and one source of chronic strain. Residents of the greater Los Angeles metropolitan area exposed to higher levels of smog, who had also experienced a recent stressful life event, exhibited poorer mental health than those exposed to pollution who had not experienced a recent stressful life event. There were, however, no direct effects of smog levels on mental health. These patterns of results were replicated in both a cross-sectional and a longitudinal study. The interplay of psychosocial vulnerability and environmental conditions is discussed.

  18. Role of Protein Carbonylation in Skeletal Muscle Mass Loss Associated with Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Esther Barreiro

    2016-05-01

    Full Text Available Muscle dysfunction, characterized by a reductive remodeling of muscle fibers, is a common systemic manifestation in highly prevalent conditions such as chronic heart failure (CHF, chronic obstructive pulmonary disease (COPD, cancer cachexia, and critically ill patients. Skeletal muscle dysfunction and impaired muscle mass may predict morbidity and mortality in patients with chronic diseases, regardless of the underlying condition. High levels of oxidants may alter function and structure of key cellular molecules such as proteins, DNA, and lipids, leading to cellular injury and death. Protein oxidation including protein carbonylation was demonstrated to modify enzyme activity and DNA binding of transcription factors, while also rendering proteins more prone to proteolytic degradation. Given the relevance of protein oxidation in the pathophysiology of many chronic conditions and their comorbidities, the current review focuses on the analysis of different studies in which the biological and clinical significance of the modifications induced by reactive carbonyls on proteins have been explored so far in skeletal muscles of patients and animal models of chronic conditions such as COPD, disuse muscle atrophy, cancer cachexia, sepsis, and physiological aging. Future research will elucidate the specific impact and sites of reactive carbonyls on muscle protein content and function in human conditions.

  19. Rethinking global health challenges: towards a 'global compact' for reducing the burden of chronic disease.

    Science.gov (United States)

    Magnusson, R S

    2009-03-01

    Chronic diseases, including cardiovascular disease, diabetes and cancer, are the leading cause of death and disability in both the developed and developing world (excluding sub-Saharan Africa). At present, the global framework for action on chronic disease is strongly 'World Health Organization (WHO)-centric', defined by two WHO initiatives: the WHO Framework Convention on Tobacco Control, and the Global Strategy on Diet, Physical Activity and Health. This paper explores the difficulties of developing a collective response to global health challenges, and draws out some implications for chronic disease. It highlights how political partnerships and improved governance structures, economic processes, and international laws and standards function as three, concurrent pathways for encouraging policy implementation at country level and for building collective commitment to address the transnational determinants of chronic disease. The paper evaluates WHO's initiatives on chronic disease in terms of these pathways, and makes the case for a global compact on chronic disease as a possible structure for advancing WHO's free-standing goal of reducing mortality from chronic diseases by an additional 2% between 2005 and 2015. Beneath this overarching structure, the paper argues that global agencies, donor governments and other global health stakeholders could achieve greater impact by coordinating their efforts within a series of semi-autonomous 'policy channels' or 'workstreams'. These workstreams - including trade and agriculture, consumer health issues and workplace health promotion - could act as focal points for international cooperation, drawing in a wider range of health stakeholders within their areas of comparative advantage. PMID:19278695

  20. Health-related quality of life and mental health problems after a disaster: are chronically ill survivors more vulnerable to health problems?

    NARCIS (Netherlands)

    Berg, B. van den; Velden, P.G. van der; Yzermans, C.J.; Stellato, R.K.; Grievink, L.

    2006-01-01

    Studies have shown that the chronically ill are at higher risk for reduced health-related quality of life (HRQL) and for mental health problems. A combination with traumatic events might increase this risk. This longitudinal study among 1216 survivors of a disaster examines whether chronically ill s

  1. Health-related quality of life and mental health problems after a disaster: Are chronically ill survivors more vulnerable to health problems?

    NARCIS (Netherlands)

    Berg, Bellis van den; Velden, Peter G van der; Yzermans, C Joris; Stellato, Rebecca K; Grievink, Linda

    2006-01-01

    Studies have shown that the chronically ill are at higher risk for reduced health-related quality of life (HRQL) and for mental health problems. A combination with traumatic events might increase this risk. This longitudinal study among 1216 survivors of a disaster examines whether chronically ill s

  2. Health-related quality of life in elderly patients hospitalized with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Erceg P

    2013-11-01

    Full Text Available Predrag Erceg,1,2 Nebojsa Despotovic,1,2 Dragoslav P Milosevic,1,2 Ivan Soldatovic,3 Sanja Zdravkovic,2 Snezana Tomic,2 Ivana Markovic,2 Gordana Mihajlovic,2 Milan D Brajovic,4,5 Ognjen Bojovic,6 Bojana Potic,2 Mladen Davidovic1 1Department of Gerontology, Faculty of Medicine, University of Belgrade, 2Clinical Department of Geriatrics, Zvezdara University Hospital, 3Institute of Medical Statistics and Informatics, Faculty of Medicine, 4Department of Internal Medicine, Faculty of Dentistry, University of Belgrade, 5Clinical Department of Cardiology, Zvezdara University Hospital, Belgrade, Serbia; 6Department of Biomedicine, University of Bergen, Bergen, Norway Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL. Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001, higher NYHA class (P=0.021, lower income (P=0.029, and longer duration of heart failure (P=0.049 were

  3. Medical students' self-report of mental health conditions

    OpenAIRE

    Strous, Rael D.; Netta Shoenfeld; Avi Lehman; Aharon Wolf; Leah Snyder; Ori Barzilai

    2012-01-01

    Objectives: To investigate the subjective presence of a range of subsyndromal and syndromal mental health conditions in medical students, and to compare the presence of these conditions between preclinical and clinical training. Methods: A cross sectional study was used among first-and fifth-year medical students. Student reported their mental health conditions using the Diagnostic and Statistical Manual of Mental Disorders criteria, the fourth version (DSM-IV). Data analysis was based on 110...

  4. Medical students' self-report of mental health conditions

    OpenAIRE

    Strous, Rael D.; Shoenfeld, Netta; Lehman, Avi; Wolf, Aharon; Snyder, Leah; Barzilai, Ori

    2012-01-01

    Objectives To investigate the subjective presenceof a range of subsyndromal and syndromal mental health conditions in medical students, and to compare the presence of these conditions between preclinical and clinical training. Methods A cross sectional study was used among first-and fifth-year medical students. Student reported their mental health conditions using the Diagnostic and Statistical Manual of Mental Disorders criteria, the fourth version (DSM-IV). Data analysis was based on 110 qu...

  5. Behaviour change and social blinkers? The role of sociology in trials of self-management behaviour in chronic conditions.

    Science.gov (United States)

    Ong, Bie Nio; Rogers, Anne; Kennedy, Anne; Bower, Peter; Sanders, Tom; Morden, Andrew; Cheraghi-Sohi, Sudeh; Richardson, Jane C; Stevenson, Fiona

    2014-02-01

    Individual-focused self-management interventions are one response to both an ageing society and the purported increase in chronic conditions. They tend to draw on psychological theories in self-management interventions, but over-reliance on these theories can reinforce a narrow focus on specified attitudinal and behavioural processes, omitting aspects of living with a chronic condition. While advances have been made in health behaviour change theory and practice, scant attention has been paid to the social, with the question of social context remaining under-theorised and under-explored empirically. This is particularly noticeable in trials of behaviour change interventions for self-management. The common sociological critique is that these ignore context and thus no explanation can be given as to why, for whom and under what circumstances a treatment works. Conversely, sociologists are criticised for offering no positive suggestions as to how context can be taken into account and for over-emphasising context with the risk of inhibiting innovation. This article provides an overview of these issues and provides examples of how context can be incorporated into the rigid method of trials of self-management for chronic conditions. We discuss modifications to both trial interventions and design that make constructive use of the concept of context. PMID:24528304

  6. Chronic medical conditions and major depressive disorder: Differential role of positive religious coping among african americans, caribbean blacks and non-hispanic whites

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2014-01-01

    Conclusions: Although the association between multiple chronic conditions and MDD may exist regardless of race and ethnicity, race/ethnicity may shape how positive religious coping buffers this association. This finding sheds more light onto race and ethnic differences in protective effects of religiosity on mental health of populations.

  7. Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes

    OpenAIRE

    Huygens, Martine W. J.; Vermeulen, Joan; Swinkels, Ilse C S; Friele, Roland D; van Schayck, Onno C. P.; de Witte, Luc P.

    2016-01-01

    Background Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients’ expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth f...

  8. Effects of acute and chronic hypohydration on kidney health and function.

    Science.gov (United States)

    Feehally, John; Khosravi, Maryam

    2015-09-01

    The kidneys play a critical role in the homeostasis of body fluid tonicity and effective circulating volume. Renal homeostatic mechanisms are frequently challenged in acutely ill people. Fluid depletion causing hypovolemia may result in renal hypoperfusion that, if left untreated, may lead to acute kidney failure. Some populations, notably older people and neonates, are less tolerant of extremes in fluid loading and deprivation, similar to those with established chronic kidney disease. Risk of kidney injury during fluid depletion is increased by medications including diuretics, nonsteroidal antiinflammatory drugs, and renin-angiotensin system blockers. There is no consistent evidence indicating that lower-than-average fluid intake can cause chronic kidney disease, nor accelerate progression of established kidney disease. Increasing consumption of sugar-containing beverages is, however, a major concern for kidney health as a precursor of obesity and diabetes. There is no evidence that high dietary protein intake can cause chronic kidney disease, nor accelerate progression of established kidney disease. Idiosyncratic, adverse renal responses have been described with creatine supplements. There are only a few clinical conditions for which high fluid intake should be considered. These include recurrent kidney stones or urinary tract infections and, possibly, polycystic kidney disease. PMID:26290296

  9. Effects of common chronic medical conditions on psychometric tests used to diagnose minimal hepatic encephalopathy

    DEFF Research Database (Denmark)

    Lauridsen, M M; Poulsen, L; Rasmussen, C K;

    2016-01-01

    Many chronic medical conditions are accompanied by cognitive disturbances but these have only to a very limited extent been psychometrically quantified. An exception is liver cirrhosis where hepatic encephalopathy is an inherent risk and mild forms are diagnosed by psychometric tests. The preferred...... diagnostic test battery in cirrhosis is often the Continuous Reaction Time (CRT) and the Portosystemic Encephalopathy (PSE) tests but the effect on these of other medical conditions is not known. We aimed to examine the effects of common chronic (non-cirrhosis) medical conditions on the CRT and PSE tests. We...... studied 15 patients with heart failure (HF), 15 with end stage renal failure (ESRF), 15 with dysregulated type II diabetes (DMII), 15 with chronic obstructive pulmonary disease (COPD), and 15 healthy persons. We applied the CRT test, which is a 10-min computerized test measuring sustained attention and...

  10. “What we want”: chronically ill adolescents’ preferences and priorities for improving health care

    Directory of Open Access Journals (Sweden)

    van Staa A

    2011-06-01

    Full Text Available AnneLoes van Staa1,2, Susan Jedeloo1, Heleen van der Stege1, On Your Own Feet Research Group1,31Expertise Center Transitions of Care, Rotterdam University, 2Institute of Health Policy and Management, Erasmus University Rotterdam, 3Department of Pediatrics, Sophia Children’s Hospital, Erasmus MC University Medical Center, Rotterdam, The NetherlandsBackground: As important users of health care, adolescents with chronic conditions deserve to be consulted about their experiences and expectations. This study aimed to explore chronically ill adolescents’ preferences regarding providers' qualities, and outpatient and inpatient care. Furthermore, suggestions for improvement of service delivery were collected.Methods: This research was a sequential mixed methods study in adolescents aged 12–19 years with various chronic conditions treated in a university children’s hospital. Methods comprised 31 face-to-face interviews at home, a hospital-based peer research project in which nine adolescents interviewed 34 fellow patients, and a web-based questionnaire (n = 990. Emerging qualitative themes were transformed into questionnaire items.Results: Having “a feeling of trust” and “voice and choice” in the hospital were central to these adolescents. Regarding providers’ qualities, “being an expert” and “being trustworthy and honest” were ranked highest, followed by "being caring and understanding”, "listening and showing respect", and “being focused on me”. Regarding outpatient consultations, preferences were ranked as follows: “answering all questions”; “attending to my and my parents’ needs”; and “clear communication”, while “limited waiting times” and “attractive outpatient surroundings” scored lowest. Regarding hospitalization, adolescents most preferred to “avoid pain and discomfort”, “keep in touch with home”, and “be entertained”, while “being hospitalized with peers” and “being heard

  11. Assessment of radiological technologist health condition by Todai health index

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the general health status of radiological technologists by using Todai Health Index(THI) that has been employed as a standard health assessment tool for a specific group. The subjects in this study were 800 radiological technologists who were working in clinics, hospitals and university hospitals in and around Seoul and in some provincial cities. A survey was conducted directly or by mail in June and July, 2001. And the response rate was 68%. Using THI, the following findings were acquired: 1. By gender, both male and female radiological technologists complained about multiple subjective symptom(I) the most, And the women made more significant complaint of eight items including irregular life. 2. By age group, the radiological technologists whose age ranged from 20 to 24 got higher marks in most of the items, including multiple subjective symptom(I) and symptoms related to eyes and skin. 3. For career, those who had worked for a year or less or for one to five years got higher marks in most of the items. 4. Concerning marital status, the unmarried people complained about many items more, and the married people's symptom was more associated with live scale(L). 5. By the type of medical institution, the radiological technologists in the university hospitals got higher marks in two items including aggressiveness(F), but those in the clinics complained about the others more. 6. Regarding a place of service, there were little differences between the radiological technologists in basement and on the ground

  12. Effect of Primary Health Care Orientation on Chronic Care Management

    OpenAIRE

    Schmittdiel, Julie A.; Shortell, Stephen M.; Rundall, Thomas G; Bodenheimer, Thomas; SELBY, Joe V.

    2006-01-01

    PURPOSE It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations.

  13. Unraveling the chronic toxicity of lead: an essential priority for environmental health.

    OpenAIRE

    Todd, A C; Wetmur, J G; Moline, J M; Godbold, J H; Levin, S M; Landrigan, P J

    1996-01-01

    Although population exposure to lead has declined, chronic lead toxicity remains a major public health problem in the United States affecting millions of children and adults. Important gaps exist in knowledge of the pathophysiology of chronic lead intoxication. These gaps have impeded development of control strategies. To close current gaps in knowledge of chronic lead toxicity, we propose an integrated, multidisciplinary, marker-based research program. This program combines a) direct measure...

  14. Use of Health Information and Communication Technologies to Promote Health and Manage Behavioral Risk Factors Associated with Chronic Disease: Applications in the Field of Health Education

    Science.gov (United States)

    Stellefson, Michael; Alber, Julia M.; Wang, Min Qi; Eddy, James M.; Chaney, Beth H.; Chaney, J. Don

    2015-01-01

    This special issue provides real-world examples of the diverse methods health education researchers are using to expand existing applications of information and communication technologies (ICTs) for health promotion and chronic disease management. The original and review articles presented in this special issue investigate eHealth, mHealth, and…

  15. Examination of the interaction of different lighting conditions and chronic mild stress in animal model.

    Science.gov (United States)

    Muller, A; Gal, N; Betlehem, J; Fuller, N; Acs, P; Kovacs, G L; Fusz, K; Jozsa, R; Olah, A

    2015-09-01

    We examined the effects of different shift work schedules and chronic mild stress (CMS) on mood using animal model. The most common international shift work schedules in nursing were applied by three groups of Wistar-rats and a control group with normal light-dark cycle. One subgroup from each group was subjected to CMS. Levels of anxiety and emotional life were evaluated in light-dark box. Differences between the groups according to independent and dependent variables were examined with one- and two-way analysis of variance, with a significance level defined at p examination confirm that the changes of lighting conditions evocate anxiety more prominently than CMS. No significant differences were found between the results of the low rotating group and the control group, supposing that this schedule is the least harmful to health. Our results on the association between the use of lighting regimens and the level of CMS provide evidence that the fast rotating shift work schedule puts the heaviest load on the organism of animals. PMID:26551746

  16. 'Keeping going': chronic joint pain in older people who describe their health as good.

    Science.gov (United States)

    Richardson, Jane C; Grime, Janet C; Ong, Bie Nio

    2014-09-01

    It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellness. We undertook a longitudinal qualitative study to explore 'wellness and resilience' in a group of older people who reported chronic joint pain and considered themselves healthy. We interviewed 27 people and followed them up with monthly diary sheets, responding to reports of changes using their chosen contact method. This article focuses on how resilience relates to how people consider themselves to be well. Participants' experience of the adversity of their pain varied, and was influenced by context and meaning. Participants described 'keeping going' in body, mind and everyday life. Flexibility and pragmatism were key aspects of keeping going. The findings support a broader version of resilience that incorporates vulnerabilities. In the context of health care we suggest that treating the frail body should not come at the expense of undermining an older person's sense of a resilient self. PMID:25067864

  17. [Using eHealth in the Continuity Care of Chronic Kidney Disease: Opportunities and Considerations].

    Science.gov (United States)

    Chen, Yu-Chi; Chang, Polun

    2016-04-01

    Kidney disease is a common complication of chronic diseases among adult and elderly populations. As early-stage chronic kidney disease (CKD) is asymptomatic, CKD patients are frequently unaware of their condition and fail to implement requisite self-care in a timely fashion. Furthermore, the shortage of case-management manpower and difficulties in follow-up have led to high incidence rates for CKD worldwide. Integrative and continuous care is key to preventing CKD. How to implement this care effectively is a challenge. However, innovative technologies, online information, and cloud technology are increasingly providing access to good-quality healthcare beyond the traditional limitations of time and location. This environment is not only increasing the participation of patients in their care and collaboration among healthcare team members but is also improving the continuity, accessibility, and promptness of care service in order to promote the effectiveness of disease management. While the primary aim of innovative technologies is to make healthcare more cost-effective, it is also causing disparities in healthcare. Within the high-tech e-healthcare system, the ability of patients to utilize these new services relates directly to their health behaviors and quality of care. Thus, emergent e-healthcare system services should be made as patient-centered as possible in order to maximize the benefits in terms of both cost and patient care. Furthermore, improving the eHealth literacy of patients is crucial to promoting innovative technology within healthcare services. PMID:27026552

  18. Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads.

    Science.gov (United States)

    Philpot, Lindsey M; Stockbridge, Erica L; Padrón, Norma A; Pagán, José A

    2016-06-01

    Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211). PMID:26440215

  19. Developmental Effects of Acute, Chronic, and Withdrawal from Chronic Nicotine on Fear Conditioning

    OpenAIRE

    Portugal, George S.; Wilkinson, Derek S.; Turner, Jill R.; Blendy, Julie A.; Gould, Thomas J.

    2012-01-01

    Pre-adolescence and adolescence are developmental periods associated with increased vulnerability for tobacco addiction, and exposure to tobacco during these periods may lead to long-lasting changes in behavioral and neuronal plasticity. The present study examined the short- and long-term effects of nicotine and nicotine withdrawal on fear conditioning in pre-adolescent, adolescent, and adult mice, and potential underlying substrates that may mediate the developmental effects of nicotine, suc...

  20. The South Australia Health Chronic Disease Self-Management Internet Trial

    Science.gov (United States)

    Lorig, Kate; Ritter, Philip L.; Plant, Kathryn; Laurent, Diana D.; Kelly, Pauline; Rowe, Sally

    2013-01-01

    Objectives: To evaluate the effectiveness of an online chronic disease self-management program for South Australia residents. Method: Data were collected online at baseline, 6 months, and 12 months. The intervention was an asynchronous 6-week chronic disease self-management program offered online. The authors measured eight health status measures,…

  1. Liposuction for chronic medical diseases and noncosmetic conditions: review of the literature

    Directory of Open Access Journals (Sweden)

    Hamdy Abuelhassan El-Khatib

    2015-03-01

    Full Text Available The purpose of this systematic literature review was to evaluate the safety of liposuction techniques and to identify the cosmetic and noncosmetic application of liposuction. Liposuction can be used to improve the quality-of-life in patients with disabling medical conditions in addition to its use for cosmetic rejuvenation. An online search of the Cochrane Library, MEDLINE, Embase, and SciELO were conducted. Forty-seven original articles reported from 1982 to February 2014 were included in this review. The articles reported on the use as well as the limitations of liposuction for treatment of noncosmetic and disabling medical conditions. The criteria used for selection of articles were: large sample size and originality. The case reports were excluded. There was a broad agreement about the applicability and the efficacy of the liposuction for treatment of these chronic medical conditions, such as multiple systemic lipomatosis, dercum's disease, chronic lymphedema, and axillary hyperhidrosis. Literatures review confirmed that Liposuction technique has provided significant and stable cure for these chronic medical conditions. Liposuction is the most frequent esthetic procedure for adipose tissue reduction and treatment of lipedema worldwide. Apart from esthetic indications, liposuction can also be used to treat chronic medical diseases and noncosmetic conditions.

  2. Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy

    Directory of Open Access Journals (Sweden)

    Forastiere Francesco

    2009-12-01

    Full Text Available Abstract Background A relationship between quality of primary health care and preventable hospitalizations has been described in the US, especially among the elderly. In Europe, there has been a recent increase in the evaluation of Ambulatory Care Sensitive Conditions (ACSC as an indicator of health care quality, but evidence is still limited. The aim of this study was to determine whether income level is associated with higher hospitalization rates for ACSC in adults in a country with universal health care coverage. Methods From the hospital registries in four Italian cities (Turin, Milan, Bologna, Rome, we identified 9384 hospital admissions for six chronic conditions (diabetes, hypertension, congestive heart failure, angina pectoris, chronic obstructive pulmonary disease, and asthma among 20-64 year-olds in 2000. Case definition was based on the ICD-9-CM coding algorithm suggested by the Agency for Health Research and Quality - Prevention Quality Indicators. An area-based (census block income index was used for each individual. All hospitalization rates were directly standardised for gender and age using the Italian population. Poisson regression analysis was performed to assess the relationship between income level (quintiles and hospitalization rates (RR, 95% CI separately for the selected conditions controlling for age, gender and city of residence. Results Overall, the ACSC age-standardized rate was 26.1 per 10.000 inhabitants. All conditions showed a statistically significant socioeconomic gradient, with low income people being more likely to be hospitalized than their well off counterparts. The association was particularly strong for chronic obstructive pulmonary disease (level V low income vs. level I high income RR = 4.23 95%CI 3.37-5.31 and for congestive heart failure (RR = 3.78, 95% CI = 3.09-4.62. With the exception of asthma, males were more vulnerable to ACSC hospitalizations than females. The risks were higher among 45-64 year

  3. Chronic pain in adolescence and internalizing mental health disorders: a nationally representative study.

    Science.gov (United States)

    Noel, Melanie; Groenewald, Cornelius B; Beals-Erickson, Sarah E; Gebert, J Thomas; Palermo, Tonya M

    2016-06-01

    Chronic pain in childhood and adolescence has been shown to heighten the risk for depressive and anxiety disorders in specific samples in adulthood; however, little is known about the association between a wider variety of chronic pains and internalizing mental health disorders. Using nationally representative data, the objectives of this study were to establish prevalence rates of internalizing mental health disorders (anxiety and depressive disorders) among cohorts with or without adolescent chronic pain, and to examine whether chronic pain in adolescence is associated with lifetime history of internalizing mental health disorders reported in adulthood. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) was used (N = 14,790). Individuals who had chronic pain in adolescence subsequently reported higher rates of lifetime anxiety disorders (21.1% vs 12.4%) and depressive disorders (24.5% vs 14.1%) in adulthood as compared with individuals without a history of adolescent chronic pain. Multivariate logistic regression confirmed that chronic pain in adolescence was associated with an increased likelihood of lifetime history of anxiety disorders (odds ratio: 1.33; 95% confidence interval: 1.09-1.63, P = 0.005) and depressive disorders (odds ratio: 1.38; confidence interval: 1.16-1.64, P < 0.001) reported in adulthood. Future research is needed to examine neurobiological and psychological mechanisms underlying these comorbidities. PMID:26901806

  4. Working Conditions and Health of European Older Workers

    OpenAIRE

    Thierry Debrand; Pascale Lengagne

    2008-01-01

    Working conditions have greatly evolved in recent decades in developed countries. This evolution has been accompanied with the appearance of new forms of work organisation that may be sources of stress and health risk for older workers. As populations are ageing, these issues are particularly worrying in terms of the health, labour force participation and Social Security expenditure. This paper focuses on the links between quality of employment and the health of older workers, using the Share...

  5. Psychosocial Work Conditions, Health, and Leadership of Managers

    OpenAIRE

    Lundqvist, Daniel

    2013-01-01

    Although psychosocial work conditions, health and leadership are concepts that have been studied for a long time, more knowledge is needed on how they are related in managers. Existing research suggests that managers are very influential in their workplaces, but the way in which their workplaces influence them is often overlooked. As a result, the potential reciprocity between managers’ psychosocial work conditions, health and leadership is not in focus. Furthermore, managers have often been ...

  6. The Relationship between Health-Promoting Behaviors and Resilience in Patients with Chronic Kidney Disease

    OpenAIRE

    Li-Ching Ma; Hong-Jer Chang; Yueh-Min Liu; Hsiang-Li Hsieh; Lan Lo; Mei-Yu Lin; Kuo-Cheng Lu

    2013-01-01

    This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD) treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD gro...

  7. Public Health Burden of Chronic Stress in a Transforming Society

    OpenAIRE

    Kopp, Mária S

    2007-01-01

    In this paper chronic stress is proposed as an integrating model that can be applied to the explanation of the suddenly changing patterns of premature mortality rates in transforming societies of Central-Eastern-Europe, especially in Hungary. The temporal factor in existing stress models is often neglected. Chronic stress has been shown to lead to typical pathogenetic results in animal experiments. Literature and the different models in the field of psychology, behavioural sciences, and epide...

  8. [Effect of phenibut on the behavior of experimental animals under conditions of voluntary chronic alcoholism].

    Science.gov (United States)

    Tiurenkov, I N; Voronkov, A V; Borodkina, L E

    2005-01-01

    The effect of phenibut on the locomotor and orientation-research activity, as well as on the alcohol and food motivation, was studied on experimental animals under conditions of voluntary chronic alcoholism. Phenibut decreased the manifestations of alcohol-induced behavioral disorders and reduced alcohol motivation. PMID:16047680

  9. Personalized Coaching Systems to support healthy behavior in people with chronic conditions

    NARCIS (Netherlands)

    Hermens, H.; Akker, op den H.; Tabak, M.; Wijsman, J.; Vollenbroek, M.

    2014-01-01

    Chronic conditions cannot be cured but daily behavior has a major effect on the severity of secondary problems and quality of life. Changing behavior however requires intensive support in daily life, which is not feasible with a human coach. A new coaching approach – so-called Personal Coaching Syst

  10. EFFECTS OF CHRONIC EXERCISE CONDITIONING ON THERMAL RESPONSES TO LIPOPOLYSACCHARIDE AND TURPENTINE ABSCESS IN FEMALE RATS.

    Science.gov (United States)

    Chronic exercise conditioning has been shown to alter basal thermoregulatory processes as well as the response to inflammatory agents. Two such agents, lipopolysaccharide (LPS) and turpentine (TPT) are inducers of fever in rats. LPS, given intraperitoneally (i.p.), involves a sys...

  11. Mediators for internalizing problems in adolescents of parents with chronic medical condition

    NARCIS (Netherlands)

    D.S. Sieh; F.J. Oort; J.M.A. Visser-Meily; A.M. Meijer

    2014-01-01

    Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

  12. Adolescents' Perceptions of Chronic Self-Concept, Peer Relations, and Learning Conditions

    Science.gov (United States)

    Liu, Weiping; Eckert, Thomas

    2014-01-01

    Based on Lewin's Field Theory, Bronfenbrenner's Bioecological Systems Theory and social network analysis, the authors collected data from 405 Chinese adolescents about their peer relations, chronic self-concept levels and learning condition variables through questionnaire distributing, and from their teachers about their annual average…

  13. A critical review of perfluorooctanoate and perfluorooctanesulfonate exposure and immunological health conditions in humans.

    Science.gov (United States)

    Chang, Ellen T; Adami, Hans-Olov; Boffetta, Paolo; Wedner, H James; Mandel, Jack S

    2016-04-01

    Whether perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS), two widely used and biopersistent synthetic chemicals, are immunotoxic in humans is unclear. Accordingly, this article systematically and critically reviews the epidemiologic evidence on the association between exposure to PFOA and PFOS and various immune-related health conditions in humans. Twenty-four epidemiologic studies have reported associations of PFOA and/or PFOS with immune-related health conditions, including ten studies of immune biomarker levels or gene expression patterns, ten studies of atopic or allergic disorders, five studies of infectious diseases, four studies of vaccine responses, and five studies of chronic inflammatory or autoimmune conditions (with several studies evaluating multiple endpoints). Asthma, the most commonly studied condition, was evaluated in seven studies. With few, often methodologically limited studies of any particular health condition, generally inconsistent results, and an inability to exclude confounding, bias, or chance as an explanation for observed associations, the available epidemiologic evidence is insufficient to reach a conclusion about a causal relationship between exposure to PFOA and PFOS and any immune-related health condition in humans. When interpreting such studies, an immunodeficiency should not be presumed to exist when there is no evidence of a clinical abnormality. Large, prospective studies with repeated exposure assessment in independent populations are needed to confirm some suggestive associations with certain endpoints. PMID:26761418

  14. Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

    DEFF Research Database (Denmark)

    Wilson, Shona; Vennervald, Birgitte J; Kadzo, Hilda; Ireri, Edmund; Amaganga, Clifford; Booth, Mark; Kariuki, H. Curtis; Mwatha, Joseph K.; Kimani, Gachuhi; Ouma, John H.; Muchiri, Eric; Dunne, David W.

    2010-01-01

    investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with...... hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.......Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen...

  15. An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome

    OpenAIRE

    Unger Elizabeth R; Nater Urs M; Boneva Roumiana S; Maloney Elizabeth M; Lin Jin-Mann S; Jones James F; Reeves William C

    2009-01-01

    Abstract Background The diagnosis of chronic fatigue syndrome (CFS) in research studies requires the exclusion of subjects with medical and psychiatric conditions that could confound the analysis and interpretation of results. This study compares illness parameters between individuals with CFS who have and those who do not have exclusionary conditions. Methods We used a population-based telephone survey of randomly selected individuals, followed by a clinical evaluation in the study metropoli...

  16. Impacts of species introductions on the health of fish communities receiving chronic radionuclide inputs

    International Nuclear Information System (INIS)

    There is widespread interest in gaining further understanding of the relative influences of multiple stressors on aquatic ecosystem structure and function. To address this, work has been done to evaluate the effects of the introduction of an efficient predator (northern pike) on a fish community in a small lake (Perch Lake, Chalk River, Ontario) receiving chronic inputs of radionuclides over a 50-year period. In general, large changes in fish community structure, with corresponding changes in fish health, occurred following the pike introduction. For example, several forage fish species were extirpated from the lake and densities of the past top predator, yellow perch, became greatly reduced, likely due to predation by northern pike and/or other species in the lake. The reduced perch numbers appeared to alleviate an ecological bottleneck, which resulted in significant increases in brown bullhead densities to levels that were much higher than observed in other water bodies under typical conditions. Corresponding changes in the health of the Perch Lake fish community could also be detected, and included decreased fish diversity, shifts in fish community size structure to smaller body sizes, significant reductions in fish condition factors, reduced hepato-somatic indices, depletion of fish internal fat reserves, hardening of the gastrointestinal tract, resorption of gonadal material, degradation of muscle tissue, emaciation and ultimately, mortality of northern pike and brown bullheads. Evaluation of data indicated that female fishes responded more quickly than did males in terms of condition loss, likely due to their higher energetic requirements. In addition, although pike and bullheads were detrimentally affected by the pike introduction, health of forage fish species, such as pumpkinseeds, did not appear to be greatly influenced. No clear relationships existed between fish community health and exposure to radionuclides in the lake. (author)

  17. Developing an indicator for the chronic health impact of traffic-related pollutant emissions

    International Nuclear Information System (INIS)

    The goal of this study is to develop an emission based indicator for the health impact of the air pollution caused by traffic. This indicator must make it possible to compare different situations, for example different Urban Travel Plans, or technical innovations. Our work is based on a literature survey of methods for evaluating health impacts and, more particularly, those which relate to the atmospheric pollution caused by transport. We then define a health impact indicator based on the traffic emissions, named IISCEP for Chronic health impact indicator of pollutant emission. Here health is understood in a restricted meaning, excluding well-being. Only primary pollutants can be considered, as the inputs are emission data and an indicator must be simple. The indicator is calculated as the sum of each pollutant emission multiplied by a dispersion and exposition factor and a substance specific toxicity factor taking account of the severity. Last, two examples are shown using the IISCEP: comparison between petrol and diesel vehicles, and Nantes urban district in 2008 vs 2002. Even if it could still be improved, IISCEP is a straightforward indicator which can be used to gauge the chronic effects of inhaling primary pollutants. It can only be used in comparisons, between different scenarios or different technologies. The quality of the emissions data and the choice of the pollutants that are considered are the two essential factors that determine its validity and reliability. - Highlights: ► The goal of the study is to develop an emission based indicator for the health impact of the air pollution caused by traffic. ► It is based on a literature survey of methods for evaluating health impacts related to the atmospheric pollution. ► We define a composite indicator based on the traffic emissions and on local data as dispersion conditions and population. ► The indicator is a combination of pollutant emission, dispersion, exposition factor, and substance specific

  18. Developing an indicator for the chronic health impact of traffic-related pollutant emissions

    Energy Technology Data Exchange (ETDEWEB)

    Lepicier, Veronique [IFSTTAR, Laboratoire Transport et Environnement, 25, av. F. Mitterrand, 69675 Bron Cedex (France); Chiron, Mireille [IFSTTAR, UMRESTTE, 25, av. F. Mitterrand, 69675 Bron Cedex (France); Joumard, Robert, E-mail: robert.joumard@laposte.net [IFSTTAR, Laboratoire Transport et Environnement, 25, av. F. Mitterrand, 69675 Bron Cedex (France)

    2013-01-15

    The goal of this study is to develop an emission based indicator for the health impact of the air pollution caused by traffic. This indicator must make it possible to compare different situations, for example different Urban Travel Plans, or technical innovations. Our work is based on a literature survey of methods for evaluating health impacts and, more particularly, those which relate to the atmospheric pollution caused by transport. We then define a health impact indicator based on the traffic emissions, named IISCEP for Chronic health impact indicator of pollutant emission. Here health is understood in a restricted meaning, excluding well-being. Only primary pollutants can be considered, as the inputs are emission data and an indicator must be simple. The indicator is calculated as the sum of each pollutant emission multiplied by a dispersion and exposition factor and a substance specific toxicity factor taking account of the severity. Last, two examples are shown using the IISCEP: comparison between petrol and diesel vehicles, and Nantes urban district in 2008 vs 2002. Even if it could still be improved, IISCEP is a straightforward indicator which can be used to gauge the chronic effects of inhaling primary pollutants. It can only be used in comparisons, between different scenarios or different technologies. The quality of the emissions data and the choice of the pollutants that are considered are the two essential factors that determine its validity and reliability. - Highlights: Black-Right-Pointing-Pointer The goal of the study is to develop an emission based indicator for the health impact of the air pollution caused by traffic. Black-Right-Pointing-Pointer It is based on a literature survey of methods for evaluating health impacts related to the atmospheric pollution. Black-Right-Pointing-Pointer We define a composite indicator based on the traffic emissions and on local data as dispersion conditions and population. Black-Right-Pointing-Pointer The

  19. Seeing is believing? A mixed-methods study exploring the quality and perceived trustworthiness of online information about chronic conditions aimed at children and young people.

    Science.gov (United States)

    McPherson, Amy C; Gofine, Miriam L; Stinson, Jennifer

    2014-01-01

    The numbers of children and young people with chronic conditions are increasing. While their information needs may vary, providing health care information can have considerable benefits, including better emotional health, less distress during treatments, and greater satisfaction with medical care. The Internet is increasingly being used to communicate health-related information to children about a range of chronic conditions. However, the quality of such websites is underexplored. Thus, the objectives of this study were to evaluate the reliability and quality of online information for children about chronic conditions using a standardized evaluation tool, and to explore children's and young people's perceptions of quality and trustworthiness regarding online health information. The study consisted of two phases. In Phase 1, websites about common pediatric chronic conditions aimed at children and containing treatment or management options were identified and the quality assessment tool DISCERN was completed. Test-retest and interrater reliability were calculated. In Phase 2, two focus groups with laptop computers were conducted with children and young people with a chronic condition to explore their perceptions of trustworthiness of online health information. In Phase 1, 165 websites were identified and 100 met the criteria and were assessed. The mean DISCERN score of all sites was 48.16 out of 75 (SD = 7.97, range 28-71, min 15 to max 75). Quality scores varied widely across the sample. The internal consistency and interrater reliability scores were both lower than previously reported in studies using the DISCERN to assess information for adults. In Phase 2, two focus groups with a total of six participants aged 11-23 years revealed a relative lack of concern about the quality and trustworthiness of online health information. Older participants reported judging the source and authorship of websites, but other participants did not question the source of the

  20. Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care

    OpenAIRE

    Ware Robert S; Jackson Claire L; Askew Deborah A; Russell Anthony

    2010-01-01

    Abstract Background Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated t...

  1. Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens

    Science.gov (United States)

    Friis, Karina; Lasgaard, Mathias; Osborne, Richard H; Maindal, Helle T

    2016-01-01

    Objectives To (1) quantify levels of subjective health literacy in people with long-term health conditions (diabetes, cardiovascular disease, chronic obstructive pulmonary disease, musculoskeletal disorders, cancer and mental disorders) and compare these to levels in the general population and (2) examine the association between health literacy, socioeconomic characteristics and comorbidity in each long-term condition group. Design Population-based survey in the Central Denmark Region (n=29 473). Main outcome measures Health literacy was measured using two scales from the Health Literacy Questionnaire (HLQ): (1) Ability to understand health information and (2) Ability to actively engage with healthcare providers. Results People with long-term conditions reported more difficulties than the general population in understanding health information and actively engaging with healthcare providers. Wide variation was found between disease groups, with people with cancer having fewer difficulties and people with mental health disorders having more difficulties in actively engaging with healthcare providers than other long-term condition groups. Having more than one long-term condition was associated with more difficulty in engaging with healthcare providers and understanding health information. People with low levels of education had lower health literacy than people with high levels of education. Conclusions Compared with the general population, people with long-term conditions report more difficulties in understanding health information and engaging with healthcare providers. These two dimensions are critical to the provision of patient-centred healthcare and for optimising health outcomes. More effort should be made to respond to the health literacy needs among individuals with long-term conditions, multiple comorbidities and low education levels, to improve health outcomes and to reduce social inequality in health. PMID:26769783

  2. Utilidad y validez de un instrumento basado en indicadores de la Nursing Outcomes Classification como ayuda al diagnóstico de pacientes crónicos de Atención Primaria con gestión ineficiente de la salud propia Utility and validity of indicators from the Nursing Outcomes Classification as a support tool for diagnosing Ineffective Self Health Management in patients with chronic conditions in Primary Health Care

    Directory of Open Access Journals (Sweden)

    J. C. Morilla-Herrera

    2011-04-01

    development of healthy life-styles are key components for managing chronic diseases. Nursing has standardized languages which describe many of these situations, such as the diagnosis «Ineffective Self Health Management» (ISHM or many of the Nursing Outcomes Classification (NOC indicators. The aims of this study were to determine the interobserver reliability of a NOC-based instrument for assessment and aid in diagnosis of the ISHM in patients with chronic conditions in Primary Health Care, to determine its diagnostic validity and to describe the prevalence of patients with this problem. Methods. Cross-sectional validation study developed in the provinces of Málaga, Cádiz and Almería from 2006 to 2009. Each patient was assessed by 3 independent observers: the first two observers evaluated scoring of the NOC indicators and the third one acted as the «gold-standard». Results. Two hundred and twenty-eight patients were included, 37.7% of them with more than one chronic condition. NOC indicators showed a high interobserver reliability (ICC0,70 and a consistency (Cronbach's alpha: 0.81. With a cut-point of 10.5, sensitivity was 61% and specificity 85%, and the area under the curve was 0.81 (CI95%: 0.77 to 0.85. The prevalence of patients with ISHM was 36% (CI 95%: 34 to 40. Conclusions. The use of NOC indicators allows evaluation of management of the therapeutic regime in people with chronic conditions with a satisfactory validity and it provides new approaches for dealing with this problem.

  3. Perceived impact of Ghana's conditional cash transfer on child health.

    Science.gov (United States)

    Owusu-Addo, Ebenezer

    2016-03-01

    A plethora of studies from sub-Saharan Africa indicate that orphaned and vulnerable children are exposed to adverse health, education and other social outcomes. Across diverse settings, conditional cash transfer (CCT) programmes have been successful in improving health outcomes amongst vulnerable children. This study explored the pathways of CCTs' impact on the health of orphans and vulnerable children in rural Ghana. Due to the multi-dimensional nature of CCTs, the programme impact theory was used to conceptualize CCTs' pathways of impact on child health. A qualitative descriptive exploratory approach was used for this study. This study drew on the perspectives of 18 caregivers, 4 community leaders and 3 programme implementers from two rural districts in Ghana. Semi-structured individual interviews were conducted with the participants. Thematic content analysis was conducted on the interview transcripts to pull together core themes running through the entire data set. Five organizing themes emerged from the interview transcripts: improved child nutrition, health service utilization, poverty reduction and social transformation, improved education and improved emotional health and well-being demonstrating the pathways through which CCTs work to improve child health. The results indicated that CCTs offer a valuable social protection instrument for improving the health of orphans and vulnerable children by addressing the social determinants of child health such as nutrition, access to health care, child poverty and education. PMID:25073762

  4. Health status of patients with self-reported chronic diseases in Jamaica

    Directory of Open Access Journals (Sweden)

    Paul A Boume

    2009-01-01

    Full Text Available Background: Developing countries such as Jamaica suffer increasingly from high levels of public health problems related to chronic diseases. Aims : To examine the physical health status and use a model to determine the significant predictors of poor health status of Jamaicans who reported being diagnosed with a chronic non-communicable disease. Methods and Materials : The current study extracted a sub-sample of 714 people from a larger nationally representative cross-sectional survey of 6,783 Jamaicans. A self-administered questionnaire was used to collect the data from the sample. Statistical analysis was performed using chi-square to investigate non-metric variables, and logistic regression to determine predictors of poor health status. Results : Approximately one-quarter ( 25.3% of the sample reported that they had poor health status. Thirty-three percent of the sample indicated unspecified chronic diseases: 7.8% arthritis, 28.9% hypertension, 17.2% diabetes mellitus and 13.3% asthma. Asthma affected 47.2% of children and 23.2% of young adults. S ignificant predictors of poor health status of Jamaicans who reported being diagnosed with chronic diseases were: age of respondents, area of residence and inability to work . Conclusion : Majority of the respondents in the sample had good health, and adults with poor health status were more likely to report having hypertension followed by diabetes mellitus and arthritis, while asthma was the most prevalent among children. Improvement in chronic disease control and health status can be achieved with improved patient education on the importance of compliance, access to more effective medication and development of support groups among chronic disease patients.

  5. Health status of patients with self-reported chronic diseases in Jamaica

    Directory of Open Access Journals (Sweden)

    Paul A. Boume

    2009-12-01

    Full Text Available Background: Developing countries such as Jamaica suffer increasingly from high levels of public health problems related to chronic diseases. Aims: To examine the physical health status and use a model to determine the significant predictors of poor health status of Jamaicans who reported being diagnosed with a chronic non-communicable disease. Methods and Materials: The current study extracted a sub-sample of 714 people from a larger nationally representative cross-sectional survey of 6,783 Jamaicans. A self-administered questionnaire was used to collect the data from the sample. Statistical analysis was performed using chi-square to investigate non-metric variables, and logistic regression to determine predictors of poor health status. Results: Approximately one-quarter (25.3% of the sample reported that they had poor health status. Thirty-three percent of the sample indicated unspecified chronic diseases: 7.8% arthritis, 28.9% hypertension, 17.2% diabetes mellitus and 13.3% asthma. Asthma affected 47.2% of children and 23.2% of young adults. Significant predictors of poor health status of Jamaicans who reported being diagnosed with chronic diseases were: age of respondents, area of residence and inability to work. Conclusion: Majority of the respondents in the sample had good health, and adults with poor health status were more likely to report having hypertension followed by diabetes mellitus and arthritis, while asthma was the most prevalent among children. Improvement in chronic disease control and health status can be achieved with improved patient education on the importance of compliance, access to more effective medication and development of support groups among chronic disease patients.

  6. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach.

    Science.gov (United States)

    Talboom-Kamp, Esther Pwa; Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting "self-management" in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  7. [Health maintenance, relaxation and hypnosis for chronic pain patients].

    Science.gov (United States)

    Boiron, Clare

    2014-10-01

    The treatment of chronic pain patients integrates more and more complementary therapies such as relaxation and hypnosis, implemented by specially trained nurses. These techniques are offered on the basis of nurses' diagnoses carried out in the framework of a clinical approach. PMID:25518140

  8. Association between Organizational Capacity and Involvement in Chronic Disease Prevention Programming among Canadian Public Health Organizations

    Science.gov (United States)

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement…

  9. Late health effects of chronic radiation exposure of bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Yarmoshenko, Ilia V.; Malinovsky, Georgy P.; Konshina, Lidia G.; Zhukovsky, Michael V. [Institute of Industrial Ecology UB RAS, 620219, 20, Sophy Kovalevskoy St., Ekaterinburg (Russian Federation); Tuzankina, Irina A. [Institute of Immunology and Physiology UB RAS, 620049, 106, Pervomayskaya St., Ekaterinburg (Russian Federation)

    2014-07-01

    Accidental explosion of waste storage tank at former soviet plutonium production plant 'Mayak' in 1957 resulted in emission of considerable amount of radioactive substances to the atmosphere. Atmospheric transfer and fallout caused contamination of the environment by Sr-90 and short-lived radionuclides (East-Ural Radioactive Trace, EURT). Due to consumption of contaminated food and milk some internal organs were affected to relatively high radiation exposure. Archive data of causes of deaths of rural population of EURT northern part for period 1957-2000 were used to create the Register on causes of deaths. Register records related to the settlements where initial surface contamination by Sr-90 was above and below 3.7 kBq/m2 were included to exposed (4 844 records) and unexposed (6 158 records) group respectively. Basing on the Register the analysis of cancer and non-cancer health effects of radiation exposure was conducted. By estimating proportionate mortality ratios statistically significant excess mortality due to the groups of causes of death as follow was observed in exposed population: stomach, liver and cervix cancers; group consisted only of stomach cancer; non-cancer deceases of infectious etiology. Non-significant but remarkably high risk was observed for the following groups of causes of death: bone cancer; leukemia; liver cancer; cervix cancer. Insignificant, virtually zero risk was found for: non-gastrointestinal solid cancers; colon and lung cancers; non-infectious non-cancer deceases. At the same time, considerable radiation doses were absorbed in bone (mean bone surface dose about 0.1 Gy) and colon (mean dose about 0.07 Gy). Doses absorbed in other organs and tissues were negligible and amounted less than 0.01 Gy for most tissues. It can be seen that some disagreement between observed effects and absorbed doses is revealed. Most remarkable is the high excess risks of stomach, liver and cervix cancers as well as non-cancer deceases of

  10. Late health effects of chronic radiation exposure of bone marrow

    International Nuclear Information System (INIS)

    Accidental explosion of waste storage tank at former soviet plutonium production plant 'Mayak' in 1957 resulted in emission of considerable amount of radioactive substances to the atmosphere. Atmospheric transfer and fallout caused contamination of the environment by Sr-90 and short-lived radionuclides (East-Ural Radioactive Trace, EURT). Due to consumption of contaminated food and milk some internal organs were affected to relatively high radiation exposure. Archive data of causes of deaths of rural population of EURT northern part for period 1957-2000 were used to create the Register on causes of deaths. Register records related to the settlements where initial surface contamination by Sr-90 was above and below 3.7 kBq/m2 were included to exposed (4 844 records) and unexposed (6 158 records) group respectively. Basing on the Register the analysis of cancer and non-cancer health effects of radiation exposure was conducted. By estimating proportionate mortality ratios statistically significant excess mortality due to the groups of causes of death as follow was observed in exposed population: stomach, liver and cervix cancers; group consisted only of stomach cancer; non-cancer deceases of infectious etiology. Non-significant but remarkably high risk was observed for the following groups of causes of death: bone cancer; leukemia; liver cancer; cervix cancer. Insignificant, virtually zero risk was found for: non-gastrointestinal solid cancers; colon and lung cancers; non-infectious non-cancer deceases. At the same time, considerable radiation doses were absorbed in bone (mean bone surface dose about 0.1 Gy) and colon (mean dose about 0.07 Gy). Doses absorbed in other organs and tissues were negligible and amounted less than 0.01 Gy for most tissues. It can be seen that some disagreement between observed effects and absorbed doses is revealed. Most remarkable is the high excess risks of stomach, liver and cervix cancers as well as non-cancer deceases of infectious

  11. A review of factors associated with mental health in siblings of children with chronic illness.

    Science.gov (United States)

    Incledon, Emily; Williams, Lauren; Hazell, Trevor; Heard, Todd R; Flowers, Alexandra; Hiscock, Harriet

    2015-06-01

    This article reviews the literature on modifiable factors associated with mental health in siblings of children with chronic illness. Three clinical databases were searched. A total of 17 studies met the inclusion criteria. Several key themes emerged from the review. Better sibling mental health was associated with camp attendance, perceived parent/peer support, illness education and enhancing control through cognitive coping strategies and routine. Parental and sibling psychoeducation interventions and social support may enhance children's mental health when their sibling has a chronic illness. PMID:24270987

  12. Toward reducing the prevalence of chronic disease: a life course perspective on health preservation.

    Science.gov (United States)

    Barondess, Jeremiah A

    2008-01-01

    Chronic disease is now hyper-endemic in the United States and is the central problem to be addressed in efforts to enhance the health of the American population. Efforts to reduce the prevalence of chronic disease through diminished exposure to risk factors have achieved significant success in recent decades, but most have been expressions of secondary or tertiary prevention. Current knowledge suggests it would be more effective to extend efforts directed at reduction of risk to earlier phases in the biology of chronic diseases, and to maintain them over the life course. This approach lends itself to a health preservation perspective-in other words, to an orientation around protection of the future health of the individual across the lifespan, from preconception to old age. This will require linked efforts of the clinical, public health, and policy communities, together with private-sector collaborators in information management, marketing, and other areas of expertise. PMID:18997362

  13. Examining Public Health System Responses to the Chronic Diseases of HIV/AIDS and Diabetes: Experiences from Mexico and Brazil

    OpenAIRE

    Gidi, Virginia Eve

    2010-01-01

    Background: Health systems around the world have historically been oriented toward acute care, but over the past century chronic diseases have become the leading causes of death globally. It has been estimated that 80% of the burden of chronic diseases occur in low and middle-income countries. However, there is a gap in the scientific literature regarding how these countries are addressing their burgeoning chronic disease burden, how chronic disease management models inform public health s...

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

    OpenAIRE

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

    2007-01-01

    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...

  15. Factors that lessen the burden of treatment in complex patients with chronic conditions: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ridgeway JL

    2014-03-01

    Full Text Available Jennifer L Ridgeway,1,2 Jason S Egginton,1,2 Kristina Tiedje,3 Mark Linzer,4,5 Deborah Boehm,4 Sara Poplau,6 Djenane Ramalho de Oliveira,7 Laura Odell,8 Victor M Montori,2,9 David T Eton1,2 1The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 2Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 3Department of Anthropology, Université Lumière Lyon 2, Lyon, France; 4Division of General Internal Medicine, Hennepin County Medical Center, 5University of Minnesota Medical School, 6Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 7Department of Social Pharmacy, Universidade Federal de Minas Gerais, Brazil; 8Pharmacy Services, 9Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA Purpose: Patients with multiple chronic conditions (multimorbidity often require ongoing treatment and complex self-care. This workload and its impact on patient functioning and well-being are, together, known as treatment burden. This study reports on factors that patients with multimorbidity draw on to lessen perceptions of treatment burden. Patients and methods: Interviews (n=50 and focus groups (n=4 groups, five to eight participants per group were conducted with patients receiving care in a large academic medical center or an urban safety-net hospital. Interview data were analyzed using qualitative framework analysis methods, and themes and subthemes were used to identify factors that mitigate burden. Focus groups were held to confirm these findings and clarify any new issues. This study was part of a larger program to develop a patient-reported measure of treatment burden. Results: Five major themes emerged from the interview data. These included: 1 problem-focused strategies, like routinizing self-care, enlisting support of others, planning for the future, and using technology; 2 emotion-focused coping strategies, like

  16. Race, Social and Environmental Conditions, and Health Behaviors in Men.

    Science.gov (United States)

    Thorpe, Roland J; Kennedy-Hendricks, Alene; Griffith, Derek M; Bruce, Marino A; Coa, Kisha; Bell, Caryn N; Young, Jessica; Bowie, Janice V; LaVeist, Thomas A

    2015-01-01

    Although understanding race differences in health behaviors among men is an important step in reducing disparities in leading causes of death in the United States, progress has been stifled when using national data because of the confounding of race, socioeconomic status, and residential segregation. The purpose of this study is to examine the nature of disparities in health behaviors among African American and white men in the Exploring Health Disparities in Integrated Communities Study-Southwest Baltimore, which was conducted in a racially integrated neighborhood of Baltimore to data from the 2003 National Health Interview Survey. After adjusting for age, marital status, insurance, income, educational attainment, poor or fair health, and obesity status, African American men in National Health Interview Survey had greater odds of being physically inactive (odds ratio [OR] = 1.48; 95% confidence interval [CI], 129-1.69), reduced odds of being a current smoker (OR = 0.77; 95% CI, 0.65-0.90), and reduced odds of being a current drinker (OR = 0.58; 95% CI, 0.50-0.67). In the Exploring Health Disparities in Integrated Communities Study-Southwest Baltimore sample, African American and white men had similar odds of being physically inactive (OR = 0.79; 95% CI, 0.50-1.24), being a current smoker (OR = 0.86; 95% CI, 0.60-1.23), or being a current drinker (OR = 1.34; 95% CI, 0.81-2.21). Because race disparities in these health behaviors were ameliorated in the sample where African American and white men were living under similar social, environmental, and socioeconomic status conditions, these findings suggest that social environment may be an important determinant of health behaviors among African American and white men. Public health interventions and health promotion strategies should consider the social environment when seeking to better understand men's health disparities. PMID:26291190

  17. Ascertainment of chronic diseases using population health data: a comparison of health administrative data and patient self-report

    Directory of Open Access Journals (Sweden)

    Muggah Elizabeth

    2013-01-01

    Full Text Available Abstract Background Health administrative data is increasingly being used for chronic disease surveillance. This study explored agreement between administrative and survey data for ascertainment of seven key chronic diseases, using individually linked data from a large population of individuals in Ontario, Canada. Methods All adults who completed any one of three cycles of the Canadian Community Health Survey (2001, 2003 or 2005 and agreed to have their responses linked to provincial health administrative data were included. The sample population included 85,549 persons. Previously validated case definitions for myocardial infarction, asthma, diabetes, chronic lung disease, stroke, hypertension and congestive heart failure based on hospital and physician billing codes were used to identify cases in health administrative data and these were compared with self-report of each disease from the survey. Concordance was measured using the Kappa statistic, percent positive and negative agreement and prevalence estimates. Results Agreement using the Kappa statistic was good or very good (kappa range: 0.66-0.80 for diabetes and hypertension, moderate for myocardial infarction and asthma and poor or fair (kappa range: 0.29-0.36 for stroke, congestive heart failure and COPD. Prevalence was higher in health administrative data for all diseases except stroke and myocardial infarction. Health Utilities Index scores were higher for cases identified by health administrative data compared with self-reported data for some chronic diseases (acute myocardial infarction, stroke, heart failure, suggesting that administrative data may pick up less severe cases. Conclusions In the general population, discordance between self-report and administrative data was large for many chronic diseases, particularly disease with low prevalence, and differences were not easily explained by individual and disease characteristics.

  18. Homocysteine Levels in Chronic Gastritis and Other Conditions: Relations to Incident Cardiovascular Disease and Dementia

    OpenAIRE

    Redéen, Stefan; Ryberg, Anna; Petersson, Fredrik; Eriksson, Olle; Nägga, Katarina; Borch, Kurt

    2009-01-01

    Background Homocysteine levels in circulation are determined by several factors and hyperhomocysteinemia is reportedly associated with cardiovascular diseases and dementia. The aim of this study is to determine the relation of chronic gastritis and other conditions to homocysteine levels and their relation to incident cardiovascular diseases and dementia. Methods An adult population-based cohort (N = 488) was screened for H. pylori infection, gastro-duodenitis (endoscopic biopsies), disease h...

  19. Perceived Health Status and Utilization of Specialty Care: Racial and Ethnic Disparities in Patients with Chronic Diseases

    Science.gov (United States)

    Glover, Saundra; Bellinger, Jessica D.; Bae, Sejong; Rivers, Patrick A.; Singh, Karan P.

    2010-01-01

    Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality…

  20. Modernisation, smoking and chronic disease: Of temporality and spatiality in global health

    OpenAIRE

    Reubi, David Herrick

    2016-01-01

    This article explores the spatio-temporal logics at work in global health. Influenced by ideas of time-space compression, the global health literature argues that the world is characterised by a convergence of disease patterns and biomedical knowledge. While not denying the influence of these temporalities and spatialities of globalisation within the global health and chronic disease field, the article argues that they sit alongside other, often-conflicting notions of time and space. To do so...

  1. Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

    OpenAIRE

    Shantanu Nundy; Jonathan J. Dick; Goddu, Anna P.; Patrick Hogan; Lu, Chen-Yuan E.; Solomon, Marla C; Arnell Bussie; Chin, Marshall H; Peek, Monica E.

    2012-01-01

    Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot...

  2. Public Health Nutrition: The Accord of Dietitian Providers in Managing Medicare Chronic Care Outpatients in Australia

    OpenAIRE

    Cant

    2010-01-01

    Medicare Australia: Chronic Disease Management program subsidizes allied health consultations for eligible outpatients with chronic disease or complex needs. In an evaluation study, private practice dietitians (n = 9) were interviewed to explore their patient management strategies including consultation time-allocation and fees. Time allocation was fee-based. Short first consultations were seen as meeting patients’ needs for low-cost services but were regarded by dietitians as ineffective, ho...

  3. Caring, chronicity and community: an emergent model of community health services provision for people living with chronic illness

    OpenAIRE

    Ryan, Denis

    2008-01-01

    Purpose An evaluation of an Integrated Care approach with the aim of exploring the components of the service which contributed to its functioning. Theory There is growing recognition internationally that conventional approaches to the management of chronic illness are not adequately meeting the needs of people with such conditions. This concern is also shared in Ireland and a pilot programme to provide an alternative community based approach was established in Callan, Co. Kilkennny, Ireland f...

  4. Return Migration among Elderly, Chronically Ill Bosnian Refugees: Does Health Matter?

    Science.gov (United States)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian; Kristiansen, Maria; Norredam, Marie Louise

    2015-10-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show that physical health, in the sense of the absence of illness and easy access to necessary health-care services and medicines, was not highly prioritized when the decision was made whether or not to return. However, if health is regarded more broadly as involving more than mere physical health and the absence of illness, health did matter. Viewed as physical, social and mental well-being in line with WHO's definition of health, health was indeed one of the most important factors when the decision to return was made. PMID:26473899

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

    Directory of Open Access Journals (Sweden)

    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.

  6. A Qualitative Study on Patient Perceptions Towards mHealth Technology Among High Risk, Chronic Disease Patients

    OpenAIRE

    Martinez, Phillip Rico

    2015-01-01

    Background: For over 17 years, the Prevention and Access to Care and Treatment (PACT) Project has actively developed a Community Health Worker model for care of chronically ill, high risk patients. Given the high burden of chronic disease and associated rising health expenditures, mHealth technology has emerged as a promising low cost, high efficacy intervention for delivery of patient-centered care and as a tool for self-management of chronic disease Objective: Attitudes and perceptions r...

  7. Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Theander K

    2014-07-01

    Full Text Available Kersti Theander,1,2 Mikael Hasselgren,2,3 Kristina Luhr,4 Jeanette Eckerblad,5 Mitra Unosson,5 Ingela Karlsson1 1Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden; 2Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden; 3Department of Medicine, Örebro University, Örebro, Sweden; 4Family Medicine Research Centre, Örebro County Council, Örebro, Sweden; 5Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Background: Patients with chronic obstructive pulmonary disease (COPD and chronic heart failure (CHF seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. Aim: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC. Method: The study is cross sectional, including patients with COPD (n=437 and CHF (n=388, registered in the patient administrative systems of PHC. The patients received specific questionnaires – the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale – by mail and additional questions about psychological and physical health. Results: The mean age was 70±10 years and 78±10 years for patients with COPD and CHF respectively (P=0.001. Patients with COPD (n=273 experienced more symptoms (11±7.5 than the CHF patients (n=211 (10±7.6. The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background

  8. Health-related quality of life and chronic obstructive pulmonary disease in North Carolina

    Directory of Open Access Journals (Sweden)

    David W. Brown

    2010-02-01

    Full Text Available Background: Comparisons of health-related quality of life (HRQOL between persons with chronic obstructive pulmonary disease (COPD and adults in the general population are not well described. Aims: To examine associations between COPD and four measures of HRQOL in a population-based sample. Patients & Methods: These relationships were examined using data from 13,887 adults aged >18 years who participated in the 2007 Behavioral Risk Factor Surveillance System (BRFSS conducted in North Carolina (NC. Logistic regression was used to obtain adjusted relative odds (aOR. Results: The age-adjusted prevalence of COPD among NC adults was 5.4% (standard error 0.27. Nearly half of adults with COPD reported fair/poor health compared with 15% of those without the condition (age-aOR, 5.5; 95% confidence interval [CI], 4.4 to 6.8. On average, adults with COPD reported twice as many unhealthy days (physical/mental as those without the condition. The age-adjusted prevalence of >14 unhealthy days during the prior 30 days was 45% for adults with COPD and 17% for those without. The aOR of >14 unhealthy days was 1.7 (95% CI, 1.4 to 2.2 times greater among adults with COPD compared with those without. Conclusions: These results suggest COPD is independently associated with lower levels of HRQOL and reinforce the importance of preventing COPD and its complications through health education messages stressing efforts to reduce total personal exposure to tobacco smoke, occupational dusts and chemicals, and other indoor and outdoor air pollutants linked to COPD and early disease recognition. Our findings represent one of the few statewide efforts in the US and provide guidance for disease management and policy decision making.

  9. Factors influencing health-related quality of life in chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Abhasnee Sobhonslidsuk; Chatchawan Silpakit; Ronnachai Kongsakon; Patchareeya Satitpornkul; Chaleaw Sripetch; Anya Khanthavit

    2006-01-01

    AIM: To investigate the factors contributing to healthrelated quality of life (HRQL) in chronic liver disease (CLD).METHODS: Patients with CLD and age- and sexmatched normal subjects performed the validated Thai versions of the short-form 36 (SF-36) by health survey and chronic liver disease questionnaire (CLDQ). Stepwise multiple regression analysis was used to assess the impact of disease severity, demography, causes of CLD,socioeconomic factors, and self-rating health perception on HRQL.RESULTS: Two-hundred and fifty patients with CLD and fifty normal subjects were enrolled into the study. Mean age and the numbers of low educated, unemployed,blue-collar career and poor health perception increased significantly from chronic hepatitis to Child's Classes A to B to C. Advanced stage of CLD was related to deterioration of HRQL. Increasing age and female reduced physical health area. Low socioeconomic factors and financial burden affected multiple areas of HRQL.In overall, the positive impact of self-rating health perception on HRQL was consistently showed.CONCLUSION: Advanced stages of chronic liver disease, old age, female sex, low socioeconomic status and financial burden are important factors reducing HRQL. Good health perception improves HRQL regardless of stages of liver disease.

  10. The Role of Personality and Social Support in Health-Related Quality of Life in Chronic Kidney Disease Patients

    OpenAIRE

    Ibrahim, Norhayati; Teo, Sharlene S. L.; Che Din, Normah; Abdul Gafor, Abdul Halim; Ismail, Rozmi

    2015-01-01

    Background Chronic kidney disease (CKD) is commonly associated with various negative health outcomes. The aim of this study was to examine the influence of personality and social support on health-related quality of life in patients with chronic kidney disease. Health-related quality of life (HRQoL) is the quality of life studied in relation to health, and it provides important information of patients’ coping with their health issues. Method Participants comprised of 200 patients experiencing...

  11. Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics

    Directory of Open Access Journals (Sweden)

    Nguyen Kim M

    2003-10-01

    Full Text Available Abstract Background Understanding health-related quality of life (HRQOL leads to more effective and focused healthcare. America's growing health disparities makes it is increasingly necessary to understand the HRQOL of pregeriatric individuals who are now 55–64 years old, i.e. before they are eligible for federally mandated health care at age 65. Our study measured the self-perceived HRQOL of pregeriatric, poor patients with multiple chronic diseases treated at 2 public clinics. Methods Consecutive patients aged 55–64 years, many with multiple chronic diseases, responded in an interview to the 36-Item Short-Form Health Survey (SF–36 as a general measure of HRQOL during a regular visit to one of two university-staffed urban public clinics. Results The perceived physical and mental functioning of 316 pregeriatric patients was tabulated from SF–36 scores to yield their HRQOL. Their scores were statistically significantly lower than those of the general US pregeriatric population and lower than averages for US patients with multiple chronic diseases. All eight subscale scores of SF–36 were 16% to 36% lower compared with the averages of the general US pregeriatric population. Further, as the number of chronic diseases increased, the lower was the HRQOL. Lower physical and mental scores were associated with a lower income, unemployment, and higher numbers of multiple chronic diseases. Conclusion Chronic diseases have a powerful negative impact on perceived mental and physical functioning in pregeriatric patients. HRQOL information can assist health care providers to gain a more complete picture of their pregeriatric patients' health.

  12. Medical students' self-report of mental health conditions

    Directory of Open Access Journals (Sweden)

    Rael D. Strous

    2012-01-01

    Full Text Available Objectives: To investigate the subjective presence of a range of subsyndromal and syndromal mental health conditions in medical students, and to compare the presence of these conditions between preclinical and clinical training. Methods: A cross sectional study was used among first-and fifth-year medical students. Student reported their mental health conditions using the Diagnostic and Statistical Manual of Mental Disorders criteria, the fourth version (DSM-IV. Data analysis was based on 110 questionnaires. Results: A total of 61 students (55.5 reported that they experienced symptoms of mental illness, albeit many with minimum severity. More than 50 of the students reported that they experienced Axis I and Axis II disorders, which mostly were mood disorders (38in year 1 and 35in year 5 and obsessive-compulsive traits (41in year 1 and 46in year 5, respectively. The least common disorders reported were psychotic disorders (5in year 1 and 0in year 5 and schizotypal traits (7in year 1 and 2in year 5. Fifth-year students reported more Axis I disorders than first-year students. Female students reported more Axis I disorders than their male peers. A further analysis indicated that there was no significant association between age and Axis disorders. Several conditions were comorbid with other mental illnesses. Conclusions: A great number of students reported that they experience mental health conditions with minimal severity. This implies a need for indispensable ongoing support programs for the special needs of medical students.

  13. Chlorophyll and pheophytin content in needles of different age of trees growing under conditions of chronic industrial pollution

    OpenAIRE

    Teresa Gowin; Igor Góral

    2015-01-01

    Chlorophyll and pheophytin content was determined by means of Vernon method (Vernon, 1960) in needles of different age. Needles of Pinus strobus L., Pinus nigra Arnd., Pinus silvestris L., and Pseudotsuga menziesii Franco growing under conditions of chronic industrial pollution as well as under unpolluted conditions were examined. High pheophytin content was found in needles of trees growing under the conditions of chronic pollution. The youngest needles always showed the highest pheophytin c...

  14. Pathological C-fibres in patients with a chronic painful condition.

    Science.gov (United States)

    Ørstavik, Kristin; Weidner, Christian; Schmidt, Roland; Schmelz, Martin; Hilliges, Marita; Jørum, Ellen; Handwerker, Herman; Torebjörk, Erik

    2003-03-01

    Little is known about the contribution of C-afferent fibres to chronic painful conditions in humans. We sought to investigate the role of C-fibres in the pathophysiology of pain and hyperalgesia in erythromelalgia as a model disease for chronic pain. Erythromelalgia is a condition characterized by painful, red and hot extremities, and patients often report tenderness on walking. We made microneurographic recordings from single C-fibres in cutaneous fascicles of the peroneal nerve in patients suffering from this disease. All patients had had a pain attack recently and psychophysical signs of allodynia and punctate hyperalgesia were found. We obtained recordings from a total of 103 C-fibres and found significantly lower conduction velocities and increased activity-dependent slowing of the conduction velocity of afferent C-fibres in the patients compared with healthy controls. Furthermore, several units with biophysical properties of mechano-insensitive fibres were pathological, being spontaneously active or sensitized to mechanical stimuli. Since these fibres also mediate the axon reflex flare, their hyperexcitability might account not only for ongoing pain and tenderness but also for redness and warming in this pain syndrome. The changes in conductive properties found in the C-fibres of these patients could be the first signs of a small-fibre neuropathy. This is the first systematic study of single C-fibres in patients and it shows an active contribution of mechano-insensitive fibres to chronic pain. PMID:12566278

  15. Characterization of the human talent in health that serves people with chronic disease: construction of a survey

    Directory of Open Access Journals (Sweden)

    Sonia Carreño-Moreno

    2016-02-01

    Full Text Available The objective of this work, is provide conceptual elements that constitute an integrated vision of care conditions required by the human talent in health HTH that caters to people with chronic disease (CD and their families, and that are translated into a tool for gathering information of survey type that allow characterization. This research was conducted in three phases: 1 Review of the literature. 2 Structuring a proposed survey 3 Refinement of the final version of the survey. As results, based on the conceptual framework it was possible to reach a comprehensive vision that served as the basis for the development of a survey to identify the conditions of HTH to care for people with chronic illness and their families. This instrument, called GCPC-A-THS (in Spanish, contains 37 items distributed in 6 additional dimensions that include aspects of care such as: sociodemographic variables of HTH, caring ability, information and communication technologies (ICTs as a means of support to care, continuity, security and also includes some items related to the level of professional satisfaction. The work done made it possible to achieve a comprehensive view of the characteristics and conditions required by the HTH for care to people with chronic illness and their families.

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

    Science.gov (United States)

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

    2016-03-01

    Recognizing patients at a higher risk of developing chronic low back pain (LBP) is important in industrial medicine. This study aimed to assess the power and quality of General Health Questionnaire (GHQ) for prediction of the odds of chronicity of acute LBP. This study was conducted on industrial workers. All subjects with acute LBP who met the inclusion criteria were enrolled. Demographic characteristics, occupational, physical, and mental parameters and the general health status of subjects were evaluated;  they were followed up for developing chronic LBP for one year. Cigarette smoking, high body mass index, job stress, physical load and high GHQ scores were found to be the risk factors for the progression of acute LBP to chronic LBP (P0.05). High GHQ score can be a risk factor for progression of acute LBP to chronic LBP. The GHQ in combination with the Job Content Questionnaire can be used as a quick and simple screening tool for detection of subjects at high risk of chronic LBP when evaluating acute LBP in an occupational setting. PMID:27107527

  17. Time to Talk: 6 Things You Should Know: The Science of Chronic Pain and Complementary Health Practices

    Science.gov (United States)

    ... V W X Y Z 5 Things You Should Know: The Science of Chronic Pain and Complementary ... Health Approaches for ASD 7 Tips: What You Should Know About Complementary Health Approaches for Multiple Sclerosis ...

  18. Enfrentamento de situações adversas e favoráveis por pessoas idosas em condições crônicas de saúde Enfrentamiento de situaciones adversas y favorables por ancianos en condiciones de salud crónicas Coping with the adverse and favorable situations by aged persons in chronic health conditions

    Directory of Open Access Journals (Sweden)

    Mercedes Trentini

    2005-02-01

    grupos de ancianos y por el rechazo a pierdas naturales relacionadas a la vejez. El enfrentamiento focalizado en el problema fue representado por la busca de atención médica y cuidado del cuerpo, como una forma de minimizar los problemas.Purpose: to investigate the adverse and favorable situations experienced by elderly people in chronic health conditions, and the coping strategies. Methodology: the sample included 18 elderly. The information was collected through interviews with open questions. The "Collective Subject Discourse" technique was used for analysis. Results: the findings demonstrated that death and separation from the family were perceived as the most significant adverse situations, while the favorable situations included the family, wisdom, experience, retirement, and life itself. The coping strategies focused on the problem and the emotion. Emotion-focused coping included: belief in God, maintaining the usual activities, family and significant other support, participation in elderly social groups and rejection of losses related to the aging process. The problem-focused coping consisted of the medical treatment and body care.

  19. Azithromycin and cough-specific health status in patients with chronic obstructive pulmonary disease and chronic cough: a randomised controlled trial

    OpenAIRE

    Berkhof, Farida F; Hertog, Nynke E Doornewaard-ten; Uil, Steven M; Kerstjens, Huib AM; van den Berg, Jan WK

    2013-01-01

    Background Macrolides reduce exacerbations in patients with COPD. Their effects on health status has not been assessed as primary outcome and is less clear. This study assessed the effects of prophylactic azithromycin on cough-specific health status in COPD-patients with chronic productive cough. Methods In this randomised controlled trial 84 patients met the eligibility criteria: age of ≥40 years, COPD GOLD stage ≥2 and chronic productive cough. The intervention-group (n = 42) received azith...

  20. [Using the health literacy concept to promote self-management in a chronic kidney disease patient].

    Science.gov (United States)

    Sun, Jia-Hui; Lin, Chiu-Chu

    2014-02-01

    Patients with chronic kidney disease (CKD) must learn and use self-management skills to control their disease and delay disease progression. Comprehension of instructions is thus critical to integrating self-management principles into daily life. In this case report, the client had difficulty implementing the behavioral changes necessary to control diet and blood sugar due to the lack of proper and sufficient information. The authors applied health literacy concepts to assess the client's knowledge and skills related to disease control and then provided health teaching at a level appropriate to the client's health literacy level. This individualized care enhanced the client's confidence and motivation to implement self-care activities. Healthcare professionals should help patients overcome barriers to reading and verbal communication to help low-health-literacy patients successfully self-manage their chronic disease. Clients may thus learn to report their symptoms clearly and accurately. PMID:24519350

  1. Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries

    Science.gov (United States)

    Arsenijevic, Jelena; Pavlova, Milena; Rechel, Bernd; Groot, Wim

    2016-01-01

    Introduction It is well-known that the prevalence of chronic diseases is high among older people, especially those who are poor. Moreover, chronic diseases can result in catastrophic health expenditure. The relationship between chronic diseases and their financial burden on households is thus double-sided, as financial difficulties can give rise to, and result from, chronic diseases. Our aim was to examine the levels of catastrophic health expenditure imposed by private out-of-pocket payments among older people diagnosed with diabetes mellitus, cardiovascular diseases and cancer in 15 European countries. Methods The SHARE dataset for individuals aged 50+ and their households, collected in 2010–2012 was used. The total number of participants included in this study was N = 51,661. The sample consisted of 43.8% male and 56.2% female participants. The average age was 67 years. We applied an instrumental variable approach for binary instrumented variables known as a treatment-effect model. Results We found that being diagnosed with diabetes mellitus and cardiovascular diseases was associated with catastrophic health expenditure among older people even in comparatively wealthy countries with developed risk-pooling mechanisms. When compared to the Netherlands (the country with the lowest share of out-of-pocket payments as a percentage of total health expenditure in our study), older people diagnosed with diabetes mellitus in Portugal, Poland, Denmark, Italy, Switzerland, Belgium, the Czech Republic and Hungary were more likely to experience catastrophic health expenditure. Similar results were observed for diagnosed cardiovascular diseases. In contrast, cancer was not associated with catastrophic health expenditure. Discussion Our study shows that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe. The effect differs across chronic diseases and countries. This may be due to different socio

  2. Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases

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    Burger Helena

    2010-05-01

    Full Text Available Abstract Background The WHODAS-2 is a disability assessment instrument based on the conceptual framework of the International Classification of Functioning, Disability, and Health (ICF. It provides a global measure of disability and 7 domain-specific scores. The aim of this study was to assess WHODAS-2 conceptual model and metric properties in a set of chronic and prevalent clinical conditions accounting for a wide scope of disability in Europe. Methods 1,119 patients with one of 13 chronic conditions were recruited in 7 European centres. Participants were clinically evaluated and administered the WHODAS-2 and the SF-36 at baseline, 6 weeks and 3 months of follow-up. The latent structure was explored and confirmed by factor analysis (FA. Reliability was assessed in terms of internal consistency (Cronbach's alpha and reproducibility (intra-class correlation coefficients, ICC. Construct validity was evaluated by correlating the WHODAS-2 and SF-36 domains, and comparing known groups based on the clinical-severity and work status. Effect size (ES coefficient was used to assess responsiveness. To assess reproducibility and responsiveness, subsamples of stable (at 6 weeks and improved (after 3 moths patients were defined, respectively, according to changes in their clinical-severity. Results The satisfactory FA goodness of fit indexes confirmed a second order factor structure with 7 dimensions, and a global score for the WHODAS-2. Cronbach's alpha ranged from 0.77 (self care to 0.98 (life activities: work or school, and the ICC was lower, but achieved the recommended standard of 0.7 for four domains. Correlations between global WHODAS-2 score and the different domains of the SF-36 ranged from -0.29 to -0.65. Most of the WHODAS-2 scores showed statistically significant differences among clinical-severity groups for all pathologies, and between working patients and those not working due to ill health (p Conclusions The latent structure originally

  3. [Working conditions and health status of railway cashiers].

    Science.gov (United States)

    Pankova, V B; Kopirovskiĭ, K M; Poliakova, V A; Gipp, E K; Andreeva, I V

    2003-01-01

    The paper presents the data of clinical and hygienic studies of railway cashiers' health. The main deleterious factors of their working conditions are poor microclimatic conditions, bacterial inoculation of the working area air, a forced working posture, and a high vocal load under mental stress. There is a significant prevalence of nervous, obstetric, gynecological, thyroid, and vocal diseases and oral dysbacteriosis among the workers of this professional group. There is evidence for the necessity of including the job of a railway cashier into the List of decreed contingents for periodical medical examinations. PMID:12934277

  4. Law as a Tool for Preventing Chronic Diseases: Expanding the Spectrum of Effective Public Health Strategies

    OpenAIRE

    Mensah, George A.; Goodman, Richard A.; Stephanie Zaza; Moulton, Anthony D.; Paula L. Kocher; William H. Dietz; Terry F. Pechacek; Marks, James S.

    2003-01-01

    In part one of this 2-part series, we reviewed the important roles that laws have played in public health and provided examples of specific laws and their effectiveness in supporting public health interventions (1). We suggested that conceptual legal frameworks for systematically applying law to preventing and controlling chronic diseases have not been fully recognized and we provided the basic elements of a conceptual legal framework. In part 2 of this series, we first provide an overview of...

  5. Twitter: a good place to detect health conditions.

    Directory of Open Access Journals (Sweden)

    Víctor M Prieto

    Full Text Available With the proliferation of social networks and blogs, the Internet is increasingly being used to disseminate personal health information rather than just as a source of information. In this paper we exploit the wealth of user-generated data, available through the micro-blogging service Twitter, to estimate and track the incidence of health conditions in society. The method is based on two stages: we start by extracting possibly relevant tweets using a set of specially crafted regular expressions, and then classify these initial messages using machine learning methods. Furthermore, we selected relevant features to improve the results and the execution times. To test the method, we considered four health states or conditions, namely flu, depression, pregnancy and eating disorders, and two locations, Portugal and Spain. We present the results obtained and demonstrate that the detection results and the performance of the method are improved after feature selection. The results are promising, with areas under the receiver operating characteristic curve between 0.7 and 0.9, and f-measure values around 0.8 and 0.9. This fact indicates that such approach provides a feasible solution for measuring and tracking the evolution of health states within the society.

  6. Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management.

    OpenAIRE

    Heijmans, M.; Waverijn, G.; Rademakers, J.; Vaart, R. van der; Rijken, M

    2015-01-01

    Objective: To provide insight into the level of health literacy among chronic disease patients in the Netherlands, to identify subgroups with low literacy and to examine the associations between health literacy and self-management. Methods: Self-report questionnaires were sent to a nationwide sample of 1.341 chronic disease patients. The Dutch Functional Communicative and Critical Health Literacy scale (FCCHL), the Partners in Health scale (PIH) and Perceived Efficacy in Patient–Doctor Intera...

  7. Family Health and Characteristics in Chronic Fatigue Syndrome, Juvenile Rheumatoid Arthritis, and Emotional Disorders of Childhood.

    Science.gov (United States)

    Rangel, Luiza; Garralda, M. Elena; Jeffs, Jim; Rose, Gillian

    2005-01-01

    Objective: To compare family health and characteristics in children with chronic fatigue syndrome (CFS), in juvenile rheumatoid arthritis (JRA), and emotional disorders. Method: Parents of 28 children and adolescents aged 11 to 18 years with CFS, 30 with JRA, and 27 with emotional disorders (i.e., anxiety and/or depressive disorders) were…

  8. Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia

    NARCIS (Netherlands)

    F. Efficace; G. Rosti; N. Aaronson; F. Cottone; E. Angelucci; S. Molica; M. Vignetti; F. Mandelli; M. Baccarani

    2013-01-01

    The main objective of this study was to compare the reporting of health status and symptom severity, for a set of core symptoms related to imatinib therapy, between chronic myeloid leukemia patients and their treating physicians. Patients were asked to complete a questionnaire including questions on

  9. Patient reported outcomes in chronic skin diseases: eHealth applications for clinical practice

    NARCIS (Netherlands)

    O.D. van Cranenburgh

    2016-01-01

    The overall aim of this thesis was to examine and integrate patient reported outcomes (PROs) in dermatological care. In part I, we specifically examined health-related quality of life (HRQoL), treatment satisfaction, and experiences with care in patients with chronic skin diseases. Our results indic

  10. Clinical drug development using dynamic biomarkers to enable personalized health care in Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Bihlet, Asger R; Karsdal, Morten A; Bay-Jensen, Anne-Christine;

    2015-01-01

    Despite massive investments in development of novel treatments for heterogeneous diseases such as Chronic Obstructive Pulmonary Disease (COPD), the resources spent have only benefitted a fraction of the population treated. Personalized Health Care to guide selection of a suitable patient population...

  11. eHealth to stimulate physical activity in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Vorrink, S.N.W.

    2016-01-01

    Persons with Chronic Obstructive Pulmonary Disease (COPD) demonstrate reduced physical activity (PA) levels compared to healthy age-matched controls. Regular PA is associated with positive health outcomes. Inactivity leads to deconditioning, which leads to increased symptoms and a further reduction

  12. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: a pilot study.

    Science.gov (United States)

    Almuneef, Maha; Qayad, Mohammed; Aleissa, Majid; Albuhairan, Fadia

    2014-11-01

    Adverse childhood experiences (ACEs) have been linked with risky health behaviors and the development of chronic diseases in adulthood. This study examined associations between ACEs, chronic diseases, and risky behaviors in adults living in Riyadh, Saudi Arabia in 2012 using the ACE International Questionnaire (ACE-IQ). A cross-sectional design was used, and adults who were at least 18 years of age were eligible to participate. ACEs event scores were measured for neglect, household dysfunction, abuse (physical, sexual, and emotional), and peer and community violence. The ACE-IQ was supplemented with questions on risky health behaviors, chronic diseases, and mood. A total of 931 subjects completed the questionnaire (a completion rate of 88%); 57% of the sample was female, 90% was younger than 45 years, 86% had at least a college education, 80% were Saudi nationals, and 58% were married. One-third of the participants (32%) had been exposed to 4 or more ACEs, and 10%, 17%, and 23% had been exposed to 3, 2, or 1 ACEs respectively. Only 18% did not have an ACE. The prevalence of risky health behaviors ranged between 4% and 22%. The prevalence of self-reported chronic diseases ranged between 6% and 17%. Being exposed to 4 or more ACEs increased the risk of having chronic diseases by 2-11 fold, and increased risky health behaviors by 8-21 fold. The findings of this study will contribute to the planning and development of programs to prevent child maltreatment and to alleviate the burden of chronic diseases in adults. PMID:24974249

  13. 社区高龄男性慢性肾脏病患者的营养和心理健康状况调查%A survey of nutritional and mental health condition in elderly community-dwelling males with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    刘旭利; 程庆砾; 刘海波; 马强; 李青霖; 张瑞芹; 王志英; 邢春光

    2014-01-01

    目的了解北京某社区高龄老年男性人群慢性肾脏病(CKD)的患病情况,并评估其营养和心理健康状况.方法采取整群分层抽样的方法,选取北京市丰台区6个社区的≥80岁男性老年人进行横断面调查,筛查出CKD患者,采用微型营养评定精法(MNA-SF)评估其营养状况,并采用霍普金斯症状调查表(HSCL-10)评估患者的心理健康状况,分析营养、心理与CKD之间的关系.结果①在接受调查的436例高龄男性中,筛查出CKD患者164例(37.6%).1期占16.5%(27例),2期占25.0%(41例),3期占45.1%(3a期50例,占30.5%,3b期24例,占14.6%),4期占8.5%(14例),5期占4.9%(8例).②在高龄CKD患者中,营养不良者占9.1%(15例),存在营养不良风险者占25.0%(41例),营养良好者占65.9%(108例);CKD1~5期患者伴有营养不良及营养不良风险的发生率分别为14.8%(4例)、26.8%(1 1例)、32.0%(16例)、33.3%(8例)、9/14、8/8,MNA-SF营养评分随CKD的进展呈逐渐下降趋势(r=0.458,P<0.01).③CKD患者的HSCL-10评分随CKD的进展呈逐步升高趋势(r=-0.337,P<0.01).结论高龄老年男性CKD的患病率较高,以CKD 3期尤其是3a期多见.随着CKD的进展,高龄患者的营养状况逐渐下降,焦虑、抑郁等心理疾病也逐渐加重.%Objective To explore the prevalence of chronic kidney disease (CKD) and evaluate their nutritional and mental health status in elderly community-dwelling males.Methods A stratified cluster random sampling method was used.A total of 436 senile males (≥ 80 years old) were recruited from 6 communities of Fengtai District,Beijing.After screening those with CKD,the risks of malnutrition were assessed by the mini nutritional assessment-short form (MNA-SF) plus anthropometric measurements and bio-chemical markers.And the mental health condition was measured by the Hopkins symptoms check list-10 (HSCL-10).Results ① The prevalence of CKD in senile males of this study was 37.6% (n

  14. Chronicity and control

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2012-01-01

    This paper proposes a way of framing the study of ‘noncommunicable diseases’ within the more general area of chronic conditions. Focusing on Africa, it takes as points of departure the situation in Uganda, and the approach to health issues developed by a group of European and African colleagues...... over the years. It suggests a pragmatic analysis that places people's perceptions and practices within a field of possibilities shaped by policy, health care systems, and life conditions. In this field, the dimensions of chronicity and control are the distinctive analytical issues. They lead on to...... consideration of patterns of sociality related to chronic conditions and their treatment....

  15. Chronic Respiratory Disease: Considerations within the Public Health System

    Directory of Open Access Journals (Sweden)

    Diana Durán Palomino

    2007-09-01

    Full Text Available Chronic Respiratory Disease (CRD is a publichealth problem in Colombia. Its severity increasesby the presence of risk factors like firesmoke, which tend to prevail in young populationand that leads consequences at physical,social and mental level in the long run. The CRDincludes a series of clinical entities with theirown characteristics, caused by the suffering, socialisolation, physiological deterioration andthe associated morbidity. All these contributeto the functional limitation, the lost quality oflife and, ultimately, can turn the individual thatsuffers it in a dependent being without future.All this takes to a greater consumption of healthresources without this means one better attention,since in many opportunities the isolated efforts, the lack of clear rules, sustained proposalsand the non use of clinical guidelines amongother causes, allow that the intervention wouldbe destined to only palliate the present symptoms,but is far from including an integral, effectivehandling and that responds to individualnecessities. This article analyze the public norms and policies that cover patients with CRD, theaspects related to the rights to an integral, safeand real treatment in the affected individualalong with the obstacles for its accomplishment.

  16. Coping strategies among adolescents with chronic headache and mental health problems: a cross-sectional population-based study

    OpenAIRE

    Hartberg, Silje; Clench-Aas, Jocelyne; Raanaas, Ruth Kjærsti; Lundqvist, Christofer

    2015-01-01

    To examine prevalence of mental health problems among adolescents with chronic headache and compare internal and external coping strategies in young people with chronic headaches with and without mental health problems. This study is based on a cross-sectional survey undertaken in Akershus County in Norway. A total of 19,985 adolescents were included in the study, covering lower secondary and upper secondary students, aged 13–19 years. Chronic headache was measured with a single item question...

  17. Developing Community Health Conditions for Happiness, Phase 1

    Directory of Open Access Journals (Sweden)

    Chalard Chantarasombat

    2011-01-01

    Full Text Available Problem statement: Complete health of physical, social and intellectual development is an appropriate plan of human development and raises the quality of life in communities. If the development plan is integrated into the local community it will create peace and generosity. Good health is also fundamental to sustainable development which will create a peaceful society where community members are happy and content. Approach: The purpose of this research in Phase 1, is to (1 Identify leaders in communities at village and sub-district level to drive the ongoing research study and development to achieve good community health conditions in all aspects and dimensions. (2 To have the participants and researchers identify the key elements and indicators of health issues that communities feel are most important to their way of life. Results: Village communities were selected by cluster sampling from the provinces of Roi-Et and Maha Sarakham. The developed model for developing community health for living happily in communities is an appropriate and practical method that can be utilized in other communities. Conclusion: The model is in accordance with Participatory Action Research (PAR and the procedures are flexible and the development plans which are the results of Phase 1 can be extended to other communities and backgrounds.

  18. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    Science.gov (United States)

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27175280

  19. Short-run Effects of Job Loss on Health Conditions, Health Insurance, and Health Care Utilization

    OpenAIRE

    Jessamyn Schaller; Ann Huff Stevens

    2014-01-01

    Job loss in the United States is associated with long-term reductions in income and long-term increases in mortality rates. This paper examines the short- to medium-term changes in health, health care access, and health care utilization after job loss that lead to these long-term effects. Using a sample with more than 9800 individual job losses and longitudinal data on a wide variety of health-related measures and outcomes, we show that job loss results in worse self-reported health, includin...

  20. Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies

    OpenAIRE

    Spencer, Nicholas J; Blackburn, Clare M; Read, Janet M

    2015-01-01

    Objective To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries. Study design Systematic review and meta-analyses. Data sources 6 electronic databases, relevant websites, reference lists and experts in the field. Study selection 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 a...

  1. Using Concept Mapping to Develop a Strategy for Self-Management Support for Underserved Populations Living With Chronic Conditions, British Columbia, August 2013–June 2014

    Science.gov (United States)

    Bergeron, Kim; Pérez, Guillermina

    2015-01-01

    Introduction Self-management support (SMS) is an essential component of public health approaches to chronic conditions. Given increasing concerns about health equity, the needs of diverse populations must be considered. This study examined potential solutions for addressing the gaps in self-management support initiatives for underserved populations. Methods Stakeholders representing government, nongovernment organizations, Aboriginal communities, health authorities, medical practices, and research institutions generated, sorted, and rated ideas on what could be done to improve self-management support for underserved populations. Concept mapping was used to facilitate the collection and organization of the data and to generate conceptual maps. Results Participants generated 92 ideas that were sorted into 11 clusters (foster partnerships, promote integrated community care, enhance health care provider training, shift government policy, support community development, increase community education, enable client engagement, incorporate client support systems, recognize client capacity, tailor self-management support programs, and develop client skills, training, and tools) and grouped into system, community, and individual levels within a partnership framework. Conclusion The strategy can stimulate public health dialogue and be a roadmap for developing SMS initiatives. It has the potential to address SMS and chronic condition inequities in underserved populations in several ways: 1) by targeting populations that have greater inequities, 2) by advocating for shifts in government policies that create and perpetuate inequities, 3) by promoting partnerships that may increase the number of SMS initiatives for underserved groups, and 4) by promoting training and engagement that increase the relevance, uptake, and overall effectiveness of SMS. PMID:26447550

  2. @selfhealthtech: Using self-administered health monitoring technologies to support the self-management of long-term conditions: what about behaviour change?

    OpenAIRE

    Heather May Morgan

    2015-01-01

    Background Proliferation of digital technologies (e.g. self-administered mobile applications and wearable devices used to record and monitor biomedical and behavioural measures) is changing the ways services, professionals and individuals approach, manage and experience health and wellbeing.1 Supporting the self-management (SSM) of long-term conditions is a priority area for population health as more people have chronic conditions and people are living longer. Policies and practices must resp...

  3. Treosulfan-based conditioning for allogeneic HSCT in children with chronic granulomatous disease: a multicenter experience.

    Science.gov (United States)

    Morillo-Gutierrez, Beatriz; Beier, Rita; Rao, Kanchan; Burroughs, Lauri; Schulz, Ansgar; Ewins, Anna-Maria; Gibson, Brenda; Sedlacek, Petr; Krol, Ladislav; Strahm, Brigitte; Zaidman, Irina; Kalwak, Krzysztof; Talano, Julie-An; Woolfrey, Ann; Fraser, Chris; Meyts, Isabelle; Müller, Ingo; Wachowiak, Jacek; Bernardo, Maria Ester; Veys, Paul; Sykora, Karl-Walter; Gennery, Andrew R; Slatter, Mary

    2016-07-21

    Chronic granulomatous disease (CGD) can be cured by allogeneic hemopoietic stem cell transplantation (HSCT). Complications include graft failure, graft-versus-host disease (GVHD), infection, and transplant-related mortality; therefore, reduced-intensity conditioning regimens are being used to improve outcomes. In this retrospective study, the aim was to determine the outcome of treosulfan-based conditioning in HSCT for pediatric patients with CGD. The following data were collected: risk features pre-HSCT, additional conditioning agents, donor type and stem cell source, toxicity, engraftment, GVHD, chimerism, viral reactivation, post-HSCT complications, length of follow-up, and outcome. Seventy patients (median age, 107 months; interquartile range [IQR], 46-232 months) from 16 centers worldwide were transplanted between 2006 and 2015. Ninety-one percent had high-risk features. Fifty-seven HLA-matched donors, 12 HLA-mismatched donors, and 1 CD3(+)TCR αβ/CD19 depleted parental haploidentical transplants were performed. No major toxicity was reported. Median times to neutrophil and platelet engraftment were 17 (IQR, 15-35) and 16 (IQR, 13-50) days. At a median follow-up of 34 months (IQR, 13-102 months), the overall survival was 91.4%, and event-free survival was 81.4%. The cumulative incidence of acute grade III-IV GVHD was 12%. Nine patients developed chronic GVHD. When split cell chimerism was available, 95% or more myeloid donor chimerism was documented in 80% of surviving patients. Secondary graft failure occurred in 12% of patients. Treosulfan-containing conditioning regimens can be used safely in HSCT for children with CGD and high-risk clinical features, achieving excellent survival with high myeloid chimerism. Further studies are needed to compare with other regimens and evaluate the long-term outcome, particularly on fertility. PMID:27216217

  4. Public Health Nutrition: The Accord of Dietitian Providers in Managing Medicare Chronic Care Outpatients in Australia

    Directory of Open Access Journals (Sweden)

    Robyn P. Cant

    2010-04-01

    Full Text Available Medicare Australia: Chronic Disease Management program subsidizes allied health consultations for eligible outpatients with chronic disease or complex needs. In an evaluation study, private practice dietitians (n = 9 were interviewed to explore their patient management strategies including consultation time-allocation and fees. Time allocation was fee-based. Short first consultations were seen as meeting patients’ needs for low-cost services but were regarded by dietitians as ineffective, however longer initial consultations increased cost to patients. No strategy in use was optimal. There is a need for change in Medicare policy to meet the needs of both dietitians and patients in achieving the behaviour change goals of patients.

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

    OpenAIRE

    Cheng, Helen; Furnham, Adrian

    2013-01-01

    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...

  6. Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions

    Directory of Open Access Journals (Sweden)

    Tran Viet-Thi

    2012-07-01

    Full Text Available Abstract Background Patients experience an increasing treatment burden related to everything they do to take care of their health: visits to the doctor, medical tests, treatment management and lifestyle changes. This treatment burden could affect treatment adherence, quality of life and outcomes. We aimed to develop and validate an instrument for measuring treatment burden for patients with multiple chronic conditions. Methods Items were derived from a literature review and qualitative semistructured interviews with patients. The instrument was then validated in a sample of patients with chronic conditions recruited in hospitals and general practitioner clinics in France. Factor analysis was used to examine the questionnaire structure. Construct validity was studied by the relationships between the instrument's global score, the Treatment Satisfaction Questionnaire for Medication (TSQM scores and the complexity of treatment as assessed by patients and physicians. Agreement between patients and physicians was appraised. Reliability was determined by a test-retest method. Results A sample of 502 patients completed the Treatment Burden Questionnaire (TBQ, which consisted of 7 items (2 of which had 4 subitems defined after 22 interviews with patients. The questionnaire showed a unidimensional structure. The Cronbach's α was 0.89. The instrument's global score was negatively correlated with TSQM scores (rs = -0.41 to -0.53 and positively correlated with the complexity of treatment (rs = 0.16 to 0.40. Agreement between patients and physicians (n = 396 was weak (intraclass correlation coefficient 0.38 (95% confidence interval 0.29 to 0.47. Reliability of the retest (n = 211 patients was 0.76 (0.67 to 0.83. Conclusions This study provides the first valid and reliable instrument assessing the treatment burden for patients across any disease or treatment context. This instrument could help in the development of treatment strategies that are both

  7. The Relationship between Health-Promoting Behaviors and Resilience in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Li-Ching Ma

    2013-01-01

    Full Text Available This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD group had lower resilience than either high-risk or early CKD groups. Factors affecting pre-ESRD resilience were gender, occupational status, diabetes and health-promoting behaviors. Factors affecting resilience of the high-risk group included level of education and health-promoting behaviors while factors affecting resilience in the early CKD group involved whether they are employed and health promoting behaviors. A significant positive correlation was found between health promoting behavior and resilience in all study subjects. Multiple regression analysis found that factors which could effectively predict resilience in patients at high-risk for CKD were gender, whether the patient had a job, nutrition, self-actualization, and stress level, accounting for 69.7% of the variance. Therefore, nursing education should focus on health promotion advocacy throughout the life of not only patients but also their families.

  8. Azithromycin and cough-specific health status in patients with chronic obstructive pulmonary disease and chronic cough : a randomised controlled trial

    NARCIS (Netherlands)

    Berkhof, Farida F.; Doornewaard-ten Hertog, Nynke E.; Uil, Steven M.; Kerstjens, Huib A. M.; van den Berg, Jan W. K.

    2013-01-01

    Background: Macrolides reduce exacerbations in patients with COPD. Their effects on health status has not been assessed as primary outcome and is less clear. This study assessed the effects of prophylactic azithromycin on cough-specific health status in COPD-patients with chronic productive cough. M

  9. Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

    Directory of Open Access Journals (Sweden)

    Stewart Allison

    2008-05-01

    Full Text Available Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Results Participating health centres had distinct areas of strength and weakness in each component of systems: 1 organisational influence – strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2 community linkages – facilitated by working together with community organisations (e.g. local stores and running community-based programs (e.g. "health week", but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3 self management – promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4 decision support – facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5 delivery system

  10. Statewide Community-based Health Promotion: A North Carolina Model to Build Local Capacity for Chronic Disease Prevention

    OpenAIRE

    Marcus Plescia, MD, MPH; Suzanna Young, RD, MPH; Rosemary L. Ritzman, PhD, MSN

    2005-01-01

    Background Public health faces major challenges to building state and local infrastructure with the capacity to address the underlying causes of chronic disease. We describe a structured statewide approach to providing technical assistance for local communities to support and develop health promotion capacity. Context Over the last two decades, the North Carolina Statewide Health Promotion program has supported local approaches to the prevention and control of chronic disease. In 1999, a majo...

  11. What makes primary care effective for people in poverty living with multiple chronic conditions?: study protocol

    Directory of Open Access Journals (Sweden)

    Barbeau David

    2010-11-01

    Full Text Available Abstract Background The inverse care law persists: people living in poverty have the greatest needs and face considerable challenges in getting the care they need. Evidence reveals that GPs encounter difficulties in delivering care to poor patients, while many of those patients feel stigmatized by healthcare professionals. Patients living in poverty report negative healthcare experiences and unmet healthcare needs. Indeed, there is a growing recognition in primary care research of the importance of addressing the capabilities and social conditions of the poor when delivering care. Few studies have looked at the factors contributing to effective and "socially responsive" care for people living in poverty. Methods/Design Our study adopts a qualitative ethnographic approach in four healthcare organizations in deprived areas of metropolitan Montreal (Québec, Canada, using patient shadowing techniques and interviews. Data will be collected through fieldwork observations and informal interviews with patients before and after consultations. We will observe medical consultations, care organization activities, and waiting areas and reception of patients. We will conduct a total of 36 individual interviews with 12 GPs and 24 patients. The interviews will be audio-recorded and transcribed for purposes of analysis. The analysis consists of debriefing sessions, coding and interpretive analysis. Discussion This study aims to investigate how positive healthcare interactions between physicians and patients can improve the management of chronic conditions. We hypothesize that factors related to care organization, to healthcare professionals' experience and to patients may enhance the quality of healthcare interactions, which may have positive impacts for preventing and managing chronic conditions. Our study will provide a unique set of data grounded in the perspectives of healthcare professionals and of patients living in poverty.

  12. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

    Directory of Open Access Journals (Sweden)

    Sevgi Akarsu

    2015-03-01

    Full Text Available Background and Design: Chronic spontaneous urticaria (CSU, the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patients with CSU and UV. Materials and Methods: In this study, the files of CSU (n=146 and UV (n=43 patients who had been hospitalized between January 2010-December 2013 were retrospectively reviewed in terms of demographic data, disease-specific history, accompanying diseases, medications and laboratory findings. Results: When comparing between the two groups for statistical differences, it was found that the frequencies of personal atopy and angioedema were significantly higher in patients with CSU; however, the patients with UV had significantly higher rates for female gender and the presence of systemic symptoms compared to those with CSU. It was determined that the mean values for erythrocyte sedimentation rate and C-reactive protein, as well as the rates of antinuclear antibody positivity and hypocomplementemia were significantly higher in the UV group, compared with those in the CSU group. Accompanying factors were determined as infections, medications, autoimmune diseases and malignities in order of frequency in both CSU and UV groups, but only the frequency of autoimmune diseases was significantly higher in patients with UV group. Conclusion: Although various authors have reported that a large number (up to 40-60% of patients with UV may present only with wheals (clinically indistinguishable from CSU; we assumed that it would be more appropriate to be considered UV as a priority in patients especially who had systemic symptom, autoimmune disease

  13. Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study

    Directory of Open Access Journals (Sweden)

    Eton DT

    2012-08-01

    Full Text Available David T Eton,1 Djenane Ramalho de Oliveira,2,3 Jason S Egginton,1 Jennifer L Ridgeway,1 Laura Odell,4 Carl R May,5 Victor M Montori1,61Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 3Medication Therapy Management Program, Fairview Pharmacy Services LLC, Minneapolis, MN, USA; 4Pharmacy Services, Mayo Clinic, Rochester, MN, USA; 5Faculty of Health Sciences, University of Southampton, Southampton, UK; 6Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USABackground: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure.Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy, and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes.Results: Thirty-two patients (20 female, 12 male, age 26–85 years were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles

  14. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    Science.gov (United States)

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  15. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    Directory of Open Access Journals (Sweden)

    Chan Brian T

    2011-10-01

    Full Text Available Abstract Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv effective strategies for HIV/AIDS care in other settings should be

  16. Health condition and residual life of deteriorating technical systems

    Energy Technology Data Exchange (ETDEWEB)

    Reinertsen, Rune

    1997-12-31

    Many offshore installations in the Norwegian Sector of the North Sea approach the end of their useful life. The same is true of many power plants and technical systems in general. This thesis describes the theory and improves the methods for the determination of the health condition and residual life of technical systems. Rather than developing new methods it discusses new ways of using existing statistical methods. The main contributions are: (1) A survey of the literature of diagnosis, prediction and life extension for deteriorating technical systems, (2) A discussion of some consequences of selecting the wrong life model, (3) A description of problems related to the determination of mean residual life of non-repairable technical systems, (4) Presentation of the concept of `technical health` to describe the soundness of a system exposed to failure mechanisms, (5) A model for predicting the technical health and residual life of a corroding system, (6) Recommends requirements and methods for using expert knowledge in safety and reliability analysis, (7) A general inspection strategy for system fault diagnosis by using Shannon entropy, (8) Points out weaknesses and strengths of risk measures used in the offshore industry today. 237 refs., 23 figs., 6 tabs.

  17. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Arabella K. M. Hayter

    2015-02-01

    Full Text Available Background: Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. Design: We undertook a qualitative study consisting of nine focus group discussions (FGDs (n=57 in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases, with the aim of defining future interventions. The transcripts were analysed thematically. Results: Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. Conclusions: In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.

  18. Cytogenetic sequelae in sex and somatic cells at mice subjected to chronic irradiation simulating occupational conditions of radiation effect

    International Nuclear Information System (INIS)

    Cytogenetic effect of chronic irradiation in low doses to study chronic radiation effect upon man under professional conditions has been investigated. The experiments have been carried out on white mice, subjected to chronic effect of 60Co gamma irradiation (during 15 - 19 months in doses of 6, 17 and 50 mrad for 6 - 7 hrs a day). It is shown, that under effect of chronic irradiation, modelling the conditions of professional irradiation effect, in sex and somatic cells of the mice chromosomal aberrations appear, which depend on the age of animals and magnitude of every day dose. However direct dependence of these changes on the magnitude of the total dose has not been established

  19. An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Unger Elizabeth R

    2009-10-01

    Full Text Available Abstract Background The diagnosis of chronic fatigue syndrome (CFS in research studies requires the exclusion of subjects with medical and psychiatric conditions that could confound the analysis and interpretation of results. This study compares illness parameters between individuals with CFS who have and those who do not have exclusionary conditions. Methods We used a population-based telephone survey of randomly selected individuals, followed by a clinical evaluation in the study metropolitan, urban, and rural counties of Georgia, USA. The medical and psychiatric histories of the subjects were examined and they underwent physical and psychiatric examinations and laboratory screening. We also employed the multidimensional fatigue inventory (MFI, the medical outcomes survey short form-36 (SF-36 and the US Centres for Disease Control and Prevention symptom inventory (SI. Results Twenty-nine percent (1,609 of the 5623 subjects who completed the detailed telephone interview reported exclusionary diagnoses and we diagnosed an exclusionary condition in 36% of 781 clinically evaluated subjects. Both medical and psychiatric exclusionary conditions were more common in women, blacks and participants from rural areas. Subjects with and without exclusions had similar levels of fatigue and impairment as measured by the MFI and SF-36; those with CFS-like illness (not meeting the formal CFS definition were more likely to have an exclusionary diagnosis. After adjusting for demographics, body mass index, fatigue subscales, SF-36 subscales and CFS symptoms, CFS-like illness did not remain significantly associated with having an exclusionary diagnosis. Conclusion Medical and psychiatric illnesses associated with fatigue are common among the unwell. Those who fulfill CFS-like criteria need to be evaluated for potentially treatable conditions. Those with exclusionary conditions are equally impaired as those without exclusions.

  20. Effect of baclofen on morphine-induced conditioned place preference, extinction, and stress-induced reinstatement in chronically stressed mice

    OpenAIRE

    Meng, Shanshan; Quan, Wuxing; Xu QI; Su, Zhiqiang; Yang, Shanshan

    2013-01-01

    Rationale and Objective A stress-induced increase in excitability can result from a reduction in inhibitory neurotransmission. Modulation of gamma-aminobutyric acid (GABA)ergic transmission is an effective treatment for drug seeking and relapse. This study investigated whether baclofen, a GABAB receptor agonist, had an impact on morphine-induced conditioned place preference (CPP), extinction, and stress-induced relapse in chronically stressed mice. Methods Chronic stress was induced by restra...

  1. Cost-Effectiveness of a Diabetes Pay-For-Performance Program in Diabetes Patients with Multiple Chronic Conditions

    OpenAIRE

    Hsieh, Hui-Min; Gu, Song-Mao; Shin, Shyi-Jang; Kao, Hao-Yun; Lin, Yi-Chieh; Chiu, Herng-Chia

    2015-01-01

    Pay for performance (P4P) has been used as a strategy to improve quality for patients with chronic illness. Little was known whether care provided to individuals with multiple chronic conditions in a P4P program were cost-effective. This study investigated cost effectiveness of a diabetes P4P program for caring patients with diabetes alone (DM alone) and diabetes with comorbid hypertension and hyperlipidemia (DMHH) from a single payer perspective in Taiwan. Analyzing data using population-bas...

  2. eHealth to stimulate physical activity in patients with chronic obstructive pulmonary disease

    OpenAIRE

    Vorrink, S.N.W.

    2016-01-01

    Persons with Chronic Obstructive Pulmonary Disease (COPD) demonstrate reduced physical activity (PA) levels compared to healthy age-matched controls. Regular PA is associated with positive health outcomes. Inactivity leads to deconditioning, which leads to increased symptoms and a further reduction of PA. This results in a downward spiral of deconditioning and inactivity. Pulmonary rehabilitation (PR) is known to improve exercise capacity; however, these benefits decline to pre-rehabilitation...

  3. Acute and chronic job stressors among ambulance personnel: predictors of health symptoms

    OpenAIRE

    van der Ploeg, E; Kleber, R.J.

    2003-01-01

    Objectives: To predict symptomatology (post-traumatic distress, fatigue, and burnout) due to acute and chronic work related stressors among ambulance personnel. Methods: Data were gathered from 123 ambulance workers in The Netherlands in a longitudinal design. At two measurements they completed standardised questionnaires to assess health symptoms, such as the Impact of Event Scale, the Maslach Burnout Inventory, and the Checklist Individual Strength. Acute stressors were assessed with specif...

  4. The Interdisciplinary eHealth Team: Chronic Care for the Future

    OpenAIRE

    Wiecha, John; Pollard, Timothy

    2004-01-01

    An interdisciplinary clinical team is a consistent grouping of people from relevant clinical disciplines, ideally inclusive of the patient, whose interactions are guided by specific team functions and processes to achieve team-defined favorable patient outcomes. Teamwork supported by properly designed eHealth applications could help create more effective systems of care for chronic disease. Given its synchronous and asynchronous communication capacity and information-gathering and -sharing ca...

  5. Chronic morbidity and health care seeking behaviour amongst elderly population in rural areas of Uttarakhand

    OpenAIRE

    Surekha Kishore; Mr. Kapil Sharma; Richa Singh; Bhanu Pratap Singh Gaur; Rachana R Satish; Yatish Bhaskar; Ritu Bhaskar

    2015-01-01

    Background: Ageing is a natural process, always associated with physiological and biological decline. Global population is ageing; the proportion of older persons has been rising steadily, from 7% in 1950 to 11% in 2007, with an expected rise to reach 22 % in 2050. With improving knowledge and awareness the health care seeking behavior has shown an increasingly positive trend. With increasing age, morbidity,   especially those arising from chronic diseases also increases. On the contrary, hea...

  6. Introducing the National Library for Health Skin Conditions Specialist Library

    Directory of Open Access Journals (Sweden)

    Williams Hywel C

    2005-04-01

    Full Text Available Abstract Background This paper introduces the new National Library for Health Skin Conditions Specialist Library http://www.library.nhs.uk/skin. Description The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. Conclusion The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches.

  7. Computer-based interactive health communications for people with chronic disease

    Directory of Open Access Journals (Sweden)

    Casey LM

    2014-04-01

    Full Text Available Leanne M Casey,1 Bonnie A Clough,1 Mary E Mihuta,1 Heather Green,1 Wayne Usher,2 Daniel A James,3,4 David D Rowlands,3 E-Liisa Laakso5 1Griffith Health Institute Behavioural Basis of Health Program, School of Applied Psychology, 2School of Education and Professional Studies, 3Sports and Biomedical Engineering Laboratory, School of Engineering, Griffith University, Queensland, Australia; 4Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Queensland, Australia; 5Griffith Health Institute Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Queensland, Australia Abstract: Chronic diseases (CD – such as cardiovascular, diabetes, cancer, and chronic respiratory diseases – are projected to be the most common causes of mortality and morbidity by 2030. Use of a participatory decision-making model that emphasizes a partnership among practitioners, patients, and their families to achieve desired goals is a key strategy in achieving optimal outcomes. The Interactive Health Communication Applications (IHCAs can support participatory decision making by providing the unique infrastructure needed to deliver support for the multiple requirements of patients with CD. The aim of this paper is to provide a descriptive review of the use of IHCAs in the treatment of chronic disease. Patient acceptability and satisfaction were identified as key issues that can be enhanced by ensuring that IHCAs provide: 1 emotional support and empowerment; 2 education and information from health professionals; and 3 telecommunication instead of onsite visiting. An important benefit of IHCAs can be an improved quality of communication between the patients and the health care professionals, which is a critical and predictive factor of treatment outcomes for many patients with CD. Similarly, there is good evidence to suggest that IHCAs can improve the patients’ adherence to both medication and behavioral

  8. The Impact of a Proactive Chronic Care Management Program on Hospital Admission Rates in a German Health Insurance Society

    OpenAIRE

    Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E.; Rula, Elizabeth Y.

    2010-01-01

    Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with corona...

  9. Changes in health-related quality of life and clinical implications in Chinese patients with chronic cough

    OpenAIRE

    Ma, Wei; Yu, Li; Wang, Yu; Li, Xin; LÜ, Hanjing; Qiu, Zhongmin

    2009-01-01

    Background Chronic cough has negative effects on quality of life. However, the changes in health-related quality of life and clinical implications remain unclear in Chinese patients with chronic cough. Methods A standard Chinese version of Leicester cough questionnaire (LCQ) was developed by an established translation procedure and its repeatability was assessed in a preliminary study involving 20 untreated patients with stable chronic cough. The quality of life was measured with the Short fo...

  10. Structural Characteristics of Gastric Cell Populations in Chronic Gastritis and Chronic Hepatitis under Conditions of Helicobacter pylori Persistence.

    Science.gov (United States)

    Lapii, G A; Bakarev, M A; Nepomnyashchikh, G I; Kapustina, V I; Nepomnyashchikh, D L; Vinogradova, E V; Postnikova, O A

    2016-02-01

    Helicobacter pylori persistence in patients with chronic gastritis is associated with a complex of nonspecific structural reactions, the type of these reactions correlates with the severity of infection: catarrhal fibrotic changes in the gastric mucosa predominate in cases with manifest colonization, while the absence of H. pylori is associated with predominance of fibrotic process. Analysis of the incidence of some pathomorphological phenomena (degeneration, atrophy, metaplasia, and dysplasia of the surface epithelium) shows no relationship between the presence of H. pylori and colonization intensity. In all patients with chronic hepatitis, the gastric mucosa is involved in the pathological process; fibrosis (gastropathy) was the most common process. No appreciable correlations between the structural changes and hepatitis activity and the presence of H. pylori were detected. PMID:26899845

  11. [Health Station, a product of combining the ideas of public health with the modern Chinese national conditions].

    Science.gov (United States)

    Li, Y C

    2016-05-01

    The Health Station was a local health organization founded by the pioneers of the public health in modern China under the national conditions of "poverty, ignorance, illness and selfishness" , being the result of combining the ideas of public health with the Chinese national conditions of modern times. Though this organization appeared in backward modern China, it was advanced all over the world. John Grant was the planner of the Peiping First Health Station, whereas Li Ting'an, its builder. PMID:27485870

  12. A review of health utilities across conditions common in paediatric and adult populations

    Directory of Open Access Journals (Sweden)

    Hopkins Robert B

    2010-01-01

    Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

  13. Primary and tertiary health professionals’ views on the health-care of patients with co-morbid diabetes and chronic kidney disease – a qualitative study

    OpenAIRE

    Lo, Clement; Ilic, Dragan; Teede, Helena; Fulcher, Greg; Gallagher, Martin; Kerr, Peter G; Murphy, Kerry; Polkinghorne, Kevan; Russell, Grant; Usherwood, Timothy; Walker, Rowan; Zoungas, Sophia

    2016-01-01

    Background Health-care for co-morbid diabetes and chronic kidney disease (CKD) is often sub-optimal. To improve health-care, we explored the perspectives of general practitioners (GPs) and tertiary health-care professionals concerning key factors influencing health-care of diabetes and CKD. Methods A total of 65 health professionals were purposively sampled from Australia’s 2 largest cities to participate in focus groups and semi-structured interviews. Four focus groups were conducted with GP...

  14. Estimating the prevalence of comorbid conditions and their effect on health care costs in patients with diabetes mellitus in Switzerland

    Directory of Open Access Journals (Sweden)

    Huber CA

    2014-10-01

    Full Text Available Carola A Huber,1 Peter Diem,2 Matthias Schwenkglenks,3 Roland Rapold,1 Oliver Reich1 1Department of Health Sciences, Helsana Group, Zürich, Switzerland; 2Department of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; 3Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland Background: Estimating the prevalence of comorbidities and their associated costs in patients with diabetes is fundamental to optimizing health care management. This study assesses the prevalence and health care costs of comorbid conditions among patients with diabetes compared with patients without diabetes. Distinguishing potentially diabetes- and nondiabetes-related comorbidities in patients with diabetes, we also determined the most frequent chronic conditions and estimated their effect on costs across different health care settings in Switzerland. Methods: Using health care claims data from 2011, we calculated the prevalence and average health care costs of comorbidities among patients with and without diabetes in inpatient and outpatient settings. Patients with diabetes and comorbid conditions were identified using pharmacy-based cost groups. Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs. Results: A total of 932,612 persons, including 50,751 patients with diabetes, were enrolled. The most frequent potentially diabetes- and nondiabetes-related comorbidities in patients older than 64 years were cardiovascular diseases (91%, rheumatologic conditions (55%, and hyperlipidemia (53%. The mean total health care costs for diabetes patients varied substantially by comorbidity status (US$3,203–$14,223. Patients with diabetes and more than two comorbidities incurred US$10,584 higher total costs than patients without comorbidity. Costs were significantly higher in patients with

  15. How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?—a scoping review

    Science.gov (United States)

    Francis, Linda; Dunt, David; Cadilhac, Dominique A

    2016-01-01

    Objectives Programmes to address chronic disease are a focus of governments worldwide. Despite growth in ‘implementation science’, there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. Settings A scoping review of the literature spanning 1985–2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Participants Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Primary and secondary outcome measures Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Results Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with ‘maintenance of programme activities’ most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Conclusions Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to

  16. Does multimorbidity influence the occurrence rates of chronic conditions? A claims data based comparison of expected and observed prevalence rates.

    Directory of Open Access Journals (Sweden)

    Ingmar Schäfer

    Full Text Available OBJECTIVE: Multimorbidity is a complex phenomenon with an almost endless number of possible disease combinations with unclear implications. One important aspect in analyzing the clustering of diseases is to distinguish between random coexistence and statistical dependency. We developed a model to account for random coexistence based on stochastic distribution. We analyzed if the number of diseases of the patients influences the occurrence rates of chronic conditions. METHODS: We analyzed claims data of 121,389 persons aged 65+ using a list of 46 chronic conditions. Expected prevalences were simulated by drawing without replacement from all observed diseases using observed overall prevalences as initial probability weights. To determine if a disease occurs more or less frequently than expected by chance we calculated observed-minus-expected deltas for each disease. We defined clinical relevance as |delta| ≥ 5.0%. 18 conditions were excluded because of a prevalence < 5.0%. RESULTS: We found that (1 two chronic conditions (e.g. hypertension were more frequent than expected in patients with a low number of comorbidities; (2 four conditions (e.g. renal insufficiency were more frequent in patients with many comorbidities; (3 six conditions (e.g. cancer were less frequent with many comorbidities; and (4 16 conditions had an average course of prevalences. CONCLUSION: A growing extent of multimorbidity goes along with a rapid growth of prevalences. This is for the largest part merely a stochastic effect. If we account for this effect we find that only few diseases deviate from the expected prevalence curves. Causes for these deviations are discussed. Our approach also has methodological implications: Naive analyses of multimorbidity might easily be affected by bias, because the prevalence of all chronic conditions necessarily increases with a growing extent of multimorbidity. We should therefore always examine and discuss the stochastic interrelations

  17. The nursing contribution to chronic disease management: a whole systems approach: Report for the National Institute for Health Research Service Delivery and Organisation programme

    OpenAIRE

    Kendall, Sally; Wilson, Patricia M; Procter, Susan; BROOKS, Fiona; Bunn, Frances; Gage, Heather; McNeilly, Elaine

    2010-01-01

    Background Transforming the delivery of care for people with Long Term Conditions (LTCs) requires understanding about how health care policies in England and historical patterns of service delivery have led to different models of chronic disease management (CDM). It is also essential in this transformation to analyse and critique the models that have emerged to provide a more detailed evidence base for future decision making and better patient care. Nurses have made, and continue to make, ...

  18. Stroke mortality: predictive value of simple laboratory tests and acute physiology, age, chronic health evaluation III scoring system: a hospital based study

    OpenAIRE

    Ajeet K. Chaurasia; Manoj K. Mathur; N C Dwivedi; Manjul Mishra

    2016-01-01

    Background: Acute stroke is a heterogeneous condition with respect to prognosis. This study was undertaken with the aim to evaluate the significance of routine simple blood parameters and APACHE (acute physiology, age, chronic health evaluation) III scoring system as methods of prediction of 1-month mortality in stroke patients and to assess the sensitivity and specificity of APACHE III scoring system in predicting short term outcome in critically ill patients having stroke. Methods: Patie...

  19. Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: An assessment of health literacy

    Directory of Open Access Journals (Sweden)

    Burnett Angus F

    2011-07-01

    Full Text Available Abstract Background Despite the large volume of research dedicated to understanding chronic low back pain (CLBP, patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course of other chronic conditions and may be important in the aetiology of CLBP. Many of the currently available health literacy measurement tools are limited since they measure narrow aspects of health literacy. The Health Literacy Measurement Scale (HeLMS was developed recently to measure broader elements of health literacy. The aim of this study was to measure broad elements of health literacy among individuals with CLBP and without LBP using the HeLMS. Methods Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups. Results HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05. However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain 'Patient attitudes towards their health' (mean difference [95% CI]: 0.46 [0.11-0.82] and significantly lower scores for each of the individual items within this domain (p d = 0.47-0.65. Conclusions Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.

  20. Chronic Stress and Adolescents' Mental Health : Modifying Effects of Basal Cortisol and Parental Psychiatric History. The TRAILS Study

    NARCIS (Netherlands)

    Zandstra, Anna Roos E.; Hartman, Catharina A.; Nederhof, Esther; van den Heuvel, Edwin R.; Dietrich, Andrea; Hoekstra, Pieter J.; Ormel, Johan

    2015-01-01

    Large individual differences in adolescent mental health following chronic psychosocial stress suggest moderating factors. We examined two established moderators, basal cortisol and parental psychiatric history, simultaneously. We hypothesized that individuals with high basal cortisol, assumed to in

  1. Growth Responses of Fish During Chronic Exposure of Metal Mixture under Laboratory Conditions

    Directory of Open Access Journals (Sweden)

    Saima Naz and Muhammad Javed

    2013-07-01

    Full Text Available Growth responses of five fish species viz. Catla catla, Labeo rohita, Cirrhina mrigala, Ctenopharyngodon idella and Hypophthalmichthys molitrix were determined, separately, under chronic exposure of binary mixture of metals (Zn+Ni at sub-lethal concentrations (1/3rd of LC50 for 12 weeks. Randomized complete block design (RCBD was followed to conduct this research work. The groups (10 fish each of Catla catla, Labeo rohita, Cirrhina mrigala, Ctenopharyngodon idella and Hypophthalmichthys molitrix having almost similar weights were investigated for their growth responses and metals bioaccumulation patterns in their body organs during chronic exposure of Zn+Ni mixture. The bioaccumulation of metals in the fish body organs viz. gills, liver, kidney, fins, bones, muscle and skin were also determined before and after growth trails under the stress of metals mixture. The exposure of fish to sub-lethal concentrations of mixture caused significant impacts on the average wet weight increments of five fish species. Ctenopharyngodon idella and Labeo rohita attained significantly higher weights, followed by that of Hypophthalmichthys molitrix, Cirrhina mrigala and Catla catla. However, the growth of metals mixture exposed fish species was significantly lesser than that of control fish (un-stressed. Significantly variable condition factor values reflected the degree of fish well-beings that correlated directly with fish growth and metal exposure concentration. Any significant change in feed intake, due to stress, is reflected in terms of fish growth showing the impacts of metal mixture on fish growth were either additive or antagonist / synergistic. Accumulation of all the metals in fish body followed the general order: liver>kidney>gills> skin >muscle> fins >bones.

  2. Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Frølich, Anne; Godtfredsen, Nina S

    2012-01-01

    To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD).......To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)....

  3. Developing a Framework to Generate Evidence of Health Outcomes From Social Media Use in Chronic Disease Management

    OpenAIRE

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

    2013-01-01

    Background While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier gen...

  4. Health-related financial catastrophe, inequality and chronic illness in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Mizanur Rahman

    Full Text Available BACKGROUND: Bangladesh has a high proportion of households incurring catastrophic health expenditure, and very limited risk sharing mechanisms. Identifying determinants of out-of-pocket (OOP payments and catastrophic health expenditure may reveal opportunities to reduce costs and protect households from financial risk. OBJECTIVE: This study investigates the determinants of high healthcare expenditure and healthcare- related financial catastrophe. METHODS: A cross-sectional household survey was conducted in Rajshahi city, Bangladesh, in 2011. Catastrophic health expenditure was estimated separately based on capacity to pay and proportion of non-food expenditure. Determinants of OOP payments and financial catastrophe were estimated using double hurdle and Poisson regression models respectively. RESULTS: On average households spent 11% of their total budgets on health, half the residents spent 7% of the monthly per capita consumption expenditure for one illness, and nearly 9% of households faced financial catastrophe. The poorest households spent less on health but had a four times higher risk of catastrophe than the richest households. The risk of financial catastrophe and the level of OOP payments were higher for users of inpatient, outpatient public and private facilities respectively compared to using self-medication or traditional healers. Other determinants of OOP payments and catastrophic expenses were economic status, presence of chronic illness in the household, and illness among children and adults. CONCLUSION: Households that received inpatient or outpatient private care experienced the highest burden of health expenditure. The poorest members of the community also face large, often catastrophic expenses. Chronic illness management is crucial to reducing the total burden of disease in a household and its associated increased risk of level of OOP payments and catastrophic expenses. Households can only be protected from these situations by

  5. The role of pulmonology in the National Health System Chronicity Strategy.

    Science.gov (United States)

    Soler-Cataluña, Juan José; Sánchez Toril, Fernando; Aguar Benito, M Carmen

    2015-08-01

    Longer life expectancy and the progressive aging of the population is changing the epidemiological pattern of healthcare, with a reduction in the incidence of acute diseases and a marked increase in chronic diseases. This change brings important social, healthcare and economic consequences that call for a reorganization of patient care. In this respect, the Spanish National Health System has developed a Chronicity strategy that proposes a substantial change in focus from traditional rescue medicine to patient- and environment-centered care, with a planned, proactive, participative and multidisciplinary approach. Some of the more common chronic diseases are respiratory. In COPD, this integrated approach has been effective in reducing exacerbations, improving quality of life, and even reducing costs. However, the wide variety of management strategies, not only in COPD but also in asthma and other respiratory diseases, makes it difficult to draw definitive conclusions. Pulmonologists can and must participate in the new chronicity models and contribute their knowledge, experience, innovation, research, and special expertise to the development of these new paradigms. PMID:25554457

  6. Human embryonic mesenchymal stem cell-derived conditioned medium rescues kidney function in rats with established chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Arianne van Koppen

    Full Text Available Chronic kidney disease (CKD is a major health care problem, affecting more than 35% of the elderly population worldwide. New interventions to slow or prevent disease progression are urgently needed. Beneficial effects of mesenchymal stem cells (MSC have been described, however it is unclear whether the MSCs themselves or their secretome is required. We hypothesized that MSC-derived conditioned medium (CM reduces progression of CKD and studied functional and structural effects in a rat model of established CKD. CKD was induced by 5/6 nephrectomy (SNX combined with L-NNA and 6% NaCl diet in Lewis rats. Six weeks after SNX, CKD rats received either 50 µg CM or 50 µg non-CM (NCM twice daily intravenously for four consecutive days. Six weeks after treatment CM administration was functionally effective: glomerular filtration rate (inulin clearance and effective renal plasma flow (PAH clearance were significantly higher in CM vs. NCM-treatment. Systolic blood pressure was lower in CM compared to NCM. Proteinuria tended to be lower after CM. Tubular and glomerular damage were reduced and more glomerular endothelial cells were found after CM. DNA damage repair was increased after CM. MSC-CM derived exosomes, tested in the same experimental setting, showed no protective effect on the kidney. In a rat model of established CKD, we demonstrated that administration of MSC-CM has a long-lasting therapeutic rescue function shown by decreased progression of CKD and reduced hypertension and glomerular injury.

  7. Periodontitis and Periodontal Disease - Innovative Strategies for Reversing the Chronic Infectious and Inflammatory Condition by Natural Products.

    Science.gov (United States)

    Lazar, Veronica; Saviuc, Crina-Maria; Chifiriuc, Mariana Carmen

    2016-01-01

    Oral microbiota of the mouth is the most diverse microbial community in the human body and plays a decisive role in the emergence and evolution of gingival pathology, contributing as well to the host general health condition, based on complex interactions established between the microbial community members and the host. A specific shift in the quantity and diversity of the microbial community developed on dental and mucosal surfaces, could lead to the occurrence of chronic inflammation mediated by the overproduction of pro-inflammatory cytokines. The mechanical treatment and current medication efficiency for the periodontal disease is limited in time due to the rapid plaque forming. Also, the antimicrobial treatment is limited by the sessile growth of the microorganisms, resulting in a poor biofilm penetration by biocides or antibiotics. In line with that, the attention of the scientific community shifted to ethnopharmacology as a complementary, or alternative therapeutic option for fighting infections with resistant bacteria. The vegetal and bee products are an important source of bioactive compounds, acting as harmless antimicrobials and periodontal inflammation suppressors. Vegetable bioproducts have been proven to exhibit multiple antipathogenic effects, such as microbicidal activity, virulence attenuation, and synergistic effects between the components found in the complex vegetal matrixes, or with conventional biocides, as well as immunomodulatory effects. The purpose of this review is to highlight the importance of vegetable products as a possible complementary treatment for periodontitis and their potential for the development of innovative therapeutic strategies. PMID:26561076

  8. Law as a Tool for Preventing Chronic Diseases: Expanding the Spectrum of Effective Public Health Strategies

    Directory of Open Access Journals (Sweden)

    George A. Mensah

    2004-04-01

    Full Text Available In part one of this 2-part series, we reviewed the important roles that laws have played in public health and provided examples of specific laws and their effectiveness in supporting public health interventions (1. We suggested that conceptual legal frameworks for systematically applying law to preventing and controlling chronic diseases have not been fully recognized and we provided the basic elements of a conceptual legal framework. In part 2 of this series, we first provide an overview of U.S. jurisprudence, describe the legal mechanisms, remedies, and tools for applying law to public health, and summarize the jurisdictional levels at which laws, mechanisms, remedies, and tools operate. We then identify the potential contours for legal frameworks of varying complexity and scope by offering examples of legal frameworks in public health practice. This paper also outlines a plan for increasing the capacity within the Centers for Disease Control and Prevention (CDC for developing legal frameworks and expanding guidance on using legal tools for preventing and controlling chronic diseases. Finally, we describe resources for building or enhancing the capacity to use law as a tool for preventing diseases, injuries, and disabilities at the local level.

  9. Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

    Directory of Open Access Journals (Sweden)

    Shantanu Nundy

    2012-01-01

    Full Text Available Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.

  10. A mHealth Application for Chronic Wound Care: Findings of a User Trial

    Directory of Open Access Journals (Sweden)

    Marcia R. Friesen

    2013-11-01

    Full Text Available This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses’ paper-based charting and is positioned for integration with facility’s larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1 the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities, (2 data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3 tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application’s design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software’s telehealth capacities.

  11. Assessment of the Acute and Chronic Health Hazards of Hydraulic Fracturing Fluids.

    Science.gov (United States)

    Wattenberg, Elizabeth V; Bielicki, Jeffrey M; Suchomel, Ashley E; Sweet, Jessica T; Vold, Elizabeth M; Ramachandran, Gurumurthy

    2015-01-01

    There is growing concern about how hydraulic fracturing affects public health because this activity involves handling large volumes of fluids that contain toxic and carcinogenic constituents, which are injected under high pressure through wells into the subsurface to release oil and gas from tight shale formations. The constituents of hydraulic fracturing fluids (HFFs) present occupational health risks because workers may be directly exposed to them, and general public health risks because of potential air and water contamination. Hazard identification, which focuses on the types of toxicity that substances may cause, is an important step in the complex health risk assessment of hydraulic fracturing. This article presents a practical and adaptable tool for the hazard identification of HFF constituents, and its use in the analysis of HFF constituents reported to be used in 2,850 wells in North Dakota between December 2009 and November 2013. Of the 569 reported constituents, 347 could be identified by a Chemical Abstract Service Registration Number (CASRN) and matching constituent name. The remainder could not be identified either because of trade secret labeling (210) or because of an invalid CASRN (12). Eleven public databases were searched for health hazard information on thirteen health hazard endpoints for 168 identifiable constituents that had at least 25 reports of use. Health hazard counts were generated for chronic and acute endpoints, including those associated with oral, inhalation, ocular, and dermal exposure. Eleven of the constituents listed in the top 30 by total health hazard count were also listed in the top 30 by reports of use. This includes naphthalene, which along with benzyl chloride, has the highest health hazard count. The top 25 constituents reportedly used in North Dakota largely overlap with those reported for Texas and Pennsylvania, despite different geologic formations, target resources (oil vs. gas), and disclosure requirements

  12. Estimated effect of ventilation and filtration on chronic health risks in U.S. offices, schools, and retail stores.

    Science.gov (United States)

    Chan, W R; Parthasarathy, S; Fisk, W J; McKone, T E

    2016-04-01

    We assessed the chronic health risks from inhalation exposure to volatile organic compounds (VOCs) and particulate matter (PM2.5) in U.S. offices, schools, grocery, and other retail stores and evaluated how chronic health risks were affected by changes in ventilation rates and air filtration efficiency. Representative concentrations of VOCs and PM2.5 were obtained from available data. Using a mass balance model, changes in exposure to VOCs and PM2.5 were predicted if ventilation rate were to increase or decrease by a factor of two, and if higher efficiency air filters were used. Indoor concentrations were compared to health guidelines to estimate percentage exceedances. The estimated chronic health risks associated with VOC and PM2.5 exposures in these buildings were low relative to the risks from exposures in homes. Chronic health risks were driven primarily by exposures to PM2.5 that were evaluated using disease incidence of mortality, chronic bronchitis, and non-fatal stroke. The leading cancer risk factor was exposure to formaldehyde. Using disability-adjusted life years (DALYs) to account for both cancer and non-cancer effects, results suggest that increasing ventilation alone is ineffective at reducing chronic health burdens. Other strategies, such as pollutant source control and the use of particle filtration, should also be considered. PMID:25639183

  13. Establishment of health clinics as mass screening and referral systems for chronic non-communicable diseases in primary health care

    Directory of Open Access Journals (Sweden)

    Kamal Heidari

    2012-01-01

    Full Text Available Background: This study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases (CNCD in the routine primary health care, and to determine the prevalence of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. Methods: This survey was conducted from March 2010, and the current paper presents data obtained until November 2011. To provide health services for prevention and control of CNCDs, with priority of type2 diabetes mellitus, Health clinics were established in different parts of Isfahan city with a population of approximately 2,100,000 in Iran. The general populations aged 30 years and above were invited to the Health clinics by public announcement. Results: A total of 198972 participants were screened. The mean age of participants was 47.8 years (48.5 men, 47.3 women, with a range of 1 to 95 years old and standard deviation of 12.3 years (12.7 men, 12.1 women. Overall, 22% of participants had impaired fasting glucose, 25% had hypercholesterolemia, 31% had hypertriglyceridemia, and 20% had metabolic syndrome. Conclusion: The high prevalence of dysglycemia and diabetes in our survey may serve as confirmatory evidence about the importance of mass screening and early diagnosis of CNCDs′ risk factors. Our model of establishing Health clinics, as a comprehensive referral system in the routine primary health care can be adopted by Middle Eastern countries, where CNCDs notably diabetes are an emerging health problem.

  14. Tapentadol in the management of chronic low back pain: a novel approach to a complex condition?

    Directory of Open Access Journals (Sweden)

    Pergolizzi J

    2011-07-01

    Full Text Available Joseph Pergolizzi1, Eli Alon2, Ralf Baron3, Cesare Bonezzi4, Jan Dobrogowski5, Rafael Gálvez6, Troels Jensen7, Hans-Georg Kress8, Marco AE Marcus9, Bart Morlion10, Serge Perrot11, Rolf-Detlef Treede121Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Universitätsspital Zurich, Switzerland; 3Universitätsklinikum Schleswig-Holstein, Kiel, Germany; 4Fondazione Salvatore Maugeri, Pavia, Italy; 5Zaklad Badania i Leczenia Bólu, Kraków, Poland; 6Hospital Universitario Virgen de las Nieves, Granada, Spain; 7Aarhus University, Denmark; 8Medical University of Vienna, Austria; 9Maastricht University Medical Center and University of Muenster, Maastricht, The Netherlands; 10University Hospitals Leuven, Belgium; 11Hôpital Dieu, Paris, France; 12Ruprecht-Karls-University, Heidelberg, GermanyAbstract: Chronic pain affects approximately 1 in 5 people in Europe, and around half of sufferers receive inadequate pain management. The most common location is the lower back. Pharmacological treatment of this condition is challenging because of the range of causative mechanisms and the difficulty of balancing analgesic efficacy and tolerability. An international panel of clinical pain specialists met in September, 2009, to discuss the treatment of chronic low back pain, and to review preclinical and clinical data relating to the new analgesic, tapentadol. A lack of consensus exists on the best treatment for low back pain. The range of regularly prescribed pharmacological agents extends from nonopioids (paracetamol, NSAIDs, and COX-2 inhibitors to opioids, antidepressants and anticonvulsants. Pain relief may be compromised, however, by an undetected neuropathic component or intolerable side effects. Treatment is potentially life-long and effective analgesics are urgently needed, with demonstrable long-term safety. Combining separate agents with different mechanisms of action could overcome the limitations of present

  15. Abnormal endogenous pain modulation is a shared characteristic of many chronic pain conditions

    OpenAIRE

    Staud, Roland

    2012-01-01

    The intensity of acute and chronic pain depends on interactions between peripheral impulse input and CNS pain mechanisms, including facilitation and inhibition. Whereas tonic pain inhibition is a characteristic of most pain-free individuals, pain facilitation can be detected in many chronic pain patients. The capability to inhibit pain is normally distributed along a wide continuum in the general population and can be used to predict chronic pain. Accumulating evidence suggests that endogenou...

  16. Person-Centered Care for Older Adults with Chronic Conditions and Functional Impairment: A Systematic Literature Review.

    Science.gov (United States)

    Kogan, Alexis Coulourides; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    Person-centered care (PCC) shifts focus away from the traditional biomedical model in favor of embracing personal choice and autonomy for people receiving health services. It has become an important avenue for improving primary care, and older adults remain a priority target for PCC because they are more likely to have complex care needs than younger individuals. Nevertheless, despite a growing body of evidence regarding its use, PCC still lacks an agreed-upon definition. A literature review was conducted to explore extant scholarship on PCC for older adults, assess corresponding definitions of PCC, and identify important elements of quality PCC. Nearly 3,000 articles published between 1990 and 2014 were identified. Excluding search results outside the parameters of this study, the final review comprised 132 nonduplicate sources focused on patient-centered care or PCC in older adults. Fifteen descriptions of PCC were identified, addressing 17 central principles or values. The six most-prominent domains of PCC were holistic or whole-person care, respect and value, choice, dignity, self-determination, and purposeful living. The body of evidence reviewed suggests that PCC is an important area of growing interest. Although multiple definitions and elements of PCC abound-with many commonalities and some overlap-the field would benefit from a consensus definition and list of essential elements to clarify how to operationalize a PCC approach to health care and services for older adults. This work guided the development of a separate American Geriatrics Society expert panel statement presenting a standardized definition and a list of PCC elements for older adults with chronic conditions or functional impairment. PMID:26626408

  17. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    OpenAIRE

    Mashayekhi, A.; Ahmadi, M; Ramezani, N.; R. Ahmadi; Seraj, B.

    2011-01-01

    Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Having knowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic ...

  18. Romanian People’s Health Condition in Relation to Nutrition Quality

    OpenAIRE

    Constandache Mihaela; Stanciu Anca-Cristina; Condrea Elena

    2012-01-01

    The standard measurement of health systems from the European states based on Euro Health Consumer Index revealed the fact that Romania is situated among the last places in Europe, also being registered a continuous depreciation of the health system during the last years. In Romania, the morbidity and mortality models have suffered important modifications lately, in the sense of an increasing prevalence of chronic diseases and mortality due to these causes, in the context of the increasing sha...

  19. Chronic obstructive pulmonary disease involves substantial health-care service and social benefit costs

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Fenger-Grøn, Morten; Fonager, Kirsten;

    2013-01-01

    cohort study performed in Denmark during 2004-2006 were linked with national register data that identified the costs of social benefits and health-care services. The cohort comprised 546 participants with COPD (forced expiratory volume in the first sec. (FEV1)/forced vital capacity (FVC) ratio < 0.......7 following bronchodilator administration] and 3,995 without COPD (in addition, 9,435 invited participants were non-responders and 331 were excluded). The costs were adjusted for gender, age, co-morbidity and educational level. RESULTS: Health care-related costs were 4,779 (2,404- 7,154) Danish kroner (DKK......) higher for participants with COPD than for those without COPD, and 2,882 (556-5,208) DKK higher than for those for non-responders. The higher costs were mainly due to the cost of medicines and inpatient care. The health-care costs increased with disease severity Global Initiative for Chronic Obstructive...

  20. Peer victimization and subjective health among students reporting disability or chronic illness in 11 Western countries

    DEFF Research Database (Denmark)

    Sentenac, Mariane; Gavin, Aoife; Nic Gabhainn, Saoirse;

    2013-01-01

    BACKGROUND: To compare the strength of the association between peer victimization at school and subjective health according to the disability or chronic illness (D/CI) status of students across countries. METHODS: This study used data from 55 030 students aged 11, 13 and 15 years from 11 countries...... participating in the 2005-06 Health Behaviour in School-aged Children survey. Self-completed questionnaires were administered in classrooms. Multivariate models of logistic regression (controlled for confounding factors and countries) were used to investigate differences in the association between peer...... victimization and poor subjective health according to the D/CI status. RESULTS: Overall, 13.5% of the students reported having been bullied at least two or three times a month. The percentage of victims was significantly higher among those reporting D/CI than among others in all countries studied. Victims of...

  1. Health Related Quality of Life of Chronic Liver Patients: A Dutch Population-Based Study

    NARCIS (Netherlands)

    S.M. van der Plas (Simone)

    2004-01-01

    markdownabstract__Abstract__ Chronic illnesses form a spectrum of diseases. Some chronic illnesses are poorly understood and unpredictable, some are understood and manageable, some are progressively disabling and some are life threatening. Nevertheless, for all chronic patients chronic illnesses ha

  2. Demographic shifts in health conditions of adolescents 10-19 years, Jamaica: using cross-sectional data for 2002 and 2007

    Directory of Open Access Journals (Sweden)

    Paul A. Bourne

    2009-08-01

    Full Text Available Background: It is well established in health literature that most adolescents have good health, but this does not mitigate the reality that there are some who are living with chronic and other health conditions. Aims: To examine the demographic shifts in health conditions and the typology of health conditions experienced by this age cohort. Materials and Method: The current study extracted a sample of 5,229 and 1,394 for adolescents 10-19 years from two surveys collected jointly by the Planning Institute of Jamaica and the Statistical Institute of Jamaica for 2002 and 2007 respectively. The survey was drawn using stratified random sampling. The sample was weighted to reflect the population of the nation. Descriptive statistics and chi-square were used in this study. The level of significance used in this research was 5% (i.e. 95% confidence interval. Results: In 2002, most of respondents had cold (28.3% and in 2007, this shifted to unspecified health conditions (35.5%. The number of reported cases of arthritis in adolescents was 0.4%, in 2002, which fell by 100% in 2007 whereas increases were observed for unspecified conditions, 42%; hypertension, 175%; and diabetes mellitus, 700%. Conclusions: There is an immediate need for health promotion and education campaigns geared towards the sensitization of adolescents about the rise in chronic illness, its challenges, lifestyle practices and willingness to seek care if particular symptoms are presently affecting them.

  3. Demographic shifts in health conditions of adolescents 10-19 years, Jamaica: Using cross-sectional data for 2002 and 2007

    Directory of Open Access Journals (Sweden)

    Paul A Bourne

    2009-01-01

    Full Text Available Background: It is well established in health literature that most adolescents have good health, but this does not mitigate the reality that there are some who are living with chronic and other health conditions. Aims: To examine the demographic shifts in health conditions and the typology of health conditions experienced by this age cohort. Materials and Method: The current study extracted a sample of 5,229 and 1,394 for adolescents 10-19 years from two surveys collected jointly by the Planning Institute of Jamaica and the Statistical Institute of Jamaica for 2002 and 2007 respectively. The survey was drawn using stratified random sampling. The sample was weighted to reflect the population of the nation. Descriptive statistics and chi-square were used in this study. The level of significance used in this research was 5% (i.e. 95% confidence interval. Results: In 2002, most of respondents had cold (28.3% and in 2007, this shifted to unspecified health conditions (35.5%. The number of reported cases of arthritis in adolescents was 0.4%, in 2002, which fell by 100% in 2007 whereas increases were observed for unspecified conditions, 42%; hypertension, 175%; and diabetes mellitus, 700%. Conclusions: There is an immediate need for health promotion and education campaigns geared towards the sensitization of adolescents about the rise in chronic illness, its challenges, lifestyle practices and willingness to seek care if particular symptoms are presently affecting them. (Bourne PA.

  4. [Chronic diseases as a priority for the public health surveillance system in Spain].

    Science.gov (United States)

    Mayoral Cortes, José María; Aragonés Sanz, Nuria; Godoy, Pere; Sierra Moros, María José; Cano Portero, Rosa; González Moran, Francisco; Pousa Ortega, Ánxela

    2016-01-01

    At present, epidemiological surveillance in Spain remains focused on the communicable diseases included in the list of notifiable diseases. However, there has been a change in epidemiological pattern that predominated until the last few decades of the twentieth century. Infectious diseases, which used to be the leading causes of morbidity and mortality, have given way to a predominance of chronic diseases. In this regard, progress has been made in the drafting and adoption of specific legal regulations on public health monitoring. However, Spain has yet to develop this legislation which, among other elements, includes the mandate to organize the surveillance of non-communicable diseases in Spain. This article aims to describe some points that should be considered in the development of a national surveillance system linked to existing strategies for the prevention and control of chronic diseases. PMID:26832857

  5. Understanding and benchmarking health service achievement of policy goals for chronic disease

    Directory of Open Access Journals (Sweden)

    Bell Erica

    2012-09-01

    Full Text Available Abstract Background Key challenges in benchmarking health service achievement of policy goals in areas such as chronic disease are: 1 developing indicators and understanding how policy goals might work as indicators of service performance; 2 developing methods for economically collecting and reporting stakeholder perceptions; 3 combining and sharing data about the performance of organizations; 4 interpreting outcome measures; 5 obtaining actionable benchmarking information. This study aimed to explore how a new Boolean-based small-N method from the social sciences—Qualitative Comparative Analysis or QCA—could contribute to meeting these internationally shared challenges. Methods A ‘multi-value QCA’ (MVQCA analysis was conducted of data from 24 senior staff at 17 randomly selected services for chronic disease, who provided perceptions of 1 whether government health services were improving their achievement of a set of statewide policy goals for chronic disease and 2 the efficacy of state health office actions in influencing this improvement. The analysis produced summaries of configurations of perceived service improvements. Results Most respondents observed improvements in most areas but uniformly good improvements across services were not perceived as happening (regardless of whether respondents identified a state health office contribution to that improvement. The sentinel policy goal of using evidence to develop service practice was not achieved at all in four services and appears to be reliant on other kinds of service improvements happening. Conclusions The QCA method suggested theoretically plausible findings and an approach that with further development could help meet the five benchmarking challenges. In particular, it suggests that achievement of one policy goal may be reliant on achievement of another goal in complex ways that the literature has not yet fully accommodated but which could help prioritize policy goals. The

  6. Childhood Trauma and Chronic Illness in Adulthood: Mental Health and Socioeconomic Status as Explanatory Factors and Buffers

    OpenAIRE

    Mock, Steven E.; Arai, Susan M.

    2011-01-01

    Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typic...

  7. New estimates of racial/ethnic differences in life expectancy with chronic morbidity and functional loss: evidence from the National Health Interview Survey.

    Science.gov (United States)

    Cantu, Phillip A; Hayward, Mark D; Hummer, Robert A; Chiu, Chi-Tsun

    2013-09-01

    This study documents the mortality, chronic morbidity and physical functioning experiences of U.S. Hispanics, non-Hispanic whites, and non-Hispanic blacks 50 years of age and older in the United States. Hispanics are classified by nativity to better assess an important source of heterogeneity in population health within that population. Drawing on mortality and morbidity data from the National Health Interview Survey, demographic models of healthy life expectancy are used to derive estimates of life expectancy, life expectancy with and without chronic morbidity conditions, and life expectancy with and without functional limitations. The results not only highlight the mortality advantages of foreign-born Hispanics, but also document their health advantages in terms of morbidity and physical functioning beyond age 50. Nativity is a highly important factor differentiating the health and mortality experiences of Hispanics: U.S.-born Hispanics have a health profile more indicative of their minority status while foreign-born Hispanics have much more favorable mortality and health profiles. Differences in smoking across racial/ethnic/nativity groups is suggested as an important reason behind the apparent health advantages of foreign-born Hispanics relative to whites as well as relative to their U.S.-born counterparts. PMID:23949255

  8. Social and economic determinants of pediatric health inequalities: the model of chronic kidney disease.

    Science.gov (United States)

    Sereni, Fabio; Edefonti, Alberto; Lepore, Marta; Agostoni, Carlo; Sandoval Diaz, Mabel; Silva Galan, Yajaira; Montini, Giovanni; Tognoni, Gianni

    2016-01-01

    Purpose of this review is to deal with priorities and strategies to significantly tackle inequalities in the management of pediatric diseases in low-middle-income countries. This issue has become a focal point of epidemiological and public health, with special reference to chronic nontransmissible diseases. We will provide our readership with an essential overview of the cultural, institutional, and political events, which have occurred over the last 20 y and which have produced the current general framework for epidemiology and public health. Then the most recent epidemiological data will be evaluated, in order to quantify the interaction between the medical components of the disease profiles and their socioeconomic determinants. Finally, a focus will be added on models of pediatric chronic kidney diseases, which are in our opinion amongst the most sensitive markers of the interplay between health and society. Collaborative, pediatrician-initiated, multicentre projects in these fields should be given priority in calls for grants supported by public agencies. The involvement of a critical mass of those working in the "fringes" of pediatric care is a final, essential mean by which significant results can be produced under the sole responsibility and research interest of centers of excellence. PMID:26466076

  9. Health outcomes of children born to mothers with chronic kidney disease: a pilot study

    Directory of Open Access Journals (Sweden)

    Indrani Banerjee

    2010-05-01

    Full Text Available This study aimed to study the health of children born to mothers with chronic kidney disease. Twenty-four children born to mothers with chronic kidney disease were compared with 39 matched control children born to healthy mothers without kidney disease. The well-being of each child was individually assessed in terms of physical health, neurodevelopment and psychological health. Families participating with renal disease were more likely to be from lower socio-economic backgrounds. Significantly fewer vaginal deliveries were reported for mothers with renal disease and their infants were more likely to experience neonatal morbidity. Study and control children were comparable for growth parameters and neurodevelopment as assessed by the Griffiths scales. There was no evidence of more stress amongst mothers with renal disease or of impaired bonding between mother and child when compared to controls. However, there was evidence of greater externalizing behavioral problems in the group of children born to mothers with renal disease. Engaging families in such studies is challenging. Nonetheless, families who participated appreciated being asked. The children were apparently healthy but there was evidence in this small study of significant antenatal and perinatal morbidity compared to controls. Future larger multi-center studies are required to confirm these early findings.

  10. Chronic health effects of sulphur mustard exposure with special reference to Iranian veterans

    Directory of Open Access Journals (Sweden)

    B Balali-Mood

    2008-01-01

    Full Text Available The widespread use of sulphur mustard (SM as an incapacitating chemical warfare agent in the past century has proved its long-lasting toxic effects. It may also be used as a chemical terrorist agent. Therefore, all health professionals should have sufficient knowledge and be prepared for any such chemical attack. SM exerts direct toxic effects on the eyes, skin, and respiratory tissue, with subsequent systemic action on the nervous, immunological, haematological, digestive, and reproductive systems. SM is an alkylating agent that affects DNA synthesis, and, thus, delayed complications have been seen since the First World War. Cases of malignancies in the target organs, particularly in haematopoietic, respiratory, and digestive systems, have been reported. Important delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate with time. Severe dry skin, delayed keratitis, and reduction of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of SM intoxication. However, despite a lot of research over the past decades on Iranian veterans, there are still major gaps in the SM literature. Immunological and neurological dysfunction, as well as the relationship between SM exposure and mutagenicity, carcinogenicity, and teratogenicity are important fields that require further studies, particularly on Iranian veterans with chronic health effects of SM poisoning. There is also a paucity of information on the medical management of acute and delayed toxic effects of SM poisoning—a subject that greatly challenges health care specialists.

  11. Mental health and quality of life in patients with chronic otitis media.

    Science.gov (United States)

    Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk

    2013-02-01

    The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p depression (p social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests. PMID:22566178

  12. Health risks of chronic moderate and heavy alcohol consumption: how much is too much?

    Science.gov (United States)

    Meyerhoff, Dieter J; Bode, Christiane; Nixon, Sara Jo; de Bruin, Eveline A; Bode, J Christian; Seitz, Helmut K

    2005-07-01

    This article presents the proceedings of a symposium held at the meeting of the International Society for Biomedical Research on Alcoholism (ISBRA) in Mannheim, Germany, in October 2004. Most of what we know about the deleterious effects of alcohol in vivo has been gleaned from studies in sober alcoholics recruited from substance abuse treatment programs. Little is known about effects of chronic drinking in the moderate or heavy range encountered in a much larger fraction of modern society. Extrapolation of information on the adverse effects of chronic drinking on organ function from clinical samples to social drinkers in the general population has to be met with great skepticism, as it may lead to wrong conclusions about the chronic effects of alcohol in social drinkers. Several recent studies suggest that moderate alcohol consumption has certain beneficial health effects, whereas heavy social alcohol consumption has recently been associated with organ abnormalities and cognitive deficits. These social drinking effects have attracted great public interest; reports of benefits of moderate drinking have also inspired inappropriate publications by the media, including misleading advertisements by the alcohol producing and distributing industry. Although adverse effects of moderate to heavy drinking on heart, liver, and cancer development have attracted attention by clinicians and researchers for some time, its compromising effects on brain and cognition have only recently been studied. This symposium brought together researchers from different disciplines, who reviewed and presented new data on consequences of social drinking in the areas of clinical neuropsychology and behavior (Drs. Nixon and Meyerhoff), neurophysiology (Dr. Nixon, Ms. De Bruin), neuroimaging (Ms. de Bruin, Dr. Meyerhoff), hepatic disease (Dr. Bode), and cancer (Dr. Seitz). The symposium aimed to clarify both the potential health benefits of moderate alcohol consumption and risks of moderate and

  13. Modelling population-level consequences of chronic external gamma irradiation in aquatic invertebrates under laboratory conditions

    International Nuclear Information System (INIS)

    We modelled population-level consequences of chronic external gamma irradiation in aquatic invertebrates under laboratory conditions. We used Leslie matrices to combine life-history characteristics (duration of life stages, survival and fecundity rates) and dose rate-response curves for hatching, survival and reproduction fitted on effect data from the FREDERICA database. Changes in net reproductive rate R0 (offspring per individual) and asymptotic population growth rate λ (dimensionless) were calculated over a range of dose rates in two marine polychaetes (Neanthes arenaceodentata and Ophryotrocha diadema) and a freshwater gastropod (Physa heterostropha). Sensitivities in R0 and λ to changes in life-history traits were analysed in each species. Results showed that fecundity has the strongest influence on R0. A delay in age at first reproduction is most critical for λ independent of the species. Fast growing species were proportionally more sensitive to changes in individual endpoints than slow growing species. Reduction of 10% in population λ were predicted at dose rates of 6918, 5012 and 74,131 μGy·h−1 in N. arenaceodentata, O. diadema and P. heterostropha respectively, resulting from a combination of strong effects on several individual endpoints in each species. These observations made 10%-reduction in λ a poor criterion for population protection. The lowest significant changes in R0 and λ were respectively predicted at a same dose rate of 1412 μGy h−1 in N. arenaceodentata, at 760 and 716 μGy h−1 in O. diadema and at 12,767 and 13,759 μGy h−1 in P. heterostropha. These values resulted from a combination of slight but significant changes in several measured endpoints and were lower than effective dose rates calculated for the individual level in O. diadema and P. heterostropha. The relevance of the experimental dataset (external irradiation rather than contamination, exposure over one generation only, effects on survival and reproduction only

  14. Assessment of the quality and variability of health information on chronic pain websites using the DISCERN instrument

    Directory of Open Access Journals (Sweden)

    Buckley Norman

    2010-10-01

    Full Text Available Abstract Background The Internet is used increasingly by providers as a tool for disseminating pain-related health information and by patients as a resource about health conditions and treatment options. However, health information on the Internet remains unregulated and varies in quality, accuracy and readability. The objective of this study was to determine the quality of pain websites, and explain variability in quality and readability between pain websites. Methods Five key terms (pain, chronic pain, back pain, arthritis, and fibromyalgia were entered into the Google, Yahoo and MSN search engines. Websites were assessed using the DISCERN instrument as a quality index. Grade level readability ratings were assessed using the Flesch-Kincaid Readability Algorithm. Univariate (using alpha = 0.20 and multivariable regression (using alpha = 0.05 analyses were used to explain the variability in DISCERN scores and grade level readability using potential for commercial gain, health related seals of approval, language(s and multimedia features as independent variables. Results A total of 300 websites were assessed, 21 excluded in accordance with the exclusion criteria and 110 duplicate websites, leaving 161 unique sites. About 6.8% (11/161 websites of the websites offered patients' commercial products for their pain condition, 36.0% (58/161 websites had a health related seal of approval, 75.8% (122/161 websites presented information in English only and 40.4% (65/161 websites offered an interactive multimedia experience. In assessing the quality of the unique websites, of a maximum score of 80, the overall average DISCERN Score was 55.9 (13.6 and readability (grade level of 10.9 (3.9. The multivariable regressions demonstrated that website seals of approval (P = 0.015 and potential for commercial gain (P = 0.189 were contributing factors to higher DISCERN scores, while seals of approval (P = 0.168 and interactive multimedia (P = 0.244 contributed to

  15. Health-related quality of life of Southern Chinese with chronic hepatitis B infection

    Directory of Open Access Journals (Sweden)

    Lam Elegance TP

    2009-06-01

    Full Text Available Abstract Background Few studies have evaluated the health-related quality of life (HRQOL of Southern Chinese with chronic hepatitis B (CHB infection. Aim To evaluate the HRQOL of Chinese patients at different stages of CHB infection and to find out factors associated with HRQOL. Methods 520 Chinese adult CHB patients of whom 156 were uncomplicated, 102 had impaired liver function, 139 had cirrhosis and 123 had hepatocellular carcinoma (HCC were interviewed with a structured questionnaire, the SF-36 Health Survey version 2 (SF-36v2, and the Chronic Liver Disease Questionnaire (CLDQ. The differences in SF-6D health preference values and SF-36v2 scores between each CHB group and Hong Kong population norms were assessed by t-test. ANOVA was used to compare the mean SF-6D health preference, SF-36v2 scores, and CLDQ scores among CHB groups. Multiple linear regressions were performed to identify determinants of HRQOL. Results CHB patients had significantly lower SF-36v2 scores than the population norm. The SF-6D values of CHB patients with uncomplicated disease, impaired liver function, HCC and cirrhosis were 0.755, 0.745, 0.720 and 0.701, respectively, all significantly lower than the population norm of 0.787. Advanced stage of CHB illness, anti-viral treatment, bilirubin level, psychological co-morbidity, younger age and female were associated with poorer HRQOL. Conclusion CHB infection had a negative impact on HRQOL. There was a progressive decrease in health preference values with CHB disease progression. The results can be used for the estimation of quality adjusted life years (QALYs for CHB patients in cost effectiveness or cost utility studies. Trial Registration http://www.hkclinicaltrials.com; HKCTR-151.

  16. Chronic psychosocial stress causes delayed extinction and exacerbates reinstatement of ethanol-induced conditioned place preference in mice

    OpenAIRE

    Bahi, Amine; Dreyer, Jean-luc

    2014-01-01

    Objective: Here, we examined the impact of chronic subordinate colony (CSC) exposure on EtOH-CPP extinction, as well as ethanol-induced reinstatement of CPP.Methods: Mice were conditioned with saline or 1.5 g/kg ethanol and were tested in the EtOH-CPP model. In the first experiment, the mice were subjected to 19 days of chronic stress, and EtOH-CPP extinction was assessed during seven daily trials without ethanol injection. In the second experiment and after the EtOH-CPP test, the mice were s...

  17. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pelle, Aline J; Smith, Otto R F; Widdershoven, Jos W; Hendriks, Eric H; Pedersen, Susanne S.

    2009-01-01

    Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF....

  18. Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management.

    NARCIS (Netherlands)

    Heijmans, M.; Waverijn, G.; Rademakers, J.; Vaart, R. van der; Rijken, M.

    2015-01-01

    Objective: To provide insight into the level of health literacy among chronic disease patients in the Netherlands, to identify subgroups with low literacy and to examine the associations between health literacy and self-management. Methods: Self-report questionnaires were sent to a nationwide sample

  19. Improvement in health status following cough-suppression physiotherapy for patients with chronic cough.

    Science.gov (United States)

    Patel, Amit S; Watkin, Gillian; Willig, Briony; Mutalithas, Kugathasan; Bellas, Helene; Garrod, Rachel; Pavord, Ian D; Birring, Surinder S

    2011-01-01

    Cough-suppression physiotherapy is a novel self-help therapy for chronic cough. We evaluated the effectiveness of cough physiotherapy in a pilot prospective observational study. We assessed cough-specific health-related quality of life (HRQOL) with the Leicester Cough Questionnaire (LCQ) and subjectively reported cough frequency and sleep disturbance in 23 patients with chronic cough refractory to medical therapy, before and after outpatient-based cough-suppression physiotherapy. Cough-suppression physiotherapy consisted of education, counselling, cough control, breathing retraining, and vocal hygiene. There was a significant improvement in cough-specific HRQOL after cough physiotherapy; mean (standard error of mean [SEM]) LCQ total score before 12.4 (0.9) versus after 15.1 (0.9); 95% confidence interval of difference -4.1 to -1.3; p , psychological (p < 0.001) and social (p < 0.04). There was a significant reduction in cough frequency scores (p = 0.002) and sleep disturbance scores (p = 0.02). Our findings suggest cough-suppression physiotherapy may lead to a clinically significant improvement in cough-specific HRQOL in patients with chronic cough. PMID:21990570

  20. Modernisation, smoking and chronic disease: Of temporality and spatiality in global health.

    Science.gov (United States)

    Reubi, David

    2016-05-01

    This article explores the spatio-temporal logics at work in global health. Influenced by ideas of time-space compression, the global health literature argues that the world is characterised by a convergence of disease patterns and biomedical knowledge. While not denying the influence of these temporalities and spatialities of globalisation within the global health and chronic disease field, the article argues that they sit alongside other, often-conflicting notions of time and space. To do so, it explores the spatio-temporal logics that underpin a highly influential epidemiological model of the smoking epidemic. Unlike the temporalities and spatialities of sameness described in much of the global health literature, the article shows that this model is articulated around temporalities and spatialities of difference. This is not the difference celebrated by postmoderns, but the difference of modernisation theorists built around nations, sequential stages and progress. Indeed, the model, in stark contrast to the 'one world, one time, one health' globalisation mantra, divides the world into nation-states and orders them along epidemiological, geographical and development lines. PMID:25956260

  1. [Integration of mental health and chronic non-communicable diseases in Peru: challenges and opportunities for primary care settings].

    Science.gov (United States)

    Diez-Canseco, Francisco; Ipince, Alessandra; Toyama, Mauricio; Benate-Galvez, Ysabel; Galán-Rodas, Edén; Medina-Verástegui, Julio César; Sánchez-Moreno, David; Araya, Ricardo; Miranda, J Jaime

    2014-01-01

    In this article, the relationship between mental health and chronic non-communicable diseases is discussed as well as the possibility to address them in a comprehensive manner in the Peruvian health system. First, the prevalence estimates and the burden of chronic non-communicable diseases and mental disorders worldwide and in Peru are reviewed. Then, the detrimental impact of depression in the early stages as well as the progress of diabetes and cardiovascular diseases is described. Additionally, the gap between access to mental health care in Peru is analyzed. Lastly, the alternatives to reduce the gap are explored. Of these alternatives, the integration of mental health into primary care services is emphasized; as a feasible way to meet the care needs of the general population, and people with chronic diseases in particular, in the Peruvian context. PMID:24718538

  2. How subchronic and chronic health effects can be neglected for GMOs, pesticides or chemicals.

    Science.gov (United States)

    Séralini, Gilles-Eric; de Vendômois, Joël Spiroux; Cellier, Dominique; Sultan, Charles; Buiatti, Marcello; Gallagher, Lou; Antoniou, Michael; Dronamraju, Krishna R

    2009-01-01

    Chronic health effects are increasing in the world such as cancers, hormonal, reproductive, nervous, or immune diseases, even in young people. During regulatory toxicological subchronic tests to prevent these on mammalian health, prior commercialization of chemicals, including pesticides and drugs, or GMOs, some statistically significant findings may be revealed. This discussion is about the need to investigate the relevant criteria to consider those as biologically significant. The sex differences and the non linear dose or time related effects should be considered in contrast to the claims of a Monsanto-supported expert panel about a GMO, the MON 863 Bt maize, but also for pesticides or drugs, in particular to reveal hormone-dependent diseases and first signs of toxicities. PMID:19584953

  3. How Subchronic and Chronic Health Effects can be Neglected for GMOs, Pesticides or Chemicals

    Directory of Open Access Journals (Sweden)

    Gilles-Eric Séralini, Joël Spiroux de Vendômois, Dominique Cellier, Charles Sultan, Marcello Buiatti, Lou Gallagher, Michael Antoniou, Krishna R. Dronamraju

    2009-01-01

    Full Text Available Chronic health effects are increasing in the world such as cancers, hormonal, reproductive, nervous, or immune diseases, even in young people. During regulatory toxicological subchronic tests to prevent these on mammalian health, prior commercialization of chemicals, including pesticides and drugs, or GMOs, some statistically significant findings may be revealed. This discussion is about the need to investigate the relevant criteria to consider those as biologically significant. The sex differences and the non linear dose or time related effects should be considered in contrast to the claims of a Monsanto-supported expert panel about a GMO, the MON 863 Bt maize, but also for pesticides or drugs, in particular to reveal hormone-dependent diseases and first signs of toxicities.

  4. Chlorophyll and pheophytin content in needles of different age of trees growing under conditions of chronic industrial pollution

    Directory of Open Access Journals (Sweden)

    Teresa Gowin

    2015-05-01

    Full Text Available Chlorophyll and pheophytin content was determined by means of Vernon method (Vernon, 1960 in needles of different age. Needles of Pinus strobus L., Pinus nigra Arnd., Pinus silvestris L., and Pseudotsuga menziesii Franco growing under conditions of chronic industrial pollution as well as under unpolluted conditions were examined. High pheophytin content was found in needles of trees growing under the conditions of chronic pollution. The youngest needles always showed the highest pheophytin content' as related to Chlorophyll content. The examined species showed different degree of Chlorophyll decomposition under the influence of polluted environment. Trees growing under control environment showed small and similar amounts of pheophytin in needles of different age. Pheophytin content does not seem to be a convenient indicator to test the effect of pollution before visual symptoms occur, since the method is very labourious and plant material very variable.

  5. Standard practice for labeling ceramic art materials for chronic adverse health hazards

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This practice describes a procedure for developing precautionary labels for ceramic art materials and provides hazard and precautionary statements based upon knowledge that exists in the scientific and medical communities. This practice concerns those chronic adverse health hazards known to be associated with a product or product component(s), when the component(s) is present in a physical form, volume, or concentration that in the opinion of a toxicologist has the potential to produce a chronic adverse health effect(s). 1.2 This practice is intended to apply exclusively to ceramic art materials which are packaged in sizes intended for use by artists or crafts people, either individually, or in a small group or class. 1.3 This practice applies to developing precautionary labeling for ceramic art materials intended for adult usage. Conformance to this practice does not imply that ceramic art materials will necessarily be labeled adequately or safe for use by children. Labeling determinations should cons...

  6. Combined effect of the environmental factors as ionizing radiation and a chronic iodine deficiency on the thyroid gland and the immune condition

    International Nuclear Information System (INIS)

    The Semipalatinsk Test Site was the primary testing venue for the Soviet Union's nuclear weapons. It is located on the steppe in northeast Kazakhstan. The tragic situation of the Semipalatinsk region is an acute and chronic radiation, repeated in big and small doses and a total absence of territorial decontamination, created unique conditions for study of the long term influence of the radiation doses on the health of the population. The Semipalatinsk region of the Republic of Kazakhstan belongs also to an area of moderate and pronounced iodine deficiency. The purpose of the research is to study the prevalence of a thyroid gland pathology and the condition of a cytokine immune link that is likely to be influenced by a combine effect of ionizing radiation and a chronic iodine deficiency. 1100 people passed through the investigation and it appears that 56, 75% of them had a thyroid pathology. Thyroid gland functional condition analysis (TSH, FT3, FT4 a-TG, a-TPO) has shown the prevalence of a subclinical hypothyroidism (33%). 28, 8% resulted in the presence of antibodies to thyroglobulin and the thyroid peroxides, whereas in the areas located further to the nuclear range, the percentage was only 13, 0%

  7. Combined effect of the environmental factors as ionizing radiation and a chronic iodine deficiency on the thyroid gland and the immune condition

    Energy Technology Data Exchange (ETDEWEB)

    Danyarova, L. [Department of Endocrynology, Research Institute of Cardiology and Internal Medicine, Almaty (Kazakhstan)

    2012-07-01

    The Semipalatinsk Test Site was the primary testing venue for the Soviet Union's nuclear weapons. It is located on the steppe in northeast Kazakhstan. The tragic situation of the Semipalatinsk region is an acute and chronic radiation, repeated in big and small doses and a total absence of territorial decontamination, created unique conditions for study of the long term influence of the radiation doses on the health of the population. The Semipalatinsk region of the Republic of Kazakhstan belongs also to an area of moderate and pronounced iodine deficiency. The purpose of the research is to study the prevalence of a thyroid gland pathology and the condition of a cytokine immune link that is likely to be influenced by a combine effect of ionizing radiation and a chronic iodine deficiency. 1100 people passed through the investigation and it appears that 56, 75% of them had a thyroid pathology. Thyroid gland functional condition analysis (TSH, FT3, FT4 a-TG, a-TPO) has shown the prevalence of a subclinical hypothyroidism (33%). 28, 8% resulted in the presence of antibodies to thyroglobulin and the thyroid peroxides, whereas in the areas located further to the nuclear range, the percentage was only 13, 0%

  8. [Health and social inequality in Europe: changes of the basic conditions for municipal health services].

    Science.gov (United States)

    Huster, E U

    1998-11-01

    Good health is not distributed equally, neither in life conditions--including the individual ability to act--nor according to the supply grid. These interrelations, shown in several empirical investigations, assume more importance in view of the groving tendency to social polarisation in the countries of Europe, different in fact in the single countries, but clear in respect of tendency: social exclusion does not only mean to have less financial resources but also social disadvantages in other realms of living, especially in health. Migration, not only from East to West, but also inside and between the countries of the European Union and inside of Eastern Europe too, is only an especially dear expression that social problems have their origin in international problems and casualities, but become visible in local and regional structures and thus in the responsibility of the municipalities. Globalisation, Europe etc., terms mostly connected with positive connotations, have not only a positive side, but also another one, namely, the re-regionalisation of social problems especially in the municipalities. Normally the municipalities have to counterbalance and to regulate the negative consequences of these European--and moreover international--changes of the structures, although their financial means are declining. The municipal health service is integrated in this contradictory constellation. To prevent irrational social and/or political developments, the reasons and possible strategies of reform policy will have to be discussed carefully. PMID:9889465

  9. The Health Impact of Urban Poor Housing and Environmental Conditions

    OpenAIRE

    Solon, Orville C.

    1989-01-01

    How does housing affect households’ health status? How does housing interact with other health inputs? What trade-offs exist between housing and medical care, housing and education and housing and nutrition? It is hoped that from this paper, other efforts towards the resolution of these questions shall be initiated.

  10. Training practitioners in evidence-based chronic disease prevention for global health.

    Science.gov (United States)

    Brownson, Ross C; Diem, Gunter; Grabauskas, Vilius; Legetic, Branka; Potemkina, Rimma; Shatchkute, Aushra; Baker, Elizabeth A; Campbell, Claudia R; Leet, Terry L; Nissinen, Aulikki; Siegel, Paul Z; Stachenko, Sylvie; True, William R; Waller, Michael

    2007-01-01

    Too often, public health decisions are based on short-term demands rather than long-term research and objectives. Policies and programmes are sometimes developed around anecdotal evidence. The Evidence-Based Public Health (EBPH) programme trains public health practitioners to use a comprehensive, scientific approach when developing and evaluating chronic disease programmes. Begun in 2002, the EBPH programme is an international collaboration. The course is organized in seven parts to teach skills in: 1) assessing a community's needs; 2) quantifying the issue; 3) developing a concise statement of the issue; 4) determining what is known about the issue by reviewing the scientific literature; 5) developing and prioritizing programme and policy options; 6) developing an action plan and implementing interventions; and 7) evaluating the programme or policy. The course takes an applied approach and emphasizes information that is readily available to busy practitioners, relying on experiential learning and includes lectures, practice exercises, and case studies. It focuses n using evidence-based tools and encourages participants to add to the evidence base in areas where intervention knowledge is sparse. Through this training programme, we educated practitioners from 38 countries in 4 continents. This article describes the evolution of the parent course and describes experiences implementing the course in the Russian Federation, Lithuania, and Chile. Lessons learned from replication of the course include the need to build a "critical mass" of public health officials trained in EBPH within each country and the importance of international, collaborative networks. Scientific and technologic advances provide unprecedented opportunities for public health professionals to enhance the practice of EBPH. To take full advantage of new technology and tools and to combat new health challenges, public health practitioners must continually improve their skills. PMID:18154226

  11. ACTIVATION MECHANISMS OF GUT-ASSOCIATED LYMPHOID TISSUE UNDER CHRONIC SOCIAL STRESS CONDITIONS

    Directory of Open Access Journals (Sweden)

    A. M. Kamyshnyi

    2015-01-01

    Full Text Available Stress-induced immune disregulation is a risk factor of autoimmune and inflammatory diseases, but, so far, the mechanisms for this effect are not fully known. Expression levels of specific mRNAs were assessed in gut-associated lymphoid tissue (GALT from Wistar rats subjected to chronic social stress (CSS. Gene expression was evaluated for NR3C1, Adrβ2, as well as IL-1β, IL-17α pro-inflammatory cytokines, and Nlrp, an inflammasome gene. Under the CSS conditions, we have shown altered distribution of RORγt +, FoxP3+, LMP2+, XBP1+ lymphocytes in GALT.The experiments were carried out with female Wistar rats aged 5–6 months. Specific mRNA expression for the target genes was determined by means of real-time PCR performed in a CFX96™ thermocycler («BioRadLaboratories, Inc»,USA. Relative levels of a target gene expression were quantified by the ΔΔCt method, being compared with rat GAPDH reference gene expression. Statistical analysis was performed with available «BioRad СFX Manager 3.1» software. Specific monoclonal rat antibodes were used for detection of immunopositive lymphocytes by means of indirect immunofluorescence technique.CSS development leads to decreased levels of mRNA expression for Nr3c1 and Adrβ2-genes in the GALT cells, being accompanied with unidirectional changes, i.e., increased transcription of pro-inflammatory cytokine mRNAs (IL-1β, IL-17α and Nlrp3-inflammasome genes. These changes are accompanied by decreased FoxP3+/RORγt + cell ratio and predominant Th17 differentiation accompanied by suppressor failure. In addition, CSS development was characterized by unidirectional tendency for increasing total number of LMP2+ lymphocytes and reduced ХВР1+ cell population density in lymphoid structures of rat ileum.The events observed in GALT cell populations under CSS conditions are opposing classical paradigm of the stress response. The CSS-associated effects do not promote immunosuppression, however, are able to cause

  12. Costs and epidemiological changes of chronic diseases: implications and challenges for health systems.

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    Full Text Available The need to integrate economic and epidemiological aspects in the clinical perspective leads to a proposal for the analysis of health disparities and to an evaluation of the health services and of the new challenges which are now being faced by health system reforms in middle income countries.To identify the epidemiological changes, the demand for health services and economic burden from chronic diseases (diabetes and hypertension in a middle income county.We conducted longitudinal analyses of costs and epidemiological changes for diabetes and hypertension in the Mexican health system. The study population included both the insured and uninsured populations. The cost-evaluation method was used, based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2014-2016, six models were constructed according to the Box-Jenkins technique, using confidence intervals of 95%, and the Box-Pierce test.Regarding epidemiological changes expected in both diseases for 2014 vs. 2016, an increase is expected, although results predict a greater increase for diabetes, 8-12% in all three studied institutions, (p < .05. Indeed, in the case of diabetes, the increase was 41469 cases for uninsured population (SSA and 65737 for the insured population (IMSS and ISSSTE. On hypertension cases the increase was 38109 for uninsured vs 62895 for insured. Costs in US$ ranged from $699 to $748 for annual case management per patient in the case of diabetes, and from $485 to $622 in patients with hypertension. Comparing financial consequences of health services required by insured and uninsured populations, the greater increase (23% will be for the insured population (p < .05. The financial requirements of both diseases will amount to 19.5% of the total budget for the uninsured and 12.5% for the insured population.If the risk factors and the different health care models remain as they currently are, the economic

  13. HealthDesk for Hemophilia: an interactive computer and communications system for chronic illness self-management.

    OpenAIRE

    Carl, F.; Gribble, T. J.

    1995-01-01

    HealthDesk for Hemophilia is an interactive computer software application designed on the premise that successful chronic illness self-management requires information, self-care skills, on-going communication with health care providers, and user-friendly record keeping. The software was pilot tested for six months in the homes of eight hemophilia patients. The purpose of the pilot was to assess the impact of HealthDesk for Hemophilia on patient satisfaction, patient-provider communication, an...

  14. Quality of Life and Mental Health Status Among Iranian Blue Workers With Self-Reported Chronic Low Back at 2015

    OpenAIRE

    Amir Bahrami-Ahmadi; Mashallah Aghilinejad; Mohammad Hassan Nassiri-Kashani; Negar Aghili; Narges Shahnaghi; Elaheh Kabir-Mokamelkhah

    2016-01-01

    Musculoskeletal disorders such as low back pain can cause a wide spectrum of chronic complications such as quality of life and general health impairment. Mental health is a wide spectrum of concepts that which those such as anxiety, depression or even quality of life had challengeable impacts on work related characters such as worker productivity, absensism. Present study was performed for evaluation of low back pain prevalence and its association with general health and quality of life statu...

  15. Apps and Adolescents: A Systematic Review of Adolescents’ Use of Mobile Phone and Tablet Apps That Support Personal Management of Their Chronic or Long-Term Physical Conditions

    Science.gov (United States)

    Fallon, Debbie; Hall, Andrew; McDonagh, Janet E; Stones, Simon R; Thomson, Wendy

    2015-01-01

    Background The prevalence of physical chronic or long-term conditions in adolescents aged 10-24 years is rising. Mobile phone and tablet mobile technologies featuring software program apps are widely used by these adolescents and their healthy peers for social networking or gaming. Apps are also used in health care to support personal condition management and they have considerable potential in this context. There is a growing body of literature on app use in health contexts, thereby making a systematic review of their effectiveness very timely. Objective To systematically review the literature on the effectiveness of mobile apps designed to support adolescents’ management of their physical chronic or long-term conditions. Methods We conducted a review of the English-language literature published since 2003 in five relevant bibliographical databases using key search terms. Two independent reviewers screened titles and abstracts using data extraction and quality assessment tools. Results The search returned 1120 hits. Of the 19 eligible full-text papers, four met our review criteria, reporting one pilot randomized controlled trial and three pretest/post-test studies. Samples ranged from 4 to 18 participants, with a combined sample of 46 participants. The apps reported were targeted at type 1 diabetes, asthma, and cancer. Two papers provided data for calculating effect size. Heterogeneity in terms of study design, reported outcomes, follow-up times, participants’ ages, and health conditions prevented meta-analyses. There was variation in whether adolescents received guidance in using the app or were solely responsible for navigating the app. Three studies reported some level of patient involvement in app design, development, and/or evaluation. Health professional involvement in the modelling stages of apps was reported in all studies, although it was not always clear whether specific clinical (as opposed to academic) expertise in working with adolescents was

  16. Associations between chronic conditions, body functions, activity limitations and participation restrictions: a cross-sectional approach in Spanish non-clinical populations

    Science.gov (United States)

    Rodríguez-Blázquez, Carmen; Damián, Javier; Andrés-Prado, María José; Almazán-Isla, Javier; Alcalde-Cabero, Enrique; Forjaz, Maria João; Castellote, Juan Manuel; González-Enríquez, Jesús; Martínez-Martín, Pablo; Comín, Magdalena; de Pedro-Cuesta, Jesús

    2016-01-01

    Objectives To analyse the relationships between chronic conditions, body functions, activity limitations and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) framework. Design A cross-sectional study. Setting 2 geographical areas in the Autonomous Region of Aragon, Spain, namely, a rural area, Cinco Villas, and an urban area in the city of Zaragoza. Participants 864 individuals selected by simple random sampling from the register of Social Security card holders, aged 50 years and over, positive to disability screening. Main outcome measures ICF Checklist—body function domains, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0, 36-item (WHODAS-36)) global scores and medical diagnoses (chronic conditions) from primary care records. Results Mild disability (WHODAS-36 level 5–24%) was present in 51.5% of the sample. In the adjusted ordinal regression model with WHODAS-36 as the dependent variable, disability was substantially associated with moderate-to-complete impairment in the following functions: mental, OR 212.8 (95% CI 72 to 628.9); neuromusculoskeletal, OR 44.8 (24.2 to 82.8); and sensory and pain, OR 6.3 (3.5 to 11.2). In the relationship between health conditions and body function impairments, the strongest links were seen for: dementia with mental functions, OR 50.6 (25.1 to 102.1); cerebrovascular disease with neuromusculoskeletal function, OR 5.8 (3.5 to 9.7); and chronic renal failure with sensory function and pain, OR 3.0 (1.49 to 6.4). Dementia, OR 8.1 (4.4 to 14.7) and cerebrovascular disease, OR 4.1 (2.7 to 6.4) were associated with WHODAS-36 scores. Conclusions Body functions are heterogeneously linked to limitations in activities and restrictions on participation, with the highest impact being due to mental and musculoskeletal functions. This may be relevant for disability assessment and intervention design, particularly if defined on a body function basis. Control of specific health

  17. Defensive coping and health-related quality of life in chronic kidney disease: a cross-sectional study

    OpenAIRE

    Ikonomou Margarita; Damigos Dimitrios; Skapinakis Petros; Kaltsouda Anna; Kalaitzidis Rigas; Mavreas Venetsanos; Siamopoulos Kostas C

    2011-01-01

    Abstract Background Coping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Little is known though about these associations in chronic kidney disease (CKD). The present study aimed to investigate the relationship of defensive coping and HRQL among patients in different CKD stages, after adjusting for psychological distress, sociodemographic and disease-related variables. Methods The sample consisted of 98 ...

  18. Prevalence of chronic complications of type 2 diabetes mellitus in a secondary health centre in Niger Delta, Nigeria

    OpenAIRE

    Ufuoma Chukwuani; Kester A. Digban; Godwin D. Yovwin; Ngozi J. Chukwuebuni

    2016-01-01

    Background: Type 2 diabetes mellitus (T2DM) in Nigeria is believed to rapidly be on the increase despite its awareness. Its related chronic complications is also expanding leading to reduction in the quality of life of patients, incurring heavy burdens to the health care system, loss of man hours from work and increasing diabetic mortality. Current information on the prevalence of chronic complications and its related clinical characteristics in Niger Delta area is scarce. The aim of this stu...

  19. Subjective health complaints in patients with chronic Whiplash Associated Disorders (WAD). Relationships with physical, psychological, and collision associated factors

    OpenAIRE

    Camilla Ihlebæk; Arit Ødegaard; John Vikne; Hege R. Eriksen; Even Lærum

    2009-01-01

     Aims: Investigate subjective health complaints (SHC) in chronic whiplash associated disorder (WAD, grade I & II) patients, and to identify physical, psychological, and collision associated factors that might be associated with high levels of comorbidity. Method: During the years 2000-2002 171 chronic WAD patients filled in questionnaires and underwent physical examination. The prevalence of SHC was recorded and compared with a representative sample of the Norwegian population (n=1014). Resul...

  20. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    A. Mashayekhi

    2011-09-01

    Full Text Available Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Havingknowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic renal failure through the crisis, with an aesthetically satisfying and functioning dentition.

  1. OCCUPATIONAL HEALTH: A REVIEW TROUGHT THE NEW WORKING CONDITIONS

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    INGRID CAROLINA GÓMEZ

    2007-01-01

    Full Text Available New work realities are considered –globalization and interdependency of enterprises; employment flexibilization andjob intensification; technological innovation; outsourcing process; actual changes between workers at a demographiclevel; incorporation of women into the remunerate work world; enterprise disappearance and fusion-, and so. Therelation between health and work are discussed into these new work facts. Even though classic labour risks still persist,the concepts of psychosocial risk factors and occupational stress due to the new work organization forms becomestronger. Health problems related to work can be prevented, considering that its determinants belong to workconditions. In this way, organizational psychologist becomes important in the health promotion programs within thework organizational environment.

  2. Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases

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    Corica Francesco

    2005-08-01

    Full Text Available Abstract Background Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study. Methods We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399, and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326. Functional capabilities were ascertained using the activities of daily living (ADL scale, and categorical variables for dependency in at least 1 ADL or dependency in 3 or more ADLs were considered in the analysis. Cognitive status was evaluated by the 10-items Hodgkinson Abbreviated Mental Test (AMT. Results Cognitive impairment was more prevalent in patients with CHF (28.0% or COPD (25.8% than in those with cancer (solid tumors = 22.9%; leukemia/lymphoma = 19.6%; metastatic cancer = 22.8%. Dependency in at least 1 ADL was highly prevalent in patients with metastatic cancer (31.3% vs. 24% for patients with CHF and 22.4% for those with non-metastatic solid tumors, p Conclusion Cancer should not be considered as an ineluctable cause of severe cognitive and physical impairment, at least not more than other chronic conditions highly prevalent in older people, such as CHF and diabetes mellitus.

  3. Working conditions and mental health: Results from the CARESUN study.

    Science.gov (United States)

    Feola, Daniela; Pedata, Paola; D'Ancicco, Francesco; Santalucia, Laura; Sannolo, Nicola; Ascione, Eduardo; Nienhaus, Albert; Magliano, Lorenza; Lamberti, Monica

    2016-05-01

    The authors conducted a work-related stress surveillance study in 2013 on 6,558 public-sector employees in Italy, examining how they perceived their jobs, via the Job Content Questionnaire, and their mental health status, via the General Health Questionnaire 12 (GHQ-12). Of the 2,094 employees completing the questionnaires, 60% were male, 52% had a medium-level education, and 76% had a medium-level job. Three hundred and eighty-five employees (18%) had a GHQ-12 score >3 and were classified as GHQ-12 cases: these were more often female (54%), medium-to-highly educated (54%), and had more often reported health problems over the previous year (51%). Thus, GHQ-12 cases represented a significant percentage of the examined population, indicating that work-related stress surveillance programs are needed for the planning of psychosocial interventions aimed at the reintegration of individuals with mental health problems. PMID:26167870

  4. What Health Issues or Conditions Affect Women Differently Than Men?

    Science.gov (United States)

    ... go untreated in women because symptoms are less obvious than in men or are more likely to ... National Institute of Mental Health. (2012). Women and Depression : Discovering Hope. Retrieved August 22, 2012, from http:// ...

  5. Work conditions and occupational health of dentists in Brazilian Public Health System

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    Suzely Adas Saliba Moimaz

    2014-03-01

    Full Text Available Introduction: work healthy conditions are essential for a great professional performance. Objective: To verify the perception of dentists regarding structural and healthy conditions of dental offices in the Brazilian Public Health System (SUS and their satisfaction with work and public job. Material and Method: In this cross-sectional study, type inquiry, 24 Brazilian dentists were interviewed. The follow variables were asked: cleaning and asepsis; maintenance and time of use of dental equipment; satisfaction with work and public job. Results: The professionals were "satisfied" or "very satisfied" with cleaning and asepsis (66.67%; Dental equipment (54.17%, reflectors (54.17% and the dental chairs (54.17% had more than 24 years of use; 20% of all professionals said that the equipment had maintenance but only to fix them. Of total, 58.33% had already given no attendance for patients and broken equipment was the most frequent cause (92.86%. It was observed satisfaction with work (79.1% and public job (95.83%. It was concluded that dentists who worked in SUS were satisfied with public job, although they had said the need for improvement on structural and healthy work conditions.

  6. INCREASED 30-DAY EMERGENCY DEPARTMENT REVISITS AMONG HOMELESS PATIENTS WITH MENTAL HEALTH CONDITIONS

    OpenAIRE

    Lam, Chun Nok; Arora, Sanjay; Menchine, Michael

    2016-01-01

    Background: Patients with mental health conditions frequently use emergency medical services.  Many suffer from substance use and homelessness. If they utilize the ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already over-crowded health care system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This...

  7. Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era.

    Science.gov (United States)

    Warlick, Erica; Ahn, Kwang Woo; Pedersen, Tanya L; Artz, Andrew; de Lima, Marcos; Pulsipher, Michael; Akpek, Gorgun; Aljurf, Mahmoud; Cahn, Jean-Yves; Cairo, Mitchell; Chen, Yi-Bin; Cooper, Brenda; Deol, Abhinav; Giralt, Sergio; Gupta, Vikas; Khoury, H Jean; Kohrt, Holbrook; Lazarus, Hillard M; Lewis, Ian; Olsson, Richard; Pidala, Joseph; Savani, Bipin N; Seftel, Matthew; Socié, Gerard; Tallman, Martin; Ustun, Celaettin; Vij, Ravi; Vindeløv, Lars; Weisdorf, Daniel

    2012-04-26

    Tyrosine kinase inhibitors (TKIs) and reduced intensity conditioning (RIC)/nonmyeloablative (NMA) conditioning hematopoietic cell transplants (HCTs) have changed the therapeutic strategy for chronic myelogenous leukemia (CML) patients. We analyzed post-HCT outcomes of 306 CML patients reported to the Center for International Blood and Marrow Transplant Research aged 40 years and older undergoing RIC/NMA HCT from 2001 to 2007: 117 (38%) aged 40 to 49 years, 119 (39%) 50 to 59 years, and 70 (23%) 60 years or older. The majority (74%) had treatment with imatinib before HCT. At HCT, most patients aged 40 to 49 years were in chronic phase (CP) 1 (74%), compared with 31% aged 60 years or older. Siblings were donors for 56% aged 40 to 49 years; older cohorts had more unrelated donors. The majority received peripheral blood grafts and RIC across all age groups. 3 year overall survival (54%, 52%, and 41%), day + 100 grade II-IV acute GVHD (26%, 32%, and 32%), chronic GVHD (58%, 51%, and 43%), and 1-year treatment-related mortality (18%, 20%, and 13%) were similar across ages. The 3-year relapse incidence (36%, 43%, and 66%) and disease-free survival (35%, 32%, and 16%) were inferior in the oldest cohort. Importantly, for CP1 patients, relapse and disease-free survival were similar across age cohorts. Allogeneic RIC HCT for older patients with CML can control relapse with acceptable toxicity and survival in TKI-exposed CML, especially if still in CP1. PMID:22408257

  8. Increasing physical activity of high intensity to reduce the prevalence of chronic diseases and improve public health.

    Science.gov (United States)

    Rehn, Tommy Aune; Winett, Richard A; Wisløff, Ulrik; Rognmo, Oivind

    2013-01-01

    High incidence and prevalence of chronic diseases, increasing obesity and inactivity as well as rising health expenditure represent a set of developments that cannot be considered sustainable, and will have dire long-term consequences given the increasing proportion of elderly people in our society. Based on a review of the experiences from previous large scale population-based prevention programs and the documented effects of increased physical activity and cardiorespiratory fitness on chronic diseases and its risk factors, we argue that increased physical activity, especially vigorous physical activity, is a major way to reduce the prevalence of chronic diseases and improve public health. We conclude that a coordinated population-based intervention program for improved health through increased physical activity in the entire population, with a special focus on high intensity exercise, urgently needs to be implemented nationally and internationally. PMID:23459225

  9. The importance of organizational characteristics for psychosocial working conditions and health

    OpenAIRE

    Bolin, Malin

    2009-01-01

    The importance of organizations for understanding differences in the working conditions and health of employees is often emphasized but rarely explored empirically. The general aim of this thesis is to describe organizational characteristics of workplaces, and to assess their impact on the psychosocial working conditions and health of employees. In modern working life, it is assumed that employees' working conditions and health are affected by a general transformation of workplaces from burea...

  10. The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. Results from the Nord-Trøndelag Health Study

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    Zwart John-Anker

    2008-12-01

    Full Text Available Abstract Background The relationship between diabetes mellitus (DM and chronic musculoskeletal complaints (MSCs is unclear. The aim of this study was to investigate the association between DM, non-fasting glucose and chronic MSCs defined as pain and/or stiffness ≥ 3 months during the past year in the general adult population. Methods The results were based on cross-sectional data from 64,785 men and women (aged ≥ 20 years who participated in the Nord-Trøndelag Health Survey, which included 1,940 individuals with known DM. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR with 95% confidence intervals (CIs. Results High non-fasting glucose was associated with a lower prevalence of chronic MSCs compared to a low glucose level. DM was associated with higher prevalence of chronic MSCs, in particular chronic widespread MSCs. In the multivariate analysis, adjusting for glucose level, BMI, age, gender and physical activity, chronic widespread MSCs was 1.6 times more likely (OR = 1.6, 95% CI 1.2–2.2 among individuals Conclusion In this cross-sectional study a high non-fasting glucose was associated with lower prevalence of chronic MSCs. Among individuals with known DM chronic widespread MSCs were more likely.

  11. Spontaneous Chronic Pain After Experimental Thoracotomy Revealed by Conditioned Place Preference: Morphine Differentiates Tactile Evoked Pain From Spontaneous Pain.

    Science.gov (United States)

    Hung, Ching-Hsia; Wang, Jeffrey Chi-Fei; Strichartz, Gary R

    2015-09-01

    Chronic pain after surgery limits social activity, interferes with work, and causes emotional suffering. A major component of such pain is reported as resting or spontaneous pain with no apparent external stimulus. Although experimental animal models can simulate the stimulus-evoked chronic pain that occurs after surgery, there have been no studies of spontaneous chronic pain in such models. Here the conditioned place preference (CPP) paradigm was used to reveal resting pain after experimental thoracotomy. Male Sprague Dawley rats received a thoracotomy with 1-hour rib retraction, resulting in evoked tactile hypersensitivity, previously shown to last for at least 9 weeks. Intraperitoneal injections of morphine (2.5 mg/kg) or gabapentin (40 mg/kg) gave equivalent 2- to 3-hour-long relief of tactile hypersensitivity when tested 12 to 14 days postoperatively. In separate experiments, single trial CPP was conducted 1 week before thoracotomy and then 12 days (gabapentin) or 14 days (morphine) after surgery, followed the next day by 1 conditioning session with morphine or gabapentin, both versus saline. The gabapentin-conditioned but not the morphine-conditioned rats showed a significant preference for the analgesia-paired chamber, despite the equivalent effect of the 2 agents in relieving tactile allodynia. These results show that experimental thoracotomy in rats causes spontaneous pain and that some analgesics, such as morphine, that reduce evoked pain do not also relieve resting pain, suggesting that pathophysiological mechanisms differ between these 2 aspects of long-term postoperative pain. Perspective: Spontaneous pain, a hallmark of chronic postoperative pain, is demonstrated here in a rat model of experimental postthoracotomy pain, further validating the use of this model for the development of analgesics to treat such symptoms. Although stimulus-evoked pain was sensitive to systemic morphine, spontaneous pain was not, suggesting different mechanistic

  12. The association of income with health behavior change and disease monitoring among patients with chronic disease.

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    David J T Campbell

    Full Text Available BACKGROUND: Management of chronic diseases requires patients to adhere to recommended health behavior change and complete tests for monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are unclear. We sought to determine the association between household income and receipt of health behavior change advice, adherence to advice, receipt of recommended monitoring tests, and self-reported reasons for non-adherence/non-receipt. METHODS: We conducted a population-weighted survey, with 1849 respondents with cardiovascular-related chronic diseases (heart disease, hypertension, diabetes, stroke from Western Canada (n = 1849. We used log-binomial regression to examine the association between household income and the outcome variables of interest: receipt of advice for and adherence to health behavior change (sodium reduction, dietary improvement, increased physical activity, smoking cessation, weight loss, reasons for non-adherence, receipt of recommended monitoring tests (cholesterol, blood glucose, blood pressure, and reasons for non-receipt of tests. RESULTS: Behavior change advice was received equally by both low and high income respondents. Low income respondents were more likely than those with high income to not adhere to recommendations regarding smoking cessation (adjusted prevalence rate ratio (PRR: 1.55, 95%CI: 1.09-2.20, and more likely to not receive measurements of blood cholesterol (PRR: 1.72, 95%CI 1.24-2.40 or glucose (PRR: 1.80, 95%CI: 1.26-2.58. Those with low income were less likely to state that non-adherence/non-receipt was due to personal choice, and more likely to state that it was due to an extrinsic factor, such as cost or lack of accessibility. CONCLUSIONS: There are important income-related differences in the patterns of health behavior change and disease monitoring, as well as reasons for non-adherence or non

  13. Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

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    Aspin Clive

    2012-06-01

    Full Text Available Abstract Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16 and family carers (n = 3. Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait

  14. The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS.

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    Michael Falk Hvidberg

    Full Text Available Myalgic encephalomyelitis (ME/chronic fatigue syndrome (CFS is a common, severe condition affecting 0.2 to 0.4 per cent of the population. Even so, no recent international EQ-5D based health-related quality of life (HRQoL estimates exist for ME/CFS patients. The main purpose of this study was to estimate HRQoL scores using the EQ-5D-3L with Danish time trade-off tariffs. Secondary, the aims were to explore whether the results are not influenced by other conditions using regression, to compare the estimates to 20 other conditions and finally to present ME/CFS patient characteristics for use in clinical practice.All members of the Danish ME/CFS Patient Association in 2013 (n=319 were asked to fill out a questionnaire including the EQ-5D-3L. From these, 105 ME/CFS patients were identified and gave valid responses. Unadjusted EQ-5D-3L means were calculated and compared to the population mean as well as to the mean of 20 other conditions. Furthermore, adjusted estimates were calculated using ordinary least squares (OLS regression, adjusting for gender, age, education, and co-morbidity of 18 self-reported conditions. Data from the North Denmark Health Profile 2010 was used as population reference in the regression analysis (n=23,392.The unadjusted EQ-5D-3L mean of ME/CFS was 0.47 [0.41-0.53] compared to a population mean of 0.85 [0.84-0.86]. The OLS regression estimated a disutility of -0.29 [-0.21;-0.34] for ME/CFS patients in this study. The characteristics of ME/CFS patients are different from the population with respect to gender, relationship, employment etc.The EQ-5D-3L-based HRQoL of ME/CFS is significantly lower than the population mean and the lowest of all the compared conditions. The adjusted analysis confirms that poor HRQoL of ME/CFS is distinctly different from and not a proxy of the other included conditions. However, further studies are needed to exclude the possible selection bias of the current study.

  15. Comparison of acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV to predict intensive care unit mortality

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    Bashu Dev Parajuli

    2015-01-01

    Full Text Available Context: Clinical assessment of severity of illness is an essential component of medical practice to predict the outcome of critically ill-patient. Acute Physiology and Chronic Health Evaluation (APACHE model is one of the widely used scoring systems. Aims: This study was designed to evaluate the Performance of APACHE II and IV scoring systems in our Intensive Care Unit (ICU. Settings and Design: A prospective study in 6 bedded ICU, including 76 patients all above 15 years. Subjects and Methods: APACHE II and APACHE IV scores were calculated based on the worst values in the first 24 h of admission. All enrolled patients were followed, and outcome was recorded as survivors or nonsurvivors. Statistical Analysis Used: SPSS version 17. Results: The mean APACHE score was significantly higher among nonsurvivors than survivors (P < 0.005. Discrimination for APACHE II and APACHE IV was fair with area under receiver operating characteristic curve of 0.73 and 0.79 respectively. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV was 85. Above cut-off point, mortality was higher for both models (P < 0.005. Hosmer-Lemeshow Chi-square coefficient test showed better calibration for APACHE II than APACHE IV. A positive correlation was seen between the models with Spearman′s correlation coefficient of 0.748 (P < 0.01. Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in our study. There was good correlation between the two models observed in our study.

  16. Essential Public Health Services' Accessibility and its Determinants among Adults with Chronic Diseases in China.

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    Miaomiao Tian

    Full Text Available Along with three years implementation of health reform in China, this study aimed at providing the up-to-date evidence about the accessibility of essential public health services (EPHS among adults with chronic diseases (CDs in both urban and rural areas, as well as determinants in access to EPHS.The data were collected from a cross-sectional survey conducted in 2013, which used a multistage stratified random sampling method to select 54 urban communities and 54 rural villages. Hypertension patients and diabetes patients were the target population who are the main beneficiaries of EPHS. Single factor analysis of influencing factors on difference access to EPHS was performed by Chi-Square analysis. Logistic regression analysis was used to determine the predictors of effective management and effective control.Patients with hypertension or diabetes were predominantly middle-aged or older persons and had a mean age of 65.26 year. People with CDs in China have a higher basic accessibility rate in EPHS with more than 90% of them having experience in receiving EPHS. And those who are willing to receive services from doctors have the most positive influence on effective management and control in blood pressure or blood glucose. But unsatisfied quality and equity of EPHS still exist in primary health system. 90% of participants could receive EPHS, but just 44% of them could control their diseases effectively. And participants from cities had the higher rates in effective management (urban: rural = 57%: 50.6% and effective control (urban: rural = 39.5%: 27.8%.People with CDs have a high level in geography and economic accessibility to EPHS, but the effectiveness of health management also needs to be improved, especially for those living in rural areas. Our study highlights the continuing need for improving ability to provide EPHS and the equality among regions. Meanwhile, strengthen health education and promotion for patients with CDs to improve their

  17. Risk factors for problem behavior in adolescents of parents with a chronic medical condition

    NARCIS (Netherlands)

    D.S. Sieh; J.M.A. Visser-Meily; F.J. Oort; A.M. Meijer

    2012-01-01

    A wide array of risk factors for problem behavior in adolescents with chronically ill parents emerges from the literature. This study aims to identify those factors with the highest impact on internalizing problem behavior (anxious, depressed and withdrawn behavior, and somatic complaints) and exter

  18. The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions

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    E. Sgnaolin

    2012-07-01

    Full Text Available Objective: Fibromyalgia syndrome (FMs is a chronic widespread pain condition that can negatively impact on all aspects of patient’s life. The purpose of this study was: first, to evaluate illness perception (IP, quality of life (QoL and affective-emotive variables (EAV of patients with FM; and second, to compare these variables to different pain conditions. Methods: Consecutive 34 women (mean age 47.4±8.3 years affected by FM were enrolled for the study from December 2009 to May 2011. IP was evaluated by means of the Revised Illness Perception Questionnaire, QoL through Nottigham Health Profile and EAV through the Beck Depression Inventory. Scores were compared with rheumatoid arthritis (RA (n=20; mean age 53±12.8 years and low back pain (LBP (n=20; 51.3±7.8 years groups. Results: FM patients scored higher than RA and LBP groups on IP (Identity scale mean: FM=8.8±2.3, AR=5.5±3.3, LBP=4.1±2.9; Kruskal-Wallis=24.42. Moreover FM patients show higher EAV (mean FM=21±9.6, AR=8.9±5.6, LBP=14.9±6.5; Kolmogorov-Smirnov Z=2.17 and QoL (Pain scale mean: FM=74.2±24.1; AR=35.7±19.9; LBP=56.5±20.4; Kolmogorov-Smirnov Z=2.27; Energy scale mean: FM=86.2±28.5; AR=46.8±35.4; LBP=61.6 ±63.7; Kolmogorov-Smirnov Z=1.98 than RA group. Conclusions: Our study highlighted dysfunctional IP, low QoL, high EAV scores in FM patients and the significant relations between these variables. Research results provided support for relevance of a multidisciplinary approach to the management of FM, including psychological interventions, according to a biopsychosocial perspective.Objective: Fibromyalgia syndrome (FMs is a chronic widespread pain condition that can negatively impact on all aspects of patient’s life. The purposes of this study were: i to evaluate illness perception (IP, quality of life (QoL and affective-emotive variables (EAV of patients with FM; and ii to compare these variables to different pain conditions. Methods: Consecutive 34 women (mean age

  19. Young People with Health Conditions and the Inclusive Education Problematic

    Science.gov (United States)

    Yates, Lyn

    2014-01-01

    This article revisits debates about inclusive education from the perspective of the "Keeping Connected" project, a qualitative longitudinal research project focusing on young people with health-related disrupted experiences of schooling. Drawing on findings from this project, three main arguments are advanced and illustrated in relation…

  20. Public Health Risk Conditioned by Chemical Composition of Ground Water

    Science.gov (United States)

    Yankovich, E.; Osipova, N.; Yankovich, K.; Matveenko, I.

    2016-03-01

    The article studies the public health potential risk originated from water consumption and estimated on the basis of the groundwater chemical composition. We have processed the results of chemical groundwater analysis in different aquifers of Tomsk district (Tomsk Oblast, Russia). More than 8400 samples of chemical groundwater analyses were taken during long-term observation period. Human health risk assessment of exposure to contaminants in drinking water was performed in accordance with the risk assessment guidance for public health concerning chemical pollution of the environment (Russian reference number: 2.1.10.1920-04-M, 2004). Identified potential risks were estimated for consuming water of each aquifer. The comparative analysis of water quality of different aquifers was performed on the basis of the risk coefficient of the total non-carcinogenic effects. The non-carcinogenic risk for the health of the Tomsk district population due to groundwater consumption without prior sanitary treatment was admitted acceptable. A rather similar picture is observed for all aquifers, although deeper aquifers show lower hazard coefficients.

  1. Extent of Drug Coverage across Generic Drug Discount Programs offered by Community Pharmacies: A look at five Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Harshali K. Patel, MS

    2012-01-01

    Full Text Available Background: Chronic conditions are expensive to treat because of the ongoing prescription cost burden. Generic drug discount programs (GDDPs that offer generics at discounted price may prove beneficial to reduce pharmacy costs for the same.Objective: The objective of this study was to assess the extent to which GDDPs provide drug coverage for five common chronic conditions.Methods: A content analyses of preexisting information was conducted. Extent of coverage based on top 200 generic drugs prescribed during 2008 for the treatment of chronic conditions such as hypertension, mental disorders, arthritis, pulmonary/respiratory conditions, and diabetes were identified. Commonly prescribed medications for these diseases were identified using published peer reviewed clinical guidelines. List of drugs covered under a GDDP for stores, Wal-Mart, Walgreens, CVS, Kroger, HEB, Target, and Randalls were obtained and compared to assess drug coverage by retail dollar sales and sales volume. Descriptive statistics and frequency/percentage of coverage were reported using SAS 9.2.Results: GDDPs covered the highest number of drugs for hypertension (21-27 across different GDDPs and the least (3-5 across different GDDPs for pulmonary/respiratory conditions. Arthritis (5-11, mental disorders (6-11 and diabetes (5-7 had similar coverage. When compared to the top 200 drugs by retail dollars spent during 2008, hypertension (68%-87% and diabetes (63%-88% had the highest coverage followed by respiratory conditions (30%-50%, arthritis (22%-48%, and mental disorders (21%-38%. Similar result was obtained when GDDP coverage was compared with the top 200 generic drugs by sales volume, where diabetes (63-88% and hypertension (57%-74% had the highest coverage and mental disorders remained the lowest (23%-37%.Conclusion/Implications: Drug coverage in GDDPs varied by pharmacies across the five common chronic conditions evaluated which may limit accessibility of these programs for

  2. Health status of grandchildren of subjects occupationally exposed to chronic radiation. Communication 3. Disease incidence

    International Nuclear Information System (INIS)

    The morbidity of 1557 grandchildren of subjects occupationally exposed to chronic radiation were analyzed. Three groups were singled out. Group 1 consisted of children whose grandfathers were exposed, group 2 of children grandmothers were exposed and group 3 of children whose both grandparent were exposed. Total morbidity level and morbidity structure for 13 classes of diseases and 60 nosological entities was assessed. The study showed that disease incidence in general, structure by disease and individual nosological entities, the share of frequently falling ill children, and health index in the test group corresponded to those in controls. Reliable differences were observed only for respiratory diseases, at the expense of acute respiratory diseases, which were frequent during the second-third years of life in children whose both grandparents were occupationally exposed to radiation

  3. The health status of grandchildren of subjects occupationally exposed to chronic radiation. Communication 2. Morphofunctional parameters

    International Nuclear Information System (INIS)

    The study was aimed at investigation of the parameters of physical development and specific features in the development of psychomotor habits and peripheral blood parameters in children aged 0 to 7 grandchildren of exposed individuals. A dynamic follow-up of physical and psychomotor development, as well as regular check-ups of peripheral blood were carried out in 877 grandchildren of test subjects occupationally exposed to chronic radiation before conception. Multifactorial analysis did not show a correlation between the deviations in the physical development of children in the studied cohort and exposure of their grandparents and/or parents. Factors other than radiation (poor health status of mother, gestosis) did influence the studied parameters. The mean levels of hemoglobin, red cells, platelets, and leukocytes in the test group were virtually the same as in controls and coincided with published data

  4. [Health-related quality of life (SF-36) in chronic low back pain and comorbid depression].

    Science.gov (United States)

    Ahrens, C; Schiltenwolf, M; Wang, H

    2010-06-01

    The purpose is to clarify if comorbidity of depression reduces health-related quality of life (SF-36) in patients with chronic low back pain (CR) and if those comorbid patients (CR+DE) benefit from multimodal pain treatment. Two groups (CR and CR+DE) each with 29 patients are compared over 6 months on study days 0, 21 (inpatient) and 180 (outpatient). Differences exist only at days 0 and 21, not at day 180, with group CR exhibiting higher SF-36 values in each case. Group CR+DE improves in the inpatient phase and especially in the outpatient phase and therefore over the entire study period more than group CR which increases solely in the inpatient phase. The comorbid group is more severely affected by their illness, but improves very constantly. The outpatient improvement suggests a good long-term prognosis. PMID:20458502

  5. Racial/Ethnic Disparities in Chronic Diseases of Youths and Access to Health Care in the United States

    Directory of Open Access Journals (Sweden)

    James H. Price

    2013-01-01

    Full Text Available Racial/ethnic minorities are 1.5 to 2.0 times more likely than whites to have most of the major chronic diseases. Chronic diseases are also more common in the poor than the nonpoor and this association is frequently mediated by race/ethnicity. Specifically, children are disproportionately affected by racial/ethnic health disparities. Between 1960 and 2005 the percentage of children with a chronic disease in the United States almost quadrupled with racial/ethnic minority youth having higher likelihood for these diseases. The most common major chronic diseases of youth in the United States are asthma, diabetes mellitus, obesity, hypertension, dental disease, attention-deficit/hyperactivity disorder, mental illness, cancers, sickle-cell anemia, cystic fibrosis, and a variety of genetic and other birth defects. This review will focus on the psychosocial rather than biological factors that play important roles in the etiology and subsequent solutions to these health disparities because they should be avoidable and they are inherently unjust. Finally, this review examines access to health services by focusing on health insurance and dental insurance coverage and access to school health services.

  6. Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population

    Directory of Open Access Journals (Sweden)

    Pasquale MK

    2012-11-01

    Full Text Available Margaret K Pasquale,1 Shawn X Sun,2 Frank Song,1 Heather J Hartnett,1 Stephen A Stemkowski11Competitive Health Analytics, Louisville, KY, USA; 2Health Economics and Outcomes Research, Forest Research Institute, Jersey City, NJ, USABackground: Exacerbations of chronic obstructive pulmonary disease (COPD lead to significant increases in resource utilization and cost to the health care system. COPD patients with chronic bronchitis and a history of exacerbations pose an additional burden to the system. This study examined health care utilization and cost among these patients.Methods: For this retrospective analysis, data were extracted from a large national health plan with a predominantly Medicare population. This study involved patients who were aged 40–89 years, had been enrolled continuously for 24 months or more, had at least two separate insurance claims for COPD with chronic bronchitis (International Classification of Diseases, Ninth Revision, Clinical Modification code 491.xx, and had pharmacy claims for COPD maintenance medications between January 1, 2007, and March 31, 2009. Two years of data were examined for each patient; the index date was defined as the first occurrence of COPD. Baseline characteristics were obtained from the first year of data, with health outcomes tracked in the second year. Severe exacerbation was defined by COPD-related hospitalization or death; moderate exacerbation was defined by oral or parenteral corticosteroid use. Adjusted numbers of exacerbations and COPD-related costs per patient were estimated controlling for demographic and clinical characteristics.Results: The final study sample involved 8554 patients; mean age was 70.1 ± 8.6 years and 49.8% of the overall population had exacerbation, 13.9% had a severe exacerbation only, 29.1% had a moderate exacerbation only, and 6.8% had both a severe and moderate exacerbation. COPD-related mean annual costs were $4069 (all figures given in US dollars for the

  7. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs.

    Science.gov (United States)

    Rayner, Lauren; Hotopf, Matthew; Petkova, Hristina; Matcham, Faith; Simpson, Anna; McCracken, Lance M

    2016-07-01

    This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services. PMID:26963849

  8. Conditions of radiological protection in the health unities

    International Nuclear Information System (INIS)

    The objective of this study was explained which conditions is practiced for occupational and environmental radiological protection. Fifteen hospitables and ambulatories services, pertaining to the public system are studies, verifying that the professional group that are preoccupied with the radioprotection conditions are the assistants services and technician. The common knowledge about Basic Standards of Radiological Protection was also observed, of which is rather precarious. (C.G.C.)

  9. The Burnout Condition of Primary Health Care Personnel

    Directory of Open Access Journals (Sweden)

    Mehmet Kaya

    2007-10-01

    Full Text Available The concept of burnout was first introduced by Fredeunberger in 1974. Fredeunberger had stated that burnout occurred more commonly in occupations whose members directly work with people. The aim of the study is to examine the burnout status of primary health care staff. The universe of this descriptive study is 466 health staff who work in primary health care units in Kecioren. The participation of the study was 54%. A Questionnaire including Maslach Burnout Inventory (MBI and some characteristics of the participants were used for data collection. Mann-whitney U and Kruskal Wallis tests have been used for analizing the survey data. Seventyseven percent of the participants were female and the emotional exhaustion score of female was higher than male (p<0.01. The age of the participants effect the individual achievement scores (p<0.01. The profession or marital status of the participants didn’t affect the MBI scores. Some socio-demografic characteristics of the participants such as gender and age, affect the scores of MBI. Comprehensive studies which display the causes of problems, needed in this issue. [TAF Prev Med Bull. 2007; 6(5: 357-363

  10. The Burnout Condition of Primary Health Care Personnel

    Directory of Open Access Journals (Sweden)

    Mehmet Kaya

    2007-10-01

    Full Text Available The concept of burnout was first introduced by Fredeunberger in 1974. Fredeunberger had stated that burnout occurred more commonly in occupations whose members directly work with people. The aim of the study is to examine the burnout status of primary health care staff. The universe of this descriptive study is 466 health staff who work in primary health care units in Kecioren. The participation of the study was 54%. A Questionnaire including Maslach Burnout Inventory (MBI and some characteristics of the participants were used for data collection. Mann-whitney U and Kruskal Wallis tests have been used for analizing the survey data. Seventyseven percent of the participants were female and the emotional exhaustion score of female was higher than male (p<0.01. The age of the participants effect the individual achievement scores (p<0.01. The profession or marital status of the participants didn’t affect the MBI scores. Some socio-demografic characteristics of the participants such as gender and age, affect the scores of MBI. Comprehensive studies which display the causes of problems, needed in this issue. [TAF Prev Med Bull 2007; 6(5.000: 357-363

  11. Health-related quality of life in different stages of chronic kidney disease and at initiation of dialysis treatment

    Directory of Open Access Journals (Sweden)

    Pagels Agneta A

    2012-06-01

    Full Text Available Abstract Objectives To evaluate health-related quality of life (HRQoL in patients in different stages of chronic kidney disease (CKD up to initiation of dialysis treatment and to explore possible correlating and influencing factors. Methods Cross-sectional design with 535 patients in CKD stages 2–5 and 55 controls assessed for HRQoL through SF-36 together with biomarkers. Results All HRQoL dimensions deteriorated significantly with CKD stages with the lowest scores in CKD 5. The largest differences between the patient groups were seen in ‘physical functioning’, ‘role physical’, ‘general health’ and in physical summary scores (PCS. The smallest disparities were seen in mental health and pain. Patients in CKD stages 2–3 showed significantly decreased HRQoL compared to matched controls, with differences of large magnitude - effect size (ES ≥ .80 - in ‘general health’ and PCS. Patients in CDK 4 demonstrated deteriorated scores with a large magnitude in ‘physical function’, ‘general health’ and PCS compared to the patients in CKD 2–3. Patients in CKD 5 demonstrated deteriorated scores with a medium sized magnitude (ES 0.5 – 0.79 in ‘role emotional’ and mental summary scores compared to the patients in CKD 4. Glomerular filtration rate Conclusions Having CKD implies impaired HRQoL, also in earlier stages of the disease. At the time for dialysis initiation HRQoL is substantially deteriorated. Co-existing conditions, such as inflammation and cardiovascular disease seem to be powerful predictors of impaired HRQoL in patients with CKD. Within routine renal care, strategies to improve function and well-being considering the management of co-existing conditions like inflammation and CVD need to be developed.

  12. Health-related and overall quality of life of patients with chronic hip and knee complaints in general practice

    OpenAIRE

    Waal, de, M.; Terwee, C. B.; Windt - Mens, van der, D.A.W.M.; Bouter, L M; Dekker, J

    2005-01-01

    BACKGROUND: Information about quality of life of patients with chronic hip or knee complaints in general practice is scarce. This study describes the health-related and overall quality of life (HRQL) of these complaints. METHODS: Data were obtained from a cohort study in general practice. HRQL at three months follow-up was analysed. HRQL was measured as: symptoms, physical, psychological and social functioning, and general health perceptions, using the Western Ontario and McMaster Universitie...

  13. Chronic Adolescent Marijuana Use as a Risk Factor for Physical and Mental Health Problems in Young Adult Men

    OpenAIRE

    Bechtold, Jordan; Simpson, Theresa; White, Helene R.; Pardini, Dustin

    2015-01-01

    Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different development...

  14. Survey of state health agencies' staff who practice the epidemiology of noninfectious diseases and conditions.

    OpenAIRE

    Boss, L P; Foster, L R

    1994-01-01

    The primary causes of mortality in the United States are noninfectious diseases and conditions. Epidemiologic and intervention activities related to most of these diseases and conditions have increased in most State health agencies over the past decade. Because little was known of the practice of noninfectious disease epidemiology in State health agencies, a mail survey was undertaken in 1991. Persons working in State health agencies who responded to the survey had a graduate degree in epidem...

  15. Pinterest as a Resource for Health Information on Chronic Obstructive Pulmonary Disease (COPD): A Social Media Content Analysis

    Science.gov (United States)

    Paige, Samantha R.; Stellefson, Michael; Chaney, Beth H.; Alber, Julia M.

    2015-01-01

    Purpose: The purpose of this study was to explore how Pinterest group pinboards are used to communicate health information on chronic obstructive pulmonary disease (COPD). Method A nonprobability census sampling method retrieved 399 pins from the 10 most followed COPD group pinboards. Pins were coded according to COPD information categories,…

  16. HEALTH RISKS FROM CHRONIC EXPOSURE TO ARSENIC VIA DRINKING WATER: FINDINGS FROM THE CLINICAL INVESTIGATIONS DATA IN INNER MONGOLIA, CHINA

    Science.gov (United States)

    Prior studies have reported a large number of arsenicism cases in the Mongolia Autonomous Region of China due to drinking arsenic-contaminated water with concentrations up to 1.8 mg/L. However, the endemic health risks from chronic exposure to arsenic in this population have not...

  17. Intraspecific variation in physiological condition of reef-building corals associated with differential levels of chronic disturbance.

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    Chiara Pisapia

    Full Text Available Even in the absence of major disturbances (e.g., cyclones, bleaching, corals are subject to high levels of partial or whole-colony mortality, often caused by chronic and small-scale disturbances. Depending on levels of background mortality, these chronic disturbances may undermine individual fitness and have significant consequences on the ability of colonies to withstand subsequent acute disturbances or environmental change. This study quantified intraspecific variations in physiological condition (measured based on total lipid content and zooxanthellae density through time in adult colonies of two common and widespread coral species (Acropora spathulata and Pocillopora damicornis, subject to different levels of biological and physical disturbances along the most disturbed reef habitat, the crest. Marked intraspecific variation in the physiological condition of A. spathulata was clearly linked to differences in local disturbance regimes and habitat. Specifically, zooxanthellae density decreased (r2 = 26, df = 5,42, p<0.02, B =  -121255, p = 0.03 and total lipid content increased (r2 = 14, df = 5,42, p = 0.01, B = 0.9, p = 0.01 with increasing distance from exposed crests. Moreover, zooxanthellae density was strongly and negatively correlated with the individual level of partial mortality (r2 = 26, df = 5,42, p<0.02, B =  -7386077, p = 0.01. Conversely, P. damicornis exhibited very limited intraspecific variation in physiological condition, despite marked differences in levels of partial mortality. This is the first study to relate intraspecific variation in the condition of corals to localized differences in chronic disturbance regimes. The next step is to ascertain whether these differences have further ramifications for susceptibility to periodic acute disturbances, such as climate-induced coral bleaching.

  18. The Role of Personality and Social Support in Health-Related Quality of Life in Chronic Kidney Disease Patients.

    Directory of Open Access Journals (Sweden)

    Norhayati Ibrahim

    Full Text Available Chronic kidney disease (CKD is commonly associated with various negative health outcomes. The aim of this study was to examine the influence of personality and social support on health-related quality of life in patients with chronic kidney disease. Health-related quality of life (HRQoL is the quality of life studied in relation to health, and it provides important information of patients' coping with their health issues.Participants comprised of 200 patients experiencing various stages of chronic kidney disease. All participants completed the Short-Form 36 (SF-36, Big Five Inventory (BFI and the Medical Outcomes Study (MOS Social Support questionnaires.Participants consisted of 108 males (54.0% and 92 females (46.0% with the mean age of 59.3 years (SD 14.5. Results showed that higher levels of extraversion and lower perceived affectionate social support were associated with higher physical HRQoL, whereas higher levels of neuroticism were associated with poorer mental HRQoL.The current study found that certain personality traits, namely extraversion and neuroticism, were found to be associated with HRQoL. In addition, affectionate social support was also associated with higher HRQoL. Therefore, special attention should be paid to the personality of CKD patients, as well as the type of social support that they have, in planning interventions to improve their health outcomes.

  19. The Evaluation of Using Resistograph when Specifying the Health Condition of a Monumental Tree

    OpenAIRE

    Marcin KUBUS

    2009-01-01

    The health condition as well as the mechanical status of Large-leaved Lime were determined by the visual and invasive methods using IML 400 Resistograph. Ten measurements of the two co - dominant boughs were made in order to specify their internal condition. Despite only minor deadwood in its crown, �Dobros?awa�s� health condition is poor and related to its extensive internal cavities. All the measurements taken using resistograph enabled the full diagnosis of the tree�s health condition. On ...

  20. The Evaluation of Using Resistograph when Specifying the Health Condition of a Monumental Tree

    Directory of Open Access Journals (Sweden)

    Marcin KUBUS

    2009-06-01

    Full Text Available The health condition as well as the mechanical status of Large-leaved Lime were determined by the visual and invasive methods using IML 400 Resistograph. Ten measurements of the two co - dominant boughs were made in order to specify their internal condition. Despite only minor deadwood in its crown, �Dobros?awa�s� health condition is poor and related to its extensive internal cavities. All the measurements taken using resistograph enabled the full diagnosis of the tree�s health condition. On the basis of the findings, the decision concerning the way and the range of required care treatments was made.

  1. Nutrition education training of health workers and other field staff to support chronically deprived communities.

    Science.gov (United States)

    Calderon, T A

    2001-12-01

    This paper focuses on the provision of adequate training in nutrition education to health and other community development workers for their improved performance and achievement. The difficulties encountered and special care needed when dealing with low-income, chronically deprived communities are raised. A brief analysis of past and present trends in nutrition education is presented to show the progress made from restricted, authoritative and not very successful proposals to more comprehensive and participatory approaches. The need to train and update regional and field-level personnel on the new approaches, theories and models offered by nutrition education is highlighted, but the scant availability of resources for training activities may be a great limitation for this undertaking. The contribution of educational, social, psychological and communication sciences, as well as marketing, in improving and broadening the performance of health and nutrition education is recognised. Some successful nutrition education projects, implemented in different regions, using various approaches, have managed to improve the nutrition situation of low-income groups and could be used as good examples to be followed. Recommendations for implementing nutrition education projects or activities need to consider some prerequisites, such as good knowledge and analysis of the nutrition situation, careful selection of the strategies and methods, careful planning and implementation, and clear definition of the procedures and instruments for follow-up and evaluation. PMID:11918493

  2. Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care.

    Science.gov (United States)

    Morales-Espinoza, Enma Marianela; Kostov, Belchin; Salami, Daniel Cararach; Perez, Zoe Herreras; Rosalen, Anna Pereira; Molina, Jacinto Ortiz; Paz, Luis Gonzalez-de; Momblona, Josep Miquel Sotoca; Àreu, Jaume Benavent; Brito-Zerón, Pilar; Ramos-Casals, Manuel; Sisó-Almirall, Antoni

    2016-04-01

    The objective was to estimate the prevalence of chronic widespread pain (CWP) and compare the quality-of-life (QoL), cardiovascular risk factors, comorbidity, complexity, and health costs with the reference population. A multicenter case-control study was conducted at 3 primary care centers in Barcelona between January and December 2012: 3048 randomized patients were evaluated for CWP according to the American College of Rheumatology definition. Questionnaires on pain, QoL, disability, fatigue, anxiety, depression, and sleep quality were administered. Cardiovascular risk and the Charlson index were calculated. We compared the complexity of cases and controls using Clinical Risk Groups, severity and annual direct and indirect health care costs. CWP criteria were found in 168 patients (92.3% women, prevalence 5.51% [95% confidence interval: 4.75%-6.38%]). Patients with CWP had worse QoL (34.2 vs 44.1, P Costs were &OV0556;3751 per year in patients with CWP vs &OV0556;1397 in controls (P cost associated with CWP is nearly 3 times higher than that of patients without CWP, controlling for other clinical factors. These findings have implications for disease management and budgetary considerations. PMID:26645546

  3. Assessment of chronic sublethal effects of imidacloprid on honey bee colony health.

    Science.gov (United States)

    Dively, Galen P; Embrey, Michael S; Kamel, Alaa; Hawthorne, David J; Pettis, Jeffery S

    2015-01-01

    Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 μg/kg over multiple brood cycles. Various endpoints of colony performance and foraging behavior were measured during and after exposure, including winter survival. Imidacloprid residues became diluted or non-detectable within colonies due to the processing of beebread and honey and the rapid metabolism of the chemical. Imidacloprid exposure doses up to 100 μg/kg had no significant effects on foraging activity or other colony performance indicators during and shortly after exposure. Diseases and pest species did not affect colony health but infestations of Varroa mites were significantly higher in exposed colonies. Honey stores indicated that exposed colonies may have avoided the contaminated food. Imidacloprid dose effects was delayed later in the summer, when colonies exposed to 20 and 100 μg/kg experienced higher rates of queen failure and broodless periods, which led to weaker colonies going into the winter. Pooled over two years, winter survival of colonies averaged 85.7, 72.4, 61.2 and 59.2% in the control, 5, 20 and 100 μg/kg treatment groups, respectively. Analysis of colony survival data showed a significant dose effect, and all contrast tests comparing survival between control and treatment groups were significant, except for colonies exposed to 5 μg/kg. Given the weight of evidence, chronic exposure to imidacloprid at the higher range of field doses (20 to 100 μg/kg) in pollen of certain treated crops could cause negative impacts on honey bee colony health and reduced overwintering success, but the most likely encountered high range of field doses relevant for seed-treated crops (5 μg/kg) had negligible effects on colony health and are unlikely a sole cause of colony declines. PMID:25786127

  4. Assessment of chronic sublethal effects of imidacloprid on honey bee colony health.

    Directory of Open Access Journals (Sweden)

    Galen P Dively

    Full Text Available Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 μg/kg over multiple brood cycles. Various endpoints of colony performance and foraging behavior were measured during and after exposure, including winter survival. Imidacloprid residues became diluted or non-detectable within colonies due to the processing of beebread and honey and the rapid metabolism of the chemical. Imidacloprid exposure doses up to 100 μg/kg had no significant effects on foraging activity or other colony performance indicators during and shortly after exposure. Diseases and pest species did not affect colony health but infestations of Varroa mites were significantly higher in exposed colonies. Honey stores indicated that exposed colonies may have avoided the contaminated food. Imidacloprid dose effects was delayed later in the summer, when colonies exposed to 20 and 100 μg/kg experienced higher rates of queen failure and broodless periods, which led to weaker colonies going into the winter. Pooled over two years, winter survival of colonies averaged 85.7, 72.4, 61.2 and 59.2% in the control, 5, 20 and 100 μg/kg treatment groups, respectively. Analysis of colony survival data showed a significant dose effect, and all contrast tests comparing survival between control and treatment groups were significant, except for colonies exposed to 5 μg/kg. Given the weight of evidence, chronic exposure to imidacloprid at the higher range of field doses (20 to 100 μg/kg in pollen of certain treated crops could cause negative impacts on honey bee colony health and reduced overwintering success, but the most likely encountered high range of field doses relevant for seed-treated crops (5 μg/kg had negligible effects on colony health and are unlikely a sole cause of colony declines.

  5. Evaluating Vegetation Health Condition Using MODIS Data in the Three Gorges Area, China

    Institute of Scientific and Technical Information of China (English)

    韩贵锋; 谢雨丝; 蔡智

    2015-01-01

    The satellite-based vegetation condition index (VCI) and temperature condition index (TCI) have been used extensively for drought detection and tracking, the assessment of weather impacts on vegetation and evaluation of the health and productivity of vegetation. In this study, in order to detect and monitor the growth condition of vegetation, we have collected data on vegetation indices and land surface temperature derived from MODIS (2001-2012) and deifned a vegetation health index (VHI) based on VCI and TCI for assessing vegetation health condition in the Three Gorges Area, China (TGA). The results of the study show that temporal and spatial characteristics of vegetation health condition can be detected, tracked and mapped by the VHI index. In most parts of the TGA, the vegetation health condition showed an overall increasing trend during the study period, especially in Wulong, Fengdu, Shizhu and other regions located in the midstream sections of the Three Gorges Reservoir. In addition, the four studied vegetation types all showed clear increasing trends during the study period. The increasing trend in the vegetation health condition shows a strong positive correlation with topographical slope and altitude (below 500 m). Over the seasons, this trend is strongest in autumn, followed by spring. However, the correlations between vegetation health condition and climatic factors are more frequently significant in summer and winter than in autumn and spring. The vegetation health condition has been low in 2006 and 2011. This finding is consistent with the extreme weather conditions in those two years. However, only in the summer is vegetation health condition signiifcantly correlated with three climatic factors in most of the study area. This result implies that vegetation growth may show a lagged response to climatic factors and may also be affected by human activities, including agricultural activities, industrial activities and other economic activities.

  6. Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates

    OpenAIRE

    Betina Blak; Mary Thompson; Hassy Dattani; Alison Bourke

    2011-01-01

    Introduction The degree of generalisability of patient databases to the general population is important for interpreting database research. This report describes the representativeness of The Health Improvement Network (THIN), a UK primary care database, of the UK population. Methods Demographics, deprivation (Townsend), Quality and Outcomes Framework (QOF) condition prevalence and deaths from THIN were compared with national statistical and QOF 2006/ 2007 data. Results Demographics wer...

  7. ‘We experienced a lack of tools for strengthening coping and health in encounters with patients with chronic illness': bridging theory and practice through formative research

    Directory of Open Access Journals (Sweden)

    Kristen Heggdal

    2015-11-01

    Full Text Available Background: Healthcare personnel in specialist care in Norway took the initiative to develop their practice in order to improve follow-up of patients with chronic illness. A research project was constructed that involved a close collaboration between practice and research in the development of a new, complex intervention to strengthen patients' ability to live with long-term conditions. Aims and objectives: This paper seeks to describe a part of the research process that involved the first- stage development of the intervention. The first objective is to describe how clinicians, patients and a health researcher collaborated, and to discuss the benefits of this collaborative work for improving practice. The second objective is to outline the intervention's aspects and components. Method: Three clinical sites were chosen for developing the intervention: a rehabilitation unit, an outpatient clinic and a centre for patient education. An interdisciplinary team of nine healthcare personnel and four patients engaged with the researcher(s in the formative research. A list of criteria for reporting on the development of complex interventions was applied to elaborate on intervention components. Results: An intervention was developed that entailed a person-centred approach to facilitating overall health in chronic illness. This involved a change in practice as the professionals acquired a new approach to the use of patients' capacity for health, and as patients began to function as active partners in health promotion. Conclusions: A close collaboration between clinicians, former patients and researcher was necessary for developing a theory and a research-based intervention that improved the follow-up of individuals diagnosed with long-term conditions. The intervention was designed to be applicable across diagnostic categories and in a variety of clinical settings. These patients experience a multitude of challenges that require attention in health

  8. Contribution of intake antioxidants through coffees and teas on general health conditions in student population

    OpenAIRE

    Sterjova, Marija; Maksimova, Viktorija

    2012-01-01

    Several types of commercially available teas and coffees contain considerable amount of antioxidants. Antioxidants are compounds that contribute in lowering of free radicals in the body and participate in protection against chronic oxidative stress-related diseases. The aim of this study is to evaluate the contribution of the total antioxidant activity of different types of coffees and some herbal infusions regularly used in the region of Macedonia and their contribution for general health co...

  9. A conditional expectation approach for associating ambient air pollutant exposures with health outcomes

    OpenAIRE

    Wannemuehler, Kathleen A.; LYLES, Robert H.; Waller, Lance A.; Hoekstra, Robert M.; Klein, Mitchel; Tolbert, Paige

    2009-01-01

    Our research focuses on the association between exposure to an airborne pollutant and counts of emergency department visits attributed to a specific chronic illness. The motivating example for this analysis of measurement error in time series studies of air pollution and acute health outcomes was a study of emergency department visits from a 20-county Atlanta metropolitan statistical area from 1993–1999. The research presented illustrates the impact of using various surrogates for unobserved ...

  10. Garre's chronic diffuse sclerosing osteomyelitis of the sacrum: a rare condition mimicking malignancy.

    LENUS (Irish Health Repository)

    Nasir, N

    2012-02-03

    Garre\\'s chronic diffuse sclerosing osteomyelitis (DSOM) is a rare disease that occurs most commonly in the mandible. We present a case of sacral DSOM that simulated an expanding destructive sacral tumour. Treatment was conducted on the basis of the available experience with the mandibular form of the disease, with partial symptomatic relief, but progressive sclerosis of the sacral lesion. To the best of our knowledge, this is the first case initially presenting in the sacrum. As an osteolytic expanding lesion simulating malignancy, it is important to recognize this entity in the sacrum.

  11. Risk factors for problem behavior in adolescents of parents with a chronic medical condition

    OpenAIRE

    Sieh, Dominik Sebastian; Visser-Meily, Johanna Maria Augusta; Oort, Frans Jeroen; Meijer, Anne Marie

    2012-01-01

    A wide array of risk factors for problem behavior in adolescents with chronically ill parents emerges from the literature. This study aims to identify those factors with the highest impact on internalizing problem behavior (anxious, depressed and withdrawn behavior, and somatic complaints) and externalizing problem behavior (aggressive and rule-breaking behavior) as measured by the Youth Self-Report (YSR). The YSR was filled in by 160 adolescents (mean age = 15.1 years) from 100 families (102...

  12. Association between time of pay-for-performance for patients and community health services use by chronic patients.

    Directory of Open Access Journals (Sweden)

    Xi Sun

    Full Text Available BACKGROUND: Pay-for-performance for patients is a cost-effective means of improving health behaviours. This study examined the association between the pay time for performance for patients and CHS use by chronic patients. METHODS: A cross-sectional study was undertaken to estimate distribution characteristics of CHS use in 2011 and collect data of socio-demographic characteristics (sex, age, education level, occupation, disposable personal income in 2011, distance between home and community health agency, chronic disease number, and time of pay-for-performance for patients. Participants were 889 rural adults with hypertension or type II diabetes aged 35 and above. Standardized CHS use means chronic patients use CHS at least once per quarter. RESULTS: Patients who received incentives prior to services had 2.724 times greater odds of using standardized CHS than those who received incentives after services (95%CI, 1.986-3.736, P<0.001. For all subgroups (socio-demographic characteristics and chronic disease number, patients who received incentives prior to services were more likely to use standardized CHS than those receiving incentives after services. CONCLUSIONS: Pay time for performance for patients was associated with CHS use by chronic patients. Patients receiving incentive prior to services were more likely to use standardized CHS. And pay time should not be ignored when the policy on pay-for-performance for patients is designed.

  13. Effect of zeolite on health condition of canines

    Directory of Open Access Journals (Sweden)

    Vučićević Ivana

    2008-01-01

    Full Text Available The paper shows the results of investigations of elementary hematological and biochemical blood parameters of German Shepherd dogs administered zeolite through feed daily for a period of 50 days. No undesired effects were established during the period of observation, and in fact there was a full normalization of the condition of the dogs that previously exhibited transitory symptoms of gastrointestinal tract disorders. No significant digressions were observed in the examined biochemical parameters of blood, either, that could indicate any harmful effects of zeolite, with the exception of the tendency toward a reduction in the concentrations of phosphorus and calcium, which was not manifest clinically as well during this period.

  14. Evaluation of Processor Health within Hierarchical Condition Monitoring System

    Czech Academy of Sciences Publication Activity Database

    Pavelková, Lenka; Jirsa, Ladislav

    Vol. 1. Portugal: SCITEPRESS – Science and Technology Publications, 2015 - (Filipe, J.; Madani, K.; Gusikhin, O.; Sasiadek, J.), s. 667-671 ISBN 978-989-758-122-9. [12th International Conference on Informatics in Control, Automation and Robotics - ICINCO 2015. Colmar (FR), 21.07.2015-23.07.2015] R&D Projects: GA MŠk 7D12004 Institutional support: RVO:67985556 Keywords : Processor Utilisation * Condition Monitoring * Bayesian Estimation * Autoregressive Model * Binomial Opinion Subject RIV: BC - Control Systems Theory http://library.utia.cas.cz/separaty/2015/AS/pavelkova-0446090.pdf

  15. Health, work and working conditions: a review of the European economic literature.

    Science.gov (United States)

    Barnay, Thomas

    2016-07-01

    Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29 %) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific "flexicurity" (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health. PMID:26280132

  16. Associations between the clinical signs of chronic endometritis with ovarian cysts and body condition loss in German Holstein Friesian cows

    OpenAIRE

    Tsousis, Georgios; Sharifi, Reza; Hoedemaker, Martina

    2009-01-01

    The objective of this retrospective field study was to associate the type and smell of discharge, the size of the uterus, the ovarian and treatment status, and the time to diagnosis of animals with chronic clinical endometritis (CCE) with the incidence of ovarian cysts and with a marked loss in body condition in German Holstein Friesian cows. Two hundred and sixty-four cows diagnosed with CCE from day 14 to day 42 postpartum participated in this study. In addition, 100 days milk production an...

  17. The impact of chronic radioactive stress on the immuno-physiological condition of small mammals

    International Nuclear Information System (INIS)

    The mass of internal organs and cellularity index of thymus and spleen were measured in small mammals inhabiting territories with a low level of chronic irradiation caused by the Chernobyl accident. Comparing with uncontaminated territories from the same region, bank voles (Clethrionomys glareolus) demonstrated an increase in liver and thymus mass and cellularity index of thymus, while sub-adult shrews (Sorex araneus) at contaminated territories had larger body mass, heavier spleen, kidney, and liver. These changes reflect an increase of tension in physiological and immunological processes in the small mammal populations in response to chronic irradiation, which have a non-specific, stress-causing nature. Laboratory mice, exposed to a single dose of irradiation equal to the annual dose received by wild animals at contaminated territories (0.07 Gy), in contrast, showed decreased mass of kidney, spleen and thymus, and cellularity of thymus and spleen compared to the control group. This shows a direct and specific impact of a single dose of irradiation

  18. The health status of grandchildren of subjects occupationally exposed to chronic radiation. Communication 1. Methods for detection and assessment of deviation in the health status

    International Nuclear Information System (INIS)

    The task of this study was development of methodological approaches to integral assessment of the health status of the grandchildren of subjects who had been occupationally exposed to chronic radiation. A register has been charted for recording the health indices and characteristics of a complex of social, biological, and medical factors in three main groups of children (grandchildren of irradiated subjects) and in one control group. Creation of a data bank helped comprehensively assess the health status of the grandchildren of exposed subjects and evaluate the rule of the radiation factor among other factors causing diseases. The methods of mathematical processing used in this study have been validated and are described

  19. [The health conditions of adolescents as a conscription resource].

    Science.gov (United States)

    Tchicherin, L P; Schepin, V O; Sogiyainen, A A

    2013-01-01

    The article analyzes the dynamics of main health indicators of youth adolescents aged 15-18 years from the point of view of readiness to serve in the armed forces of the Russian Federation. The actual aspects of organization of medical examination of conscripts are considered. The ten years dynamics of indicators of morbidity of adolescents aged 15-17 years of Moscow oblast was studied in comparison with the data from the Central federal okrug and Russia in general. The activity of medical organizations and medical personnel is studied The main resources of enhancement and implementation in the territories of measures within the framework of the governmental Concept of federal program of training of citizen for military service up to 2020 are identified. The practice recommendations are developed concerning the optimization medical support of youth training for military service, intersectorial integration, enhancement of the role of pediatric service first of all the children polyclinics in the field of effective implementation of tasks of recruitment of army with healthy contingent. PMID:24027841

  20. Identification of clusters of individuals relevant to temporomandibular disorders and other chronic pain conditions: the OPPERA study.

    Science.gov (United States)

    Bair, Eric; Gaynor, Sheila; Slade, Gary D; Ohrbach, Richard; Fillingim, Roger B; Greenspan, Joel D; Dubner, Ronald; Smith, Shad B; Diatchenko, Luda; Maixner, William

    2016-06-01

    The classification of most chronic pain disorders gives emphasis to anatomical location of the pain to distinguish one disorder from the other (eg, back pain vs temporomandibular disorder [TMD]) or to define subtypes (eg, TMD myalgia vs arthralgia). However, anatomical criteria overlook etiology, potentially hampering treatment decisions. This study identified clusters of individuals using a comprehensive array of biopsychosocial measures. Data were collected from a case-control study of 1031 chronic TMD cases and 3247 TMD-free controls. Three subgroups were identified using supervised cluster analysis (referred to as the adaptive, pain-sensitive, and global symptoms clusters). Compared with the adaptive cluster, participants in the pain-sensitive cluster showed heightened sensitivity to experimental pain, and participants in the global symptoms cluster showed both greater pain sensitivity and greater psychological distress. Cluster membership was strongly associated with chronic TMD: 91.5% of TMD cases belonged to the pain-sensitive and global symptoms clusters, whereas 41.2% of controls belonged to the adaptive cluster. Temporomandibular disorder cases in the pain-sensitive and global symptoms clusters also showed greater pain intensity, jaw functional limitation, and more comorbid pain conditions. Similar results were obtained when the same methodology was applied to a smaller case-control study consisting of 199 chronic TMD cases and 201 TMD-free controls. During a median 3-year follow-up period of TMD-free individuals, participants in the global symptoms cluster had greater risk of developing first-onset TMD (hazard ratio = 2.8) compared with participants in the other 2 clusters. Cross-cohort predictive modeling was used to demonstrate the reliability of the clusters. PMID:26928952